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Little is known regarding intuitive eating (IE), diet quality and adherence. We investigated the associations between IE, diet quality and metabolic health after gestational diabetes (GDM), who have an increased diabetes risk. Data from 179 women with GDM from MySweetheart trial (NCT02872974) were analyzed. IE was assessed using 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. Metabolic outcomes included weight, central body fat and insulin resistance. Diet quality was calculated using the Alternative Health Eating Index (AHEI) and compliance with national recommendations was evaluated. Both IE subscales were associated with lower BMI and fat mass (BIA) at 1-year postpartum (all p ≤ 0.034). The EPR subscale inversely correlated with fat mass (DXA) and visceral adipose tissue (both p ≤ 0.028), whereas RHSC with higher insulin sensitivity (Matsuda, p = 0.034). RHSC during pregnancy predicted increased AHEI (p = 0.043) at 1-year postpartum, whilst EPR predicted lower fat mass and insulin resistance (HOMA-IR) (all p ≤ 0.04). In longitudinal analyses, both subscales were associated with increased adherence to dairy and fiber intake recommendations (both p ≤ 0.023). These data suggest IE may be an interesting approach to improve diet quality and metabolic outcomes in women with GDM.

Non-dieting approaches, including mindful/intuitive eating, to health improvement are of increasing interest, yet little is known about young adults’ social media exposure to them. Therefore, this study aimed to describe the imagery related to mindful/intuitive eating which is visible to young adult Instagram users. Images categorized under the hashtags ‘mindfuleating’ and ‘intuitiveeating’ were searched in September 2021 using the ‘top posts’ view. Screen captures of 1200 grid-view images per hashtag were used to construct coding frameworks and to determine saturation. Sample sizes for #mindfuleating and #intuitiveeating were 405 and 495 images, respectively. Individual images were coded collaboratively. Almost half of each sample depicted food or drink, of which 50–60% were healthy foods. Approximately 17% were single-person images, of which the majority were young, female adults with healthy weight. Approximately one-third of text suggested credibility through credentials, profession, or evidence. Messaging was similar for both hashtags, encompassing mindful/intuitive eating (~40%), nutrition/eating behaviours (~15%), physical/mental health (~20%), disordered eating (~12%), and body-/self-acceptance (~12%). Differences were observed between hashtags for weight-related concepts (20%/1%) and anti-diet/weight-neutral approaches (10%/35%). The representation on Instagram of mindful and intuitive eating portrays healthy lifestyles without a focus on weight but lacks demographical and body-type diversity. Instagram holds the potential for health professionals to disseminate culturally/demographically inclusive, evidence-based health/nutrition information to youth.

Internally regulated eating style, the eating style that is driven by internal bodily sensations of hunger and satiation, is a concept that has received increasing attention in the literature and health practice over the last decades. The various attempts that have been made so far to conceptualise internally regulated eating have taken place independently of one another, and each sheds light on only parts of the total picture of what defines internally regulated eating. This has resulted in a literature that is rather fragmented. More importantly, it is not yet clear which are the characteristics that comprise this eating style. In this paper, we identify and describe the full spectrum of these characteristics, namely, sensitivity to internal hunger and satiation signals, self-efficacy in using internal hunger and satiation signals, self-trusting attitude for the regulation of eating, relaxed relationship with food and tendency to savour the food while eating. With this research, we introduce a common language to the field and we present a new theoretical framework that does justice not just to the full breadth of characteristics that are necessary for the internally regulated eating style but also to the associations between them and the potential mechanisms by which they contribute to this eating style. [ABSTRACT FROM AUTHOR]

Objective: Intuitive eating is an adaptive style of eating that has generated significant research attention. Theoretically, intuitive eating is a core construct that features prominently in the Acceptance Model of Intuitive Eating, a framework that explains how positive environmental influences can foster intuitive eating practices via body appreciation. Empirically, intuitive eating has been connected to a broad range of adaptive mental health indices. At present, a quantitative synthesis of intuitive eating and its correlates has yet to be conducted. This was the objective of the current meta‐analysis. Method: Ninety‐seven studies (89% cross‐sectional) were included. Random effects meta‐analyses were conducted on 23 psychological correlates, divided into three clusters: eating behavior and body image disturbances, positive body image and other adaptive factors, and general psychopathology. Meta‐analytic path analyses were also computed to test the validity of the Acceptance Model. Results: Intuitive eating was inversely associated with multiple indices of eating pathology, body image disturbances, and psychopathology (rs = −.23 to −.58). Intuitive eating was positively associated with numerous positive psychological constructs, such as positive body image, self‐esteem, and wellbeing (rs =.20 to.58). Men reported higher levels of intuitive eating than women (d = 0.39), with differences being largest in Caucasian samples. Meta‐analytic path analyses strongly supported the hypothesized pathways specified in the Acceptance Model of Intuitive Eating. Conclusions: There is a strong evidence base for intuitive eating's connection to numerous adaptive psychological constructs. Attention should now shift toward prospective and experimental designs so that the temporal nature of these relationships can be identified. [ABSTRACT FROM AUTHOR]

