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Objective:To examine mediation by (i) diet quality and (ii) diet quantity in the associations of mindful eating domains with 3-year change in depressive symptoms.Design:Depressive symptoms were measured with the Center for Epidemiologic Studies Depression scale at baseline and 3-year follow-up. Four mindful eating domains (Focused Eating; Eating in response to Hunger and Satiety Cues; Eating with Awareness; Eating without Distraction) were measured with the Mindful Eating Behavior Scale. Food intake was measured with a 238-item FFQ. Diet quality was defined as the Mediterranean Diet Score (MDS). Diet quantity was defined as total energy intake (kcal/d; 1 kcal = 4·184 kJ). Mediation analyses with percentile-corrected bootstrap confidence intervals were conducted to calculate indirect effects.Setting:Longitudinal Aging Study Amsterdam.Participants:Adults aged 55 years or above (n 929).Results:Diet quality (MDS) did not mediate associations of any of the four mindful eating domains with change in depressive symptoms. In contrast, total energy intake did mediate the associations with change in depressive symptoms for the mindful eating domains Eating with Awareness (indirect effects fully adjusted models: B = −0·014, 95 % CI −0·037, −0·002) and Eating without Distraction (B = −0·013, 95 % CI −0·033, −0·001), but not for the other two domains. Post hoc multiple mediation analyses showed similar results.Conclusions:Higher scores on two mindful eating domains were associated with a decrease in depressive symptoms through lower total energy intake. Diet quantity, but not diet quality, could be a possible underlying mechanism in the associations between mindful eating and change in depressive symptoms.

Contains fulltext : 179418.pdf (Publisher’s version ) (Closed access) Objective: To examine associations of mindful eating domains with depressive symptoms and depression in three European countries. Moderation by change in appetite - with increased appetite as marker for depression with atypical features - was also tested. Methods: Data were collected in Denmark (n=1522), Spain (n=1512) and the Netherlands (n=1439). Multiple linear and logistic regression analyses segregated by country were used to test associations of four mindful eating domains (Mindful Eating Behaviour Scale; MEBS) with depressive symptoms (continuous score on the Center for Epidemiologic Studies Depression Scale; CES-D) and depression (scoring above the clinically relevant cut-off score on the CES-D, and/or use of antidepressants, and/or psychological treatment). Moderation by change in appetite was tested with bias-corrected bootstrap confidence intervals. Results: The domains Focused Eating, Eating with Awareness and Eating without Distraction were significantly negatively associated with depressive symptoms and depression in all three countries (e.g. Focused Eating Denmark: B=-0.71, 95%CI: -0.87, -0.54; OR=0.89, 95%CI: 0.86, 0.93). The domain Hunger and Satiety Cues (only measured in the Netherlands) was significantly positively associated with depressive symptoms in the adjusted models (B=0.09, 95%CI: 0.02, 0.16), but not with depression (OR=1.02, 95%CI: 0.98, 1.05). These associations were found for both people with and without increased appetite. Limitations: The cross-sectional design, which makes it impossible to draw causal conclusions. Conclusions: The present study indicates that higher scores on three mindful eating domains are consistently associated with a lower level of depressive symptoms and a lower likelihood of having depression in three European countries. 7 p.

Contains fulltext : 197947.pdf (Publisher’s version ) (Closed access) Earlier cross-sectional research showed that a higher level of mindful eating is associated with less depression. This study investigated associations of attentive mindful eating with change in depressive symptoms, as well as mediation by psychological eating styles, in the Longitudinal Aging Study Amsterdam (n = 946). The mindful eating domains Focused Eating, Eating in response to Hunger and Satiety Cues, Eating with Awareness and Eating without Distraction were measured by the Mindful Eating Behavior Scale. Three-year change in depressive symptoms was measured with the Center for Epidemiologic Studies Depression Scale. Emotional, external and restrained eating were measured by the 20-item version of the Dutch Eating Behaviour Questionnaire. Higher baseline scores on Focused Eating, Eating with Awareness and Eating without Distraction were associated with a 3-year decrease in depressive symptoms. Eating in response to Hunger and Satiety Cues was not associated with a change in depressive symptoms. Multiple mediation models showed mediation by external eating for the domains Eating with Awareness, Eating without Distraction, and Eating in response to Hunger and Satiety Cues, but no mediation by emotional and restrained eating. No mediation by the eating styles was found for Focused Eating. In this study, higher scores on three mindful eating domains were associated with a decrease in depressive symptoms. Mediation analyses suggest that three domains are associated with depression through external eating. 8 p.