We evaluated the associations between intuitive eating during and after pregnancy with metabolic health at 1-year postpartum in women with gestational diabetes mellitus and in high-risk gestational diabetes mellitus subgroups. One hundred seventeen women who consented and completed the French intuitive eating questionnaire during and after pregnancy were included. We found an association between intuitive eating during and after pregnancy with lower body mass index, weight retention, fasting glucose, and HbA1c at 1-year postpartum in women with gestational diabetes mellitus and in high-risk gestational diabetes mellitus subgroups with overweight/obese or with prediabetes in the postpartum period. Our results suggest that intuitive eating could be an effective intervention for weight and glucose control in women with gestational diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background and Purpose: Many college students have nutrient poor and energy dense diets and are also more likely to experience poor body image, which can result in unsafe dieting behaviors for the purpose of managing weight. Intuitive eating is an alternative approach to dieting that focuses on physiological hunger and fullness cues, while eating for both satisfaction and health without restriction of any foods. Methods: This study examined the association between intuitive eating and diet quality in a college population. College students, aged 18-56 years, completed an online survey which assessed intuitive eating using the Intuitive Eating Scale-2 (IES-2) and diet quality using the Starting The Conversation (STC) simplified food frequency instrument. Results: IES-2 total score was positively correlated with higher overall diet quality and was negatively correlated with fast food and chip consumption. Eating for physical rather than emotional reasons and body-food choice congruence IES-2 subscales were positively correlated with diet quality while the unconditional permission to eat subscale was negatively correlated with diet quality. Conclusion: Strategies that focus on eating for health and well-being and minimize emotional eating are associated with higher overall diet quality and may be incorporated in dietary interventions among college students aimed at promoting healthy behaviors. [ABSTRACT FROM AUTHOR]

Background: Association of physiological recovery with nutrition has scarcely been studied. We investigated whether physiological recovery during sleep relates to eating habits, i.e., eating behaviour and diet quality. Methods: Cross-sectional baseline analysis of psychologically distressed adults with overweight (N = 252) participating in a lifestyle intervention study in three Finnish cities. Recovery measures were based on sleep-time heart rate variability (HRV) measured for 3 consecutive nights. Measures derived from HRV were 1) RMSSD (Root Mean Square of the Successive Differences) indicating the parasympathetic activation of the autonomic nervous system and 2) Stress Balance (SB) indicating the temporal ratio of recovery to stress. Eating behaviour was measured with questionnaires (Intuitive Eating Scale, Three-Factor Eating Questionnaire, Health and Taste Attitude Scales, ecSatter Inventory™). Diet quality was quantified using questionnaires (Index of Diet Quality, Alcohol Use Disorders Identification Test Consumption) and 48-h dietary recall. Results: Participants with best RMSSD reported less intuitive eating (p = 0.019) and less eating for physical rather than emotional reasons (p = 0.010) compared to those with poorest RMSSD; participants with good SB reported less unconditional permission to eat (p = 0.008), higher fibre intake (p = 0.028), higher diet quality (p = 0.001), and lower alcohol consumption (p < 0.001) compared to those with poor SB, although effect sizes were small. In subgroup analyses among participants who reported working regular daytime hours (n = 216), only the associations of SB with diet quality and alcohol consumption remained significant. Conclusions: Better nocturnal recovery showed associations with better diet quality, lower alcohol consumption and possibly lower intuitive eating. In future lifestyle interventions and clinical practice, it is important to acknowledge sleep-time recovery as one possible factor linked with eating habits. Trial registration: ClinicalTrials.gov Identifier NCT01738256, Registered 17 August 2012. [ABSTRACT FROM AUTHOR]

Body dissatisfaction is pervasive among women in the United States. As a result, women feel pressured to participate in body‐related corumination. In response to evidence suggesting that diet culture and body‐related corumination can produce significant harm, scholars have increasingly proposed intuitive eating as a body‐positive alternative. This study explores the relationships between body‐specific corumination, body dissatisfaction, friendship quality, and intuitive eating. Results from this study's mixed‐methods investigation suggest that increase body‐related corumination is associated with increased body dissatisfaction and decreased intuitive eating. Relationship quality is associated with intuitive eating, and intuitive eating is negatively associated with body dissatisfaction. Results from this study's qualitative data indicate that women experience body‐related conversations in specific ways that can enforce unhealthy patterns of behavior and conversation. [ABSTRACT FROM AUTHOR]

The rapid rise in obesity prevalence is life-style related and tackling this problem requires a pro-active multi-faceted approach to management. A private health care provider in Melbourne, Australia, developed a multidisciplinary rehabilitation program for patients who had undergone bariatric surgery or receiving pharmacological weight loss treatments. The study aim was to assess the programs' effect on patients' quality of life, mental well-being, and eating behaviours. A prospective, observational, before and after study design was used. A total of 54 patients, 27 who had bariatric surgery and 27 receiving pharmacotherapy participated. Outcome measures were: change in weight and BMI, intuitive eating scale, impact of weight on quality of life scale and the depression, anxiety and stress scale. Both medical and surgical patients reported improvements in their health-related quality of life and eating behaviours. Despite this, at program completion 71.4% of patients who had bariatric surgery reported severe anxiety and 52.4% severe stress levels. Participation in a rehabilitation program that provided patients with peer support and access to expert advice supported patients to make healthy eating choices and improved their quality of life. The high prevalence of stress and anxiety related symptoms highlights the need to provide individuals who have undergone bariatric surgery with ongoing mental health support. [ABSTRACT FROM AUTHOR]