Contains fulltext : 212587.pdf (Publisher’s version ) (Open Access) In two experimental studies in women, we investigated whether repeated testing improved the predictive validity of self-reported emotional eating (EE) for distress-induced food intake. We also tested whether there is support for a process of meaning making where pre-test and re-test EE are indirectly related through a serial causal chain of alexithymia and poor introspective awareness (IA). In study 1 (n=80), self-reported alexithymia and IA were measured before retesting EE. In study 2 (n=128), alexithymia and IA were measured after re-testing EE. In support of a process of meaning making, in both studies there was a significant serial chain of pre-test EE to re-test EE through alexithymia and IA. Further, re-test EE predicted somewhat more variance in distress-induced food intake than pre-test EE, though the difference was not significant. In conclusion, repeated testing may help respondents get a better understanding of a measure, thereby improving the validity of that measure. 12 p.

Do people with a high score on a scale for eating in response to negative emotions also show high food intake in response to positive emotions?. We studied these effects in 60 female students that were preselected on the basis of extreme high or low scores on an emotional eating questionnaire. Using a between subject design we experimentally tested the difference in food intake following a mood induction designed to induce joy or sadness (the joy vs. sad mood condition). The high and low emotional eaters did not differ in their food intake, but emotional eating significantly moderated the relationship between mood condition and food intake. Whereas low emotional eaters ate similar amounts after the sad and after the joy mood condition, high emotional eaters ate significantly more after the sad mood condition than after the joy mood condition. A further finding was that a similar moderator effect for emotional eating was found for intake of sweet food but not for intake of salty food. These findings would suggest that eating in response to negative and to positive emotions refer to two different construct.

Item does not contain fulltext The present study investigates whether the so-called disinhibition effect is better accounted for by tendency toward overeating than by restraint. The rationale was that in mood-induction studies, so far, the disinhibition effect has only been found in studies that applied the Restraint Scale and hardly ever in studies that used other restraint scales. Tension was induced by the public-speaking method in half of 86 female college students before they participated in an alleged taste test. The Restraint Scale (RS), the Three-Factor Eating Questionnaire (TFEQ) and the Dutch Eating Behaviour Questionnaire (DEBQ) were used to measure restraint and tendency toward overeating. No differences were found between the tension and the control condition as to the amounts of food the participants ate. Also no proof of the disinhibition effect was obtained and, remarkably, tendency toward overeating did not predict the amount of food eaten. Possible explanations for these results are offered in the discussion. (Eating Weight Disord. 12: e58-e63, 2007).

Effects of nitrogen dioxide (NO2) on respiratory health have been the subject of extensive research. The outcomes of these studies were not consistent. Exposure to nitrous acid, which is a primary product of combustion, and is also formed when NO2 reacts with water, may play an important role in respiratory health. We estimate the independent effects of exposure to nitrogen dioxide and nitrous acid on respiratory symptoms during the first year of life.Nitrogen dioxide and nitrous acid concentrations were measured once (1996-1998) in the homes of 768 infants who were at risk for developing asthma. Infants were living in southern New England. The frequency of respiratory symptoms in these children was recorded during the first year of life.Infants living in homes with an NO2 concentration exceeding 17.4 ppb (highest quartile) had a higher frequency of days with wheeze (rate ratio = 2.2; 95% confidence interval = 1.4-3.4), persistent cough (1.8; 1.2-2.7), and shortness of breath (3.1; 1.8-5.6) when compared with infants in homes that had NO2 concentrations lower than 5.1 ppb (lowest quartile), controlling for nitrous acid concentration. Nitrous acid exposure was not independently associated with respiratory symptoms.Among infants at risk for developing asthma, the frequency of reported respiratory symptoms in the first year of life was associated with levels of NO2 not currently considered to be harmful.