Introduction: A growing body of literature has investigated diet and mental health, however, it is often viewed through a "weight-centric" lens, where weight loss is considered a primary outcome and motivator. This review aims to shed new insights into the connections between mental health and wellbeing, and eating behaviours that focus on internal cues and regulators and do not centralise around weight. Such "weight-neutral approaches" have been associated with improved psychological health and wellbeing, however, consolidated evidence is lacking. Objectives: To explore eating styles that do not centralise around weight, and their relationship with mental health and wellbeing and other health outcomes. Methods: A systematic search was performed including observational studies of adult populations, with ≥1 mental health and wellbeing or physical health outcome, and ≥1 validated measure of eating behaviour reflective of a weight-neutral approach. Outcomes were characterised into four domains (mental health and wellbeing, physical health, health promoting behaviours and other eating behaviours). Risk of bias was assessed using the Newcastle-Ottawa Scale. Results: In total 8281 records were identified with 86 studies including 75 unique datasets and 78 unique exposures included. Eating behaviours included intuitive eating (n=48), mindful eating (n=19), and eating competence (n=11). All eating behaviours incorporated biological, physiological, and social factors, with 297 outcomes categorised for mental health and wellbeing (n=122), physical health (n=116), health promoting behaviours (n=51) and other eating behaviour (n=8). Greater intuitive and mindful eating were significantly related to lower levels of disordered eating, and depressive symptoms, as well as greater body image, self-compassion, and mindfulness. Greater intuitive eating, mindful eating and eating competence were significantly related to a lower BMI, and greater diet quality and physical activity. Eating competence and intuitive eating were significantly related to higher fruit and vegetable intake, and eating competence alone was significantly related to higher fibre intake, and greater sleep quality. Conclusions: This review provides evidence that intuitive eating, mindful eating and eating competence are positively related to a range of mental and physical health outcomes. Considered within the biopsychosocial model, these findings enhance understanding around the impact of approaches to healthy eating patterns that are not focused on weight loss, and contributes a case towards promoting health-centric eating behaviour in mental health care. Future research should focus on experimental studies and broader population groups. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Stress is associated with negative health outcomes in adults, including increased adiposity. Eating behaviors to cope with stress can have a negative effect on adiposity. There is limited research on positive eating behaviors, such as intuitive eating (IE), and their relationship to stress and adiposity. Thus, this study aimed to examine the association between stress and adiposity and to assess whether IE is a mediator of that pathway. Data were analyzed from a cross-sectional study of 114 women between 40–64 years of age. Participants completed in-person visits and self-reported questionnaires, including the Intuitive Eating Scale and Perceived Stress Scale. Adiposity was assessed using dual energy x-ray absorptiometry. Measurements included total body fat percentage and android/gynoid (AG) ratio as a measure of abdominal adiposity. Participants provided ten salivary cortisol samples over two days, collected upon waking, 30-, 45-, and 60-minutes after waking, and prior to bed. Several methods were used to characterize cortisol secretion and exposure, including the diurnal cortisol slope and the cortisol area under the curve with respect to ground (AUCg). Linear regression was used to assess the associations between perceived stress and IE and between features of diurnal cortisol and IE. Mediation models were tested to examine the indirect effects of IE on the relationship between perceived stress and adiposity and to test the indirect effects of IE on the relationship between cortisol measures and adiposity. Linear regression analyses indicated that higher cortisol AUCg was associated with lower scores on the eating for physical reasons subscale (β: −0.01, p = 0.008). After adjusting for covariates, neither higher perceived stress nor diurnal cortisol were associated with intuitive eating. There was no evidence of mediation of the association of stress on adiposity through IE. Our findings demonstrate a relationship between higher overall morning cortisol and lower scores on the eating for physical reasons subscale of the Intuitive Eating Scale. Future research should seek to understand how intuitive eating may be used as a technique for individuals who engage in emotional eating to cope with stress, and to prevent excess adiposity resulting from stress in midlife women. • Higher morning cortisol is associated with lower intuitive eating. • Perceived stress was not associated with intuitive eating. • Perceived stress and cortisol were not directly associated with adiposity. [ABSTRACT FROM AUTHOR]

The present study assessed the links between interoceptive sensibility, binge, disordered (emotional, restrained, and external) and intuitive eating among individuals with obesity (n = 57) and normal weight (n = 29). Individuals with obesity presented lower “attention regulation,” “body-listening,” and “trusting” interoceptive dimensions. When age was controlled, group differences on “trusting” remained significant. Individuals with obesity showed lower intuitive eating, higher emotional, and binge eating compared to controls. Higher “body listening,” “eating for physical rather than emotional reasons,” and “reliance on hunger and satiety cues” predicted lower binge eating whereas “external eating” predicted higher binge eating among individuals with obesity. Eating for physical reasons and reliance on hunger and satiety had protective mediating roles in the relationship between external and binge eating in both groups. Interoceptive sensibility and intuitive eating should conjointly serve as psychotherapeutic targets for disordered eating, obesity, and weight management. [ABSTRACT FROM AUTHOR]

Orthorexic eating behaviors can be conceptualized as a bidimensional construct encompassing an orthorexia nervosa dimension (ON) and a healthy orthorexia dimension (HO). Although variable-centered studies showed that ON and HO are distinguishable orthorexic eating behaviors, the evidence of whether they can co-occur or be distinct in subgroups of individuals is still limited. The present study aimed to address previous person-centered studies' limitations by examining profiles of ON and HO among a convenience sample of 251 French-speaking Canadian adults (85.7% women; M age = 33.56). Profile membership was examined as function of participants characteristics such as age, gender, body mass index, frequency of physical activity and sports and vegetarianism. The relation between profile membership, intuitive eating and disordered eating attitudes and behaviors was also assessed. Latent profile analysis (LPA) were used to estimate profiles of ON and HO. Results from LPA did not provide support for the distinguishability of ON and HO. Indeed, they revealed the presence of two profiles showing co-occurring levels of ON and HO that only differed quantitatively: low (68.9% of the sample; low levels of ON and HO) or moderate orthorexic eating behaviors (31.1%; moderate levels of ON and HO). Participants who declared being vegetarian and being more frequently involved in physical activities and sports were more likely to belong to the moderate orthorexic eating behaviors' profile. Finally, participants from the moderate orthorexic eating behaviors' profile showed higher levels of disordered eating attitudes and behaviors, whereas those from the low orthorexic eating behaviors' profile showed higher levels of intuitive eating. Findings from the present study question the distinguishability of ON and HO dimensions. They also suggest that, similarly to ON, HO is also related to higher eating and lifestyle preoccupations. [ABSTRACT FROM AUTHOR]

Abstract Background Obesity is a cardiovascular disease risk factor. Conventional weight loss (CWL) programmes focus on weight loss, however ‘health, not weight loss, focused’ (HNWL) programmes concentrate on improved health and well-being, irrespective of weight loss. What are the differences in CVD risk outcomes between these programmes? Aim To conduct a systematic review and meta-analysis to compare the effects of HNWL with CWL programmes on cardiovascular disease risk factors. Methods We searched CENTRAL, MEDLINE, EMBASE, PsycINFO, CINAHL, ASSIA, clinical trial registers, commercial websites and reference lists for randomised controlled trials comparing the two programmes (initially searched up to August 2015 and searched updated to 5 April 2019). We used the Mantel-Haneszel fixed-effect model to pool results. Sub-group and sensitivity analyses that accounted for variations in length of follow-up, enhanced programmes and risk of bias dealt with heterogeneity. Results Eight randomised controlled trials of 20,242 potential studies were included. Improvements in total cholesterol-HDL ratio (mean difference − 0.21 mmol/L, 95% confidence interval [− 3.91, 3.50]) and weight loss (− 0.28 kg [− 2.00, 1.44]) favoured HNWL compared to CWL programmes in the long term (53–104 week follow-up), whereas improvements in systolic (− 1.14 mmHg, [− 5.84, 3.56]) and diastolic (− 0.15 mmHg, [− 3.64, 3.34]) blood pressure favoured CWL programmes. These differences did not reach statistical significance. Statistically significant improvements in body satisfaction (− 4.30 [− 8.32, − 0.28]) and restrained eating behaviour (− 4.30 [− 6.77, − 1.83]) favoured HNWL over CWL programmes. Conclusions We found no long-term significant differences in improved CVD risk factors; however, body satisfaction and restrained eating behaviour improved more with HNWL compared to CWL programmes. Yet firm conclusions cannot be drawn from small studies with high losses to follow-up and data sometimes arising from a single small study. Systematic review registration PROSPERO CRD42015019505

Abstract Background Dialectical behavior therapy conceptualizes problematic behaviors as attempts to regulate emotions that occur when the individual lacks effective skills with which to manage his or her emotions and cope with distress. Problematic eating behaviors, e.g., binge and emotional eating, may serve to alleviate aversive emotional states, being highly associated with overweight and obesity. Dialectical behavior therapy skills training has been proven effective in reducing binge eating in several clinical studies. However, few studies reveal the effects of DBT on adaptive eating behaviors or the stability of outcomes. Objectives This study aimed to test the effect of a brief DBT-based skills training intervention, and the stability of outcomes at 3- and 8-month follow-ups. Methods Self-report measures of binge eating, emotional eating, intuitive eating, and mindful eating were taken on 5 timepoints before and after a 10-session DBT skills training intervention (2 baseline measures, 1 post-test, and 2 follow-ups). Data were analyzed using a mixed-model intention-to-treat approach and mediation analysis was conducted with path analysis. Results After the intervention, intuitive eating and mindful eating scores were significantly higher than before the intervention, while emotional eating and binge eating scores were lower. The results remained stable during the follow-up period, with minor fluctuations and small trends towards returning to baseline values for binge eating and emotional eating. Mindful eating partially mediated the improvements in all outcomes. Limitations Given that results are entirely based on self-report measures and that some instruments showed poor reliability, in addition to the high attrition rates, the results should be interpreted as preliminary. Conclusions The results provide evidence that a brief DBT intervention is effective not only in reducing problematic eating but also in increasing adaptive eating, achieving reasonably stable results. Also, the mediation analysis results support the hypothesis that mindful eating partially explains the effects of the intervention on binge and emotional eating. Future research should address the limitations of this study by investigating a more diverse sample, triangulating different measurement strategies, and including other putative mediators.

Assess how intuitive eating relates to dietary intake. Survey data were collected in Project Eating and Activity in Teens and Young Adults , the fourth wave of a longitudinal cohort study (weighted n = 1,830, 49% women; mean age = 31 years). Intuitive eating was assessed using a 7-item scale adapted from the Intuitive Eating Scale and Intuitive Eating Scale-2. Dietary intake was measured via a semiquantitative food frequency questionnaire. Mean servings were stratified by gender and intuitive eating quartiles and adjusted for sociodemographic characteristics and caloric intake. Women and men in the top intuitive eating quartile consumed 0.6–0.3 servings more fruit and 0.4–0.6 servings more vegetables daily, respectively, compared with the bottom quartile, whereas men in the top quartile also consumed 0.6 servings fewer whole grains (all P < 0.05) than the bottom quartile. Intuitive eating shows promise as a healthier alternative to practices such as dieting. [ABSTRACT FROM AUTHOR]