Contains fulltext : 124145.pdf (Publisher’s version ) (Closed access) The Dutch Eating Behavior Questionnaire (DEBQ) was developed to measure eating styles that may contribute to or attenuate the development of overweight. It comprises three scales that measure emotional, external and restrained eating. The main goal of this study is to evaluate the internal structure of the Spanish version of the DEBQ using updated psychometric techniques in a sample of women. A sample of 647 Spanish females answered the questionnaire. Both exploratory structural equation modeling and confirmatory factor analysis were used to evaluate the factor structure of the DEBQ. Reliabilities were estimated with Cronbach's alpha. The relations between the subscales of the DEBQ and age, BMI, and scores on the Eating Attitude Test-26 (EAT) and the Restrained Scale-Revised (RS) were computed with Pearson correlations. Results showed that the internal structure was similar to the theoretical proposal, although items associated with boredom and idleness presented cross-loading problems. The reliability estimates were satisfactory. The Emotional and External Eating factors correlated with the BMI, and External Eating was negatively correlated with age. The Restraint factor of the DEBQ showed significant relationships with scales of the EAT-26 and RS. The dimensional validity of the DEBQ is reproduced in a Spanish sample, and the DEBQ seems to be an effective instrument for research in Spanish females. Minor modifications to the DEBQ are recommended. 7 p.

Introduction Idiopathic Environmental Intolerance (IEI) attributed to electromagnetic fields (EMF) refers to self-reported sensitivity mainly characterised by the attribution of non-specific physical symptoms to low-level EMF exposure emitted from sources such as mobile phones. Scientific studies have not provided evidence for the existence of IEI-EMF, but these studies did not resemble the real-life situation or suffered from poor exposure characterisation and biased recall of health symptoms. To improve existing methods for the study of IEI-EMF, an Ecological Momentary Assessment (EMA) study is designed. Methods and analysis The study is an EMA study in which respondents carry personal exposure metres (exposimeters) that measure radiofrequency (RF) EMF, with frequent assessment of health symptoms and perceived EMF exposure through electronic diary registration during five consecutive days. Participants will be a selection from an epidemiological study who report to be sensitive to RF EMF. The exposimeters measure electric field strength in 12 frequency bands. Diary questions include the occurrence and severity of 10 non-specific physical symptoms, mood states and perceived exposure to (sources of) EMF. The relationship of actual and perceived EMF exposure and mood with non-specific physical symptoms will be analysed using multilevel regression analysis with time-shift models. Discussion The study has several advantages over previous studies, including assessment of personal EMF exposure and non-specific physical symptoms by an ecological method with a minimised chance of recall bias. The within-person design reduces confounding by time-stable factors (eg, personal characteristics). In the conduct of the study and the analysis and interpretation of its outcomes, some methodological issues including a high participant burden, reactivity, compliance to the study protocol and the potential of chance findings due to multiple statistical testing will be accounted for and limited as much as possible.

Het voorschrijven van een vermageringsdieet bij een probleem met overeten is op dit moment controversieel. De dieten werken meestal niet blijvend. Bovendien geldt lijnen als belangrijke risicofactor voor eetstoornissen. Er zijn echter ook succesvolle lijners. Potentieel succesvolle lijners kunnen met de Nederlandse Vragenlijst voor Eetgedrag (nve) eenvoudig en valide worden opgespoord. Met behulp van de nve kan worden vastgesteld of een dieet kans van slagen heeft of dat slechts van gedragstherapie baat te verwachten is.