• Gratitude is related to body appreciation and intuitive eating. • The gratitude model is tested with Japanese women for the first time. • All paths in the original model are replicated in the current model. • Two unique paths are added, which may be related to Japanese cultural values. Culture is believed to play a central role in body image and eating problems, and for this reason, it is important to conduct cross-cultural investigations of relevant theoretical models. This study involves a non-Western replication of one of the few existing models of positive body image, the gratitude model of body appreciation , which was originally developed using American women. The model postulates that a grateful attitude is associated with body appreciation and intuitive eating via reduced contingent self-worth and social comparison. The current study aims to examine the applicability of the model to Japanese women. A sample of 648 Japanese women (age range = 15–69, M = 42.1, SD = 15.7) completed online measures of gratitude, contingent self-worth, social comparison, body appreciation, and intuitive eating. In general, all paths in the original model were replicated in the current model. However, two new paths were added to achieve good fit, including a path from basing one's self-worth on others' approval to body appreciation and another path from gratitude directly to intuitive eating. These differential pathways are discussed in the context of Japanese culture that emphasizes appreciation towards foods and self-definition based on social approval. In addition, implications for intervention are described. [ABSTRACT FROM AUTHOR]

Intuitive eating is the ability to eat in response to physiological hunger and satiety cues rather than to external or emotional cues. The purpose of this research was to adapt the Intuitive Eating Scale-2 (IES-2; Tylka and Kroon Van Diest 2013) to Turkish in an adult sample. The factor structure of the IES-2 was evaluated in Study 1 (n = 264) with exploratory factor analysis (EFA), and in Study 2 (n = 271) with confirmatory factor analysis (CFA). Additionally, the correlations of the IES-2 scores with measures of self-esteem, disordered eating, obsessive thoughts, and body anxiety in social situations were assessed in Study 1 to evaluate the scale's convergent validity. EFA results supported the four-factor structure of the original scale with the following factors: eating for physical rather than emotional reasons (EPR), unconditional permission to eat (UPE), reliance on hunger and satiety cues (RHSC), and body-food choice congruence (BFCC). Intercorrelations between the IES-2 total scores and other study constructs were in the expected direction, and ranged from medium to large. CFA results yielded acceptable fit values and supported the 4-factor model of the original scale. A second-order CFA showed that UPE had no association with the second-order latent variable, Intuitive Eating. The results suggest that the IES-2 is a valid and reliable measure of intuitive eating for the adult population in Turkey. Furthermore, it is recommended that Turkish IES-2 total scores be computed without the UPE items. The findings and clinical implications are discussed, and suggestions for future research in other cultural contexts are provided. [ABSTRACT FROM AUTHOR]

Body dissatisfaction and eating disorders have become major global concerns, including in Asian populations. Few studies have examined intervention effects on body dissatisfaction and disordered eating in China, especially for interventions with positive psychological perspectives (e.g., intuitive eating). In this pilot study, 66 women participated in an eight-module intuitive eating intervention delivered online (n = 42; mean age, 30.74 years) and face-to-face (n = 24; mean age, 19.46 years) for 8 weeks. Measures of body image and eating behaviors were used to assess the intervention’s feasibility, acceptability, and initial efficacy. Linear mixed models were used to analyze the data. The intervention had significant effects on both groups, promoting positive body image and intuitive eating and reducing negative body image and disordered eating behaviors. The effects of the online and face-to-face interventions did not differ significantly. Thus, whether delivered online or face-to-face, an intuitive eating intervention may effectively improve Chinese women’s body image and eating behaviors. However, the efficacy of the intuitive intervention in the Chinese context should be confirmed in future studies with designs in randomized control trials.

Intuitive (IE) and mindful (ME) eating share internally focused eating, yet previous studies have shown that these concepts are not strongly correlated, which suggests that they might be differently related to food intake. The study aimed to adapt the original Intuitive (IES-2) and Mindful (MES) Eating Scales to the Polish language, to test their psychometric parameters and, further, to examine associations of IE and ME with an intake of selected food groups, i.e., healthy foods (fresh and processed vegetables, fresh fruit) and unhealthy foods (sweets, salty snacks). A cross-sectional study was conducted in 2020 in a group of 1000 Polish adults (500 women and 500 men) aged 18–65 (mean age = 41.3 ± 13.6 years). The factor structure was assessed with exploratory (EFA) and confirmatory (CFA) factor analysis as well as structural equation modeling (SEM). Measurement invariance across gender was assessed with multiple-group analysis. Internal consistency and discriminant validity of the two scales was tested. Spearman’s correlation coefficient was used to examine the correlation between IES-2 and MES subscales with food intake. A 4-factor, 16-item structure was confirmed for IES-2, while EFA and CFA revealed a 3-factor, 17-item structure of MES. Both scales demonstrated adequate internal consistency and discriminant validity. Full metric and partial scalar invariance were found for IES-2, while MES proved partial invariances. “Awareness” (MES) and “Body–Food Choice Congruence” (IES-2) positively correlated with intake of healthy foods and negatively with the intake of unhealthy ones. “Eating For Physical Rather Than Emotional Reasons” (IES-2) and “Act with awareness” (MES) favored lower intake of unhealthy foods, whereas “Unconditional Permission to Eat” and “Reliance on Hunger and Satiety Cues” (IES-2) showed an inverse relationship. A greater score in “Acceptance” (MES) was conducive to lower intake of all foods except sweets. The results confirmed that adapted versions of the IES-2 and MES are valid and reliable measures to assess IE and ME among Polish adults. Different IE and ME domains may similarly explain intake of healthy and unhealthy foods, yet within a single eating style, individual domains might have the opposite effect. Future studies should confirm our findings with the inclusion of mediating factors, such as other eating styles, childhood experiences, dieting, etc.