BackgroundGene × environment (G × E) interactions in eating pathology have been increasingly investigated, however studies have been limited by sample size due to the difficulty of obtaining genetic data.ObjectiveTo synthesize existing G × E research in the eating disorders (ED) field and provide a clear picture of the current state of knowledge with analyses of larger samples.MethodComplete data from seven studies investigating community (n = 1750, 64.5% female) and clinical (n = 426, 100% female) populations, identified via systematic review, were included. Data were combined to perform five analyses: 5-HTTLPR × Traumatic Life Events (0–17 events) to predict ED status (n = 909), 5-HTTLPR × Sexual and Physical Abuse (n = 1097) to predict bulimic symptoms, 5-HTLPR × Depression to predict bulimic symptoms (n = 1256), and 5-HTTLPR × Impulsivity to predict disordered eating (n = 1149).ResultsThe low function (s) allele of 5-HTTLPR interacted with number of traumatic life events (P < .01) and sexual and physical abuse (P < .05) to predict increased likelihood of an ED in females but not males (Fig. 1). No other G × E interactions were significant, possibly due to the medium to low compatibility between datasets (Fig. 1).ConclusionEarly promising results suggest that increased knowledge of G × E interactions could be achieved if studies increased uniformity of measuring ED and environmental variables, allowing for continued collaboration to overcome the restrictions of obtaining genetic samples.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Exposure to high levels of house dust mite (HDM) allergens is associated with the development of allergic sensitization to HDM, a risk factor for the development of asthma, rhinitis, and allergic dermatitis. We studied the effect of an early intervention with mite-impermeable mattress covers on HDM allergen levels and the development of asthma and mite allergy throughout the first 8 years of life.High-risk children (allergic mother) were prenatally recruited and randomly allocated to two groups receiving mite allergen-impermeable (n = 416) and placebo mattress covers (n = 394) or no intervention (n = 472). Asthma and allergies were assessed yearly by questionnaire. Specific immunoglobulin E and bronchial hyper-responsiveness were measured at the age of 8 years. Mattress dust samples collected at different time points were analyzed for HDM allergens.At the age of 8 years, levels of HDM allergen Der f1 but not Der p1 were lower in the active than the placebo mattress cover group. In repeated measures analyses, we found a temporary decreased risk of asthma symptoms at the age of 2 years in the intervention group compared to the placebo group and a temporary association between higher HDM allergen exposure at the age of 3 months and more asthma symptoms.Early intervention with mite-impermeable mattress covers is successful in reducing exposure to Der f1; it only temporarily reduces the risk of asthma symptoms and does not reduce the risk of hay fever, eczema, and allergic sensitization.

Item does not contain fulltext In 2008 publiceerde het Kwaliteitsinstituut van de Gezondheidszorg CBO de richtlijn 'Diagnostiek en behandeling van obesitas'. Volgens deze richtlijn geldt bij volwassenen de diagnose obesitas bij een BMI (body mass index) >=30 kg/m2 (aangevuld met een beoordeling van de buikomvang). De in de richtlijn aanbevolen behandeling bestaat uit het verminderen van de energie-inname en het verhogen van de lichamelijke activiteit (en eventuele toevoeging op maat van psychologische interventies ter ondersteuning van gedragsverandering) (p 19 en p20). De aanbevolen behandeling in de richtlijn is gebaseerd op evidence uit twee meta-analyses (Anderson et al, 2001; Avenell et al, 2004). Volgens deze meta-analyses zou een energiebeperkt dieet (600 kilocalorieën minder dan gebruikelijk) resulteren in een gewichtsdaling van circa 5 (-3.5 tot 7) kg na een jaar, waarvan na vier tot vijf jaar een gewichtsdaling van 3,5 kg behouden zou blijven. Vreemd genoeg zijn in de richtlijn niet de uitkomsten verwerkt van een meta-analyse uit 2007 in The American Psychologist die tot een geheel andere conclusie kwam, namelijk Diets are not the answer (Mann et al., (2007). In deze meta-analyse kwam naar voren dat het percentage deelnemers dat op de lange termijn een deel van het gewichtsverlies wist vast te houden slechts klein was en dat bijna de helft van de deelnemers na vier jaar zelfs zwaarder was dan vóór het dieet. Wie heeft er gelijk? 4 p.