This work aimed to evaluate the association between intuitive eating and dietary pattern, according to the NOVA classification, in a population with type 2 diabetes mellitus (T2DM). This was an observational cross-sectional study in patients at a university hospital in Vitória-ES, Brazil. For data collection, a semi-structured questionnaire was used, and food intake was assessed by the level of processing according to the NOVA classification. Intuitive eating was assessed by the Intuitive Eating Scale-2, and 179 individuals, mostly female and elderly, were evaluated. The chance of individuals consuming unprocessed or minimally processed foods was doubled in those participants who had dieted (OR=2.149; CI95%=1.142-4.045; p=0.018). In contrast, eating with unconditional permission reduced the chances of participants consuming this group of foods by 52.7% (OR=0.473; CI95%=0.235-0.952; p=0.036). Moreover, the chances of participants consuming ultra-processed foods was increased by 2.34 times in those having T2DM for more than 10 years (OR=2.344; CI95%=1.114-4.933; p=0.025). When assessing intuitive eating, it was observed that eating in congruence with bodily needs reduced the chances of the individual consuming ultra-processed foods by 45% (OR=0.547; CI95%=0.309-0.968; p=0.038). Therefore, the subscales of intuitive eating were associated differently with food intake according to the level of food processing in individuals with T2DM. [ABSTRACT FROM AUTHOR]

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Introduction: Lifestyle factors, including inadequate eating patterns, emerge as a critical determinant of chronic disease. Apart from caring for patients, nurses should also take an active role in monitoring and managing their own health. Understanding the intricate relationship between nurses' eating behavior and managing their own health is crucial for fostering a holistic approach to healthcare, therefore our study aimed to evaluate eating behavior and demographic factors influencing chronic disease prevalence in a sample of community nurses from Romania., Methods: Between October-November 2023, 1920 community nurses were invited to answer an online survey, using an advertisement in their professional network. Of them, 788 responded. In the survey, which included a semi-quantitative food frequency questionnaire with 53 food items, the Intuitive Eating Survey 2 (IES-2), and demographic items were used., Results: A multivariate model was built for the prediction of the association between eating behavior and other factors associated with chronic diseases. The majority of participants were females (95.1%), with the largest age group falling between 40 and 49.9 years (48.2%). Regarding the EFSA criteria for adequate carbohydrate and fat intake, 20.2% of the group have a high intake of carbohydrates, respectively, 43.4% of the group have a high intake of fat. Analysis of chronic diseases indicated that 24.9% of individuals reported at least one diagnosis by a physician. The presence of chronic disease was associated with a low level of perceived health status, with an OR = 3.388, 95%CI (1.684-6.814), compared to those reporting excellent or very good perceived health status. High stress had an OR = 1.483, 95%CI (1.033-2.129). BMI had an OR = 1.069, 95%CI (1.032-1.108), while low carbohydrate diet score had an OR = 0.956, 95%CI (0.920-0.992). Gender and IES-2 did not significantly contribute to the model, but their effect was controlled., Discussion: By unraveling the intricate interplay between nutrition, lifestyle, and health outcomes in this healthcare cohort, our findings contribute valuable insights for the development of targeted interventions and support programs tailored to enhance the well-being of community nurses and, by extension, the patients they support., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Onofrei, Puiu, Chirita-Emandi and Serban.)

Introduction: University students have been particularly affected during the COVID-19 pandemic, and several sociodemographic and behavioral factors may be associated with the risk of overweight in this population. The aim of this study was to assess the impact of the pandemic on the eating behavior and nutritional status of university students, and the factors associated with these changes, especially the role of intuitive eating in this process., Methods: This is a repeated measures observational study with data collected in the first and third year of the COVID-19 pandemic in Brazil, from students over the age of 18 in the undergraduate programs of a federal university in southeastern Brazil. The survey was conducted using an online form. Eating behavior was assessed using the "Intuitive Eating Scale-2"., Results: 251 university students took part, most of them female with a median age of 22. There was an increase in body mass index (BMI) and intuitive eating score between the two periods. In the first year of the pandemic, being female and using tobacco reduced the chances of students being overweight. Living in a marital relationship, worrying about weight gain and body dissatisfaction increased the chances of this outcome. In the third year of the pandemic, it was observed that practicing restrictive diets, having inadequate body perception, worrying about weight gain and living in a marital relationship increased the chances of students being overweight. Being female and eating more intuitively, in line with bodily needs, reduced these odds, demonstrating a protective role in this scenario., Conclusion: There was an increase in BMI and intuitive eating score during the pandemic. Sociodemographic, lifestyle and behavioral variables had both a positive and negative influence on nutritional status. Intuitive eating was shown to be a protective factor during this period, reducing the chances of being overweight in this population. Thus, more intuitive eating may favor greater weight stability, and may, therefore, have helped to reduce the impact of the pandemic on weight gain. In this way, people who ate more intuitively partially resisted the context that favored weight gain (stress, changes in diet and physical inactivity)., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Souto, Salaroli, da Silva, Cattafesta, Silva and Soares.)