Item does not contain fulltext The present study addresses the emergence of emotional eating in adolescence in relation to maternal or paternal psychological control. A reduction of food intake is considered the biological natural response to distress, therefore we tested whether the a-typical stress response of emotional eating develops in interaction with genetic vulnerability. Carrying the A1 allele of the dopamine D2 receptor (DRD2) gene Taq1A polymorphism (rs1800497) is associated with reduced dopamine D2 receptor availability in the brain. We hypothesized that carrying this allele would confer risk for the development of emotional eating, particularly so in adolescents with adverse rearing experiences. Participants were 279 Dutch adolescents (average age of 13.4) that participated in a prospective study with a four-year follow-up. We found a moderator effect of DRD2 genotype on the relation between both maternal and paternal psychological control and increases in emotional eating in both sexes. Adolescents showed only an increase in emotional eating in relation to high psychological control if they carried at least one DRD2 A1 allele. This study is the first to show that the relationship between adverse rearing experiences and emotional eating might be dependent on genetic make-up.

Background In epidemiological studies, small-scale spatial variation in air quality is estimated using land-use regression (LUR) and dispersion models. An important issue of exposure modeling is the predictive performance of the model at unmeasured locations. Objective In this study, we aimed to evaluate the performance of two LUR models (large area and city specific) and a dispersion model in estimating small-scale variations in nitrogen dioxide (NO2) concentrations. Methods Two LUR models were developed based on independent NO2 monitoring campaigns performed in Amsterdam and in a larger area including Amsterdam, the Netherlands, in 2006 and 2007, respectively. The measurement data of the other campaign were used to evaluate each model. Predictions from both LUR models and the calculation of air pollution from road traffic (CAR) dispersion model were compared against NO2 measurements obtained from Amsterdam. Results and conclusion The large-area and the city-specific LUR models provided good predictions of NO2 concentrations [percentage of explained variation (R2) = 87% and 72%, respectively]. The models explained less variability of the concentrations in the other sampling campaign, probably related to differences in site selection, and illustrated the need to select sampling sites representative of the locations to which the model will be applied. More complete traffic information contributed more to a better model fit than did detailed land-use data. Dispersion-model estimates for NO2 concentrations were within the range of both LUR estimates.

Contains fulltext : 77275.pdf (Publisher’s version ) (Closed access) van Strien et al. [van Strien, T., Engels, R. C. M. E., van Leeuwe, J., Snoek, H. M. (2005). The Stice model of overeating: tests in clinical and non-clinical samples. Appetite, 45, 205–213] extended the negative affect pathway of Stice's dual pathway model of overeating Stice [Stice, E. (1994). Review of the evidence for a sociocultural model of bulimia nervosa and an exploration of the mechanisms of action. Clinical Psychology Review, 14(7), 633–661] successfully with the variables lack of interoceptive awareness and emotional eating. This study aimed to replicate these findings in a sample of female college students with food consumption as the measure for overeating. Structural equation modeling was used to test the original and the extended model and both models fitted. In the extended model, the relation between negative affect and consumption seemed to run only via lack of interoceptive awareness and emotional eating.