This study examined the measurement invariance of three scales that assessed emotional eating, restrained eating, and intuitive eating across eight countries (Australia, Belgium, Canada, China, Italy, Japan, Spain and the United States) in order to determine their suitability for cross-country body image research. A total of 6272 young adults took part in this study. Participants completed an online survey including the Emotional Eating subscale of the Three Factor Eating Questionnaire-Revised 21, the Restraint subscale of the Eating Disorder Examination Questionnaire , and the Reliance on Hunger and Satiety Cues subscale of The Intuitive Eating Scale-2. Multi-group confirmatory factor analysis was used to evaluate potential cross-country differences in functioning of the measures. Partial invariance for all three scales was found, with only minor levels of non-invariance identified. Multiple indicator multiple cause models identified BMI and gender as potential influences on scores for these measures. Sources of invariance across groups are discussed, as well as implications for further substantive research across countries involving these measures. [ABSTRACT FROM AUTHOR]

• Romanian Intuitive Eating Scale-2 (IES-2) scores best conceptualised as 3-dimensional. • Scores on IES-2 have adequate internal consistency and are invariant across gender. • Evidence of test-retest reliability was poor. • Evidence was construct validity was weak. The construct of intuitive eating is most often measured using the 23-item Intuitive Eating Scale-2 (IES-2). Here, we examined the psychometrics of a Romanian translation of the IES-2. Eight-hundred-and-thirty Romanian adults completed the IES-2 along with measures of positive body image, symptoms of disordered eating, and psychological well-being. Exploratory factor analyses (EFAs) with a split-half subsample (n = 420) indicated that IES-2 scores reduced to three factors in women and four in men, both of which diverged from the parent model. Confirmatory factor analysis with a second split-half sample (n = 410) indicated that the parent model had poor fit indices, whereas fit of the EFA-derived models were acceptable but not uniformly ideal. Scores on the 3-factor model – which had comparatively better fit of the models tested – had adequate internal consistency and evidenced scalar invariance across gender. However, evidence of test-retest reliability after four weeks (n = 205) was poor and evidence of construct validity, assessed through correlations with additional measures included in the survey, was weak at best. Based on these results, we question the degree to which the construct of intuitive eating can be applied to nations undergoing nutrition transitions. [ABSTRACT FROM AUTHOR]

Aim: 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. Methods: 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. Results: 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). Conclusions: The results support dietitian‐led multidisciplinary lifestyle interventions for multidisciplinary management of high‐risk patients of all BMI classes. [ABSTRACT FROM AUTHOR]

Two promising strategies to manage eating behaviour are intuitive eating (IE; following hunger) and pinned eating (PE; ignoring hunger/eating at specific times of the day). This study compared IE and PE on behavioural markers. Participants (n 56) were randomly assigned to IE (n 28) or PE (n 28) and given instructions to follow for 1 week. Drive to eat, behaviour, behavioural intentions and self-efficacy were measured at baseline and follow-up. Participants also evaluated their specific intervention. Comparable changes over time were found for both conditions for many measures. Significant conditions by time interactions were found for healthy snacking, total self-efficacy and self-efficacy for weight loss: those following IE showed an increase in each of these outcomes compared to those following PE who showed no change. The IE group found their intervention more useful than those following PE. Further research is needed to build on these preliminary findings.

Abstract Background Internal motivation and good psychological capabilities are important factors in successful eating-related behavior change. Thus, we investigated whether general acceptance and commitment therapy (ACT) affects reported eating behavior and diet quality and whether baseline perceived stress moderates the intervention effects. Methods Secondary analysis of unblinded randomized controlled trial in three Finnish cities. Working-aged adults with psychological distress and overweight or obesity in three parallel groups: (1) ACT-based Face-to-face (n = 70; six group sessions led by a psychologist), (2) ACT-based Mobile (n = 78; one group session and mobile app), and (3) Control (n = 71; only the measurements). At baseline, the participants’ (n = 219, 85% females) mean body mass index was 31.3 kg/m2 (SD = 2.9), and mean age was 49.5 years (SD = 7.4). The measurements conducted before the 8-week intervention period (baseline), 10 weeks after the baseline (post-intervention), and 36 weeks after the baseline (follow-up) included clinical measurements, questionnaires of eating behavior (IES-1, TFEQ-R18, HTAS, ecSI 2.0, REBS), diet quality (IDQ), alcohol consumption (AUDIT-C), perceived stress (PSS), and 48-h dietary recall. Hierarchical linear modeling (Wald test) was used to analyze the differences in changes between groups. Results Group x time interactions showed that the subcomponent of intuitive eating (IES-1), i.e., Eating for physical rather than emotional reasons, increased in both ACT-based groups (p = .019); the subcomponent of TFEQ-R18, i.e., Uncontrolled eating, decreased in the Face-to-face group (p = .020); the subcomponent of health and taste attitudes (HTAS), i.e., Using food as a reward, decreased in the Mobile group (p = .048); and both subcomponent of eating competence (ecSI 2.0), i.e., Food acceptance (p = .048), and two subcomponents of regulation of eating behavior (REBS), i.e., Integrated and Identified regulation (p = .003, p = .023, respectively), increased in the Face-to-face group. Baseline perceived stress did not moderate effects on these particular features of eating behavior from baseline to follow-up. No statistically significant effects were found for dietary measures. Conclusions ACT-based interventions, delivered in group sessions or by mobile app, showed beneficial effects on reported eating behavior. Beneficial effects on eating behavior were, however, not accompanied by parallel changes in diet, which suggests that ACT-based interventions should include nutritional counseling if changes in diet are targeted. Trial registration ClinicalTrials.gov (NCT01738256), registered 17 August, 2012.

The application of behavioral theories in several areas has aroused the interest in investigating how these theories are incorporated by the field of Food and Nutrition, problematizing its interdisciplinarity. This paper aims to contextualize Nutrition as a science and its development in a social context in which neoliberalism operates as a system for managing political, economic, and social life. The aim is to gather theoretical elements related to the notion of behavior extracted from the field of Psychology in order to contribute to the deepening of reflections on the emergence of techniques based on theories of behavior, such as Behavioral Nutrition, Mindful Eating and Intuitive Eating, in addition to presenting considerations on the limits related to the application of these approaches in the training and practice of health professionals. [ABSTRACT FROM AUTHOR]

Objective: College women engage in high rates of disordered eating behaviors (DEBs), and most do not receive treatment. Campuses lack resources to meet this need, thus accessible and affordable treatment options are important. Intuitive eating (IE) is gaining mainstream interest, but intervention research is scarce, with no known clinical trials in college women. This uncontrolled pilot trial examined the feasibility, acceptability, and preliminary efficacy of an eight‐week IE intervention delivered through two potentially accessible and affordable modalities: group and guided self‐help (GSH). Method: Racially and ethnically diverse college women (N = 71; <50% White) were recruited from a large public Mid‐Atlantic university and randomized to group (n = 40) or GSH (n = 31). Assessments occurred at 0 (pre‐test), 8 (post‐test), and 16 weeks (follow‐up). Group participants attended eight weekly 1.5‐hour sessions. GSH participants engaged in self‐study and had eight weekly 20‐minute phone calls. Results: Both conditions demonstrated feasibility, with superior retention and attendance in GSH. Over 90% of those attending at least one session in either condition were retained through follow‐up. Both conditions were highly acceptable, and produced medium to large reductions in DEBs, body dissatisfaction, and weight‐bias internalization, and improvements in body appreciation, IE, and satisfaction with life from pre‐ to post‐test, which were maintained at follow‐up. Discussion Results of this pilot are encouraging and support the development of a larger randomized controlled trial. Avenues for refinement include strategies to improve feasibility of the group condition, and conducting longer‐term follow‐up to examine maintenance of effects and the intervention's eating disorder prevention potential. [ABSTRACT FROM AUTHOR]

Objective: Eating disorder recovery research has emphasized the absence of symptoms over the presence of adaptive aspects like positive body image and healthy eating attitudes. The current study examined how body appreciation and intuitive eating related to eating disorder recovery using a comprehensive recovery definition (physical, behavioral, and cognitive recovery). Method: Data were collected from 66 women with an eating disorder history and 31 controls with no history of eating pathology. Participants completed an online survey followed by a phone interview. Results: The fully recovered group did not differ from controls on body appreciation, with both groups endorsing significantly higher levels of body appreciation than the partially recovered and current eating disorder groups. Similarly, the fully recovered group did not differ from controls on overall intuitive eating, with both groups endorsing significantly higher levels of overall intuitive eating than the partially recovered and current eating disorder groups. Discussion Positive psychological constructs such as body appreciation and intuitive eating relate to eating disorder recovery status. Understanding recovery within a strengths‐based framework may inform intervention and relapse prevention. [ABSTRACT FROM AUTHOR]

Introduction: the use of a restrictive diet for treating obesity has been proven inefficient in the long-term. Besides, body dissatisfaction could be the reason for starting a restrictive diet. In this sense, intuitive eating emerges as an alternative for reconnecting individuals with their bodies and the signals it sends. Objective: to evaluate an individuals' tendency to follow physiological signs of hunger and satiety and correlate them with body dissatisfaction in overweight people. Materials and methods: this is a transversal and quantitative study with users of a specialized obesity treatment service in the city of Fortaleza. Sociodemographic data was collected and the Intuitive Eating Scale - 2 (IES-2) and Stunkard Silhouettes Scale were applied; weight and height were also collected. Results: A negative correlation was observed between "Reliance on Hunger and Satiety Cues", weight (ρ=-0,298; p=0,030) and current silhouette (ρ=-0,341; p=0,012) and also between "Body-Food Choice Congruence" and current silhouette (ρ=-0,297; p=0,031). Discussion: the literature analysis and the presented data have shown that there are interactions between hunger and satiety cues, body-food choice congruence, and anthropometric variables and body perception. Conclusion: reliance on hunger and satiety cues is linked with body image and weight, and body-food choice congruence are also linked with body image. [ABSTRACT FROM AUTHOR]

Purpose: Negative affect is associated with body image and eating‐related problems. Nonetheless, research on mediating emotional processes in this relationship is scant. The present study explored a path model testing the effect of negative and positive affect (PA) on disordered eating symptoms, via its effect on intuitive eating and body image flexibility, while controlling for the effect of body mass index. Methods: Participants included 273 women, aged between 18 and 45 years old, who completed an online survey with self‐report measures. Results: The tested model showed an excellent fit to the empirical data and explained a total of 64% of the variance of disordered eating attitudes and behaviours. This model revealed that the impact of negative and PA on disordered eating symptoms depends on the level of intuitive eating and body image flexibility, even when controlling for the effect of body mass index. Conclusions: This study contributes to the understanding of the adaptative and mediational role that intuitive eating and body image flexibility play in the link between affectivity and eating‐related difficulties. Indeed, these emotional regulation processes seem to play a protective role against disordered eating, by reducing reactivity and impulsive eating in response to negative and PA. The study findings suggest that prevention and intervention programs focused on body and eating‐related difficulties should promote a more aware and adaptative pattern of eating and body image flexibility, which seems especially relevant to deal with Western societies' body and eating‐related paradoxical messages. [ABSTRACT FROM AUTHOR]

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