Het voorschrijven van een vermageringsdieet bij een probleem met overeten is controversieel, omdat lijnen in de restraint-theorie als belangrijke risicofactor voor anorexia nervosa, bulimia nervosa en de eetbuistoornis wordt aangemerkt. Sommige deskundigen gaan zelfs zover te propageren dat er met lijnen maar beter helemaal kan worden gestopt. Het is echter de vraag of dit terecht is, want we gaan er dan van uit dat lijnen bij niemand werkt en dat alle lijners het risico van een eetstoornis lopen. Dit blijkt gelukkig niet conform de werkelijkheid. Naast niet-succesvolle lijners blijken er wel degelijk ook succesvolle lijners te zijn. Ook wordt op basis van uitkomsten van recent onderzoek betwijfeld of eetstoornissen wel kunnen voorkomen uit een sterke mate van lijngerichtheid alleen. We zien dat ook de mate waarin een persoon gemakkelijk zijn of haar zelfcontrole verliest (disinhibitie) een belangrijke predictor is voor overeten en eetstoornissen. Met vragenlijsten kan op eenvoudige wijze kan worden nagegaan wie wel en wie niet behoort tot de succesvolle lijners en de niet-succesvolle lijners. De vragenlijsten maken het mogelijk eetstoornissen of eventueel subklinische vormen daarvan op te sporen. Bovendien kan van elke patient met een eet- of gewichtsprobleem worden vastgesteld of een goede respons op een vermageringsdieet te verwachten is of dat dieten juist gecontra-indiceerd zijn en alleen van psychotherapie of gedragstherapie heil te verwachten is.

We assessed the accuracy of questionnaire reports of cat and dog ownership and presence of cockroaches in predicting measured allergen concentrations in house dust. We collected dust samples in the homes of 932 newborns living in New England. Dust samples were taken from the main living area and the infant's bedding. Allergen content of house dust was measured by enzyme-linked immunosorbent assays (ELISA) and related to questionnaire information on past and current cat and dog ownership and presence of cockroaches. Allergen levels were dichotomized using the limit of detection and the following cut points: 1.0 microg/g and 8.0 microg/g for cat, 2.0 microg/g and 10.0 microg/g for dog, and 2 U/g and 8 U/g for cockroach allergen. For the upper cut point, both specificity and sensitivity of questionnaire-reported cat and dog ownership and presence of cockroaches were high. For the limit of detection and lower cut point, specificity was high (> 80%), whereas sensitivity was low, particularly for current cat and dog ownership (21-60%). Taking pet ownership during the preceding 2 years into account increased the sensitivity by 10%, but it remained relatively poor. In conclusion, questionnaire-reported pet ownership and presence of cockroaches predicts allergen levels above the upper cut point but is a relatively poor measure of allergen exposure above the limit of detection and the lower cut point. Knowledge of past pet ownership can improve pet allergen exposure assessment by means of questionnaire. However, for epidemiologic purposes, measured concentrations of allergens are necessary.

It has been suggested that the period immediately after birth is a sensitive period for the development of atopic disease.We investigated whether birth characteristics and environmental factors are associated with the development of atopic dermatitis in the first year of life.Seventy-six children with and 228 without atopic dermatitis, all children of mothers with respiratory allergy or asthma (PIAMA birth cohort study) were included in the study. Atopic dermatitis was defined as a positive history of an itchy skin condition with at least two of the following characteristics: visible dermatitis, history of outer arms/leg involvement, or general dry skin. Multiple logistic regression analysis was performed to study the independent effects of various risk factors.A birth weight/=4000 g compared to 3000-4000 g was a significant risk factor for atopic dermatitis (odds ratio (OR)=2.4; 95% CI: 1.1-5.1) as was day care attendance (OR=2.9; 95% CI: 1.5-5.9). Exclusive breastfeeding in the first 3 months was negatively associated with atopic dermatitis (OR=0.6; 95% CI: 0.3-1.2), especially with visible dermatitis (OR=0.4; 95% CI: 0.2-1.0). Gender, gestational age, the presence of siblings or pets, and parental smoking were not significantly associated with atopic dermatitis.This study shows that a high birth weight and day care attendance increase the risk of atopic dermatitis in the first year of life, while exclusive breastfeeding is a protective factor when dermatitis is found on inspection.

Reduction of allergen exposure from birth may reduce sensitization and subsequent allergic disease.To measure the influence of mite allergen-impermeable mattress encasings and cotton placebo encasings on the amount of dust and mite allergen in beds.A total of 810 children with allergic mothers took part in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study. Allergen-impermeable and placebo mattress encasings were applied to the childrens' and the parents' beds before birth. Dust samples were taken from the beds of children and their parents before birth and 3 and 12 months after birth. Extracts of dust samples were analysed for mite allergens (Der p 1 and Der f 1).Active mattress encasings were significantly more effective in reducing dust and mite allergen levels than placebo encasings. Mite allergen levels were low in general and the treatment effect was modest. Twelve months after birth, mattresses with active mattress encasings had about half the amount of Der 1 (Der p 1 + Der f 1)/m2, compared to mattresses with placebo encasings, for the child's and the parental mattress.This study shows that mite-impermeable mattress encasings have a significant but modest effect on dust and mite allergen levels of mattresses with low initial mite allergen levels, compared to placebo.

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Objective The examination of the prediction of grams of ice cream eaten by preload, restraint, susceptibility toward overeating, and interaction terms. Method A milkshake-ice cream study on 200 females using the Restraint Scale (RS) and the restraint and disinhibition scales from the Three-Factor Eating Questionnaire (TFEQ) and the Dutch Eating Behavior Questionnaire (DEBQ). Restraint and tendency toward disinhibition are treated as continuous variables in hierarchical step up multiple regression analyses. Results There was no disinhibition effect, as subjects did not overeat after the milkshake, neither in function of their restraint nor in function of their tendency toward overeating or any interactions between these. Tendency toward overeating was the most important variable for ice cream consumption. Restraint itself, the part that remained after tendency toward overeating had been partialed out, was not related to ice cream consumption. In terms of its association with ice cream consumption, the DEBQ disinhibition scale seems more promising than the TFEQ disinhibition scale. Discussion Restraint theory seems mainly valid for dieters with a tendency toward overeating. Tendency toward overeating may even be a better predictor than restraint, opening the possibility that overeating precedes dieting. © 2000 by John Wiley & Sons, Inc. Int J Eat Disord 28: 333–338, 2000.

The clarification of the present confusion about the confounding of success and failure in the measurement of restrained eating.Close inspection of results regarding the Restraint Scale (RS) and the restraint scales of homogeneous measures of restrained eating, for example, the restraint scales of the Three-Factor Eating Questionnaire (TFEQ) and the Dutch Eating Behaviour Questionnaire (DEBQ).Various studies have led to the distinction of two different types of confounding of success and failure in the measurement of restrained eating. The first confounding is associated with the RS and the inability of its scores to differentiate between inhibition and disinhibition of restraint in one person, as a result of variance across time within one person in food intake and binging. The second type of confounding applies to the homogeneous measures of restrained eating, for example, the restraint scales of the TFEQ and DEBQ. Here the confounding is associated with the inability of their restraint scores to differentiate between dieters with low versus high susceptibility toward failure of restraint, as a result of variance across persons in food intake and binging.In contrast to the first confounding, the confounding of successful and unsuccessful dieters in subjects with high restraint scores can be easily unconfounded, by using a two-factorial classification including both scores on "pure" measures of restraint and scales for tendency toward overeating. For future research, the distinction between successful and unsuccessful dieters is an important first step in clarifying why some dieters do overeat under certain conditions.

We have started a large birth cohort study in which pregnant women with and without atopy are differentially included. In view of the large number of subjects to be screened (12000), a simple questionnaire was developed for the assessment of atopy in pregnant women.The objective of our study was to evaluate the efficacy of a questionnaire using serum IgE tests.During a antenatal visit to the midwife clinic, 175 expecting mothers completed a questionnaire and from each subject blood was obtained in which total and specific IgE against house dust mite, cat, dog, birch and grass was determined.When atopy was defined as the presence of a positive test for IgE against at least one allergen, seven questions from the questionnaire had a sensitivity and specificity of 55.0% and 88.7%, respectively. With the use of the questionnaire it was possible to select about 50% of the subjects with specific IgE to one or more common inhalant allergens. The positive predictive value of the screening questions was 71.7%. Taking total IgE into account did not change these results.The screening questionnaire is an efficient tool for differential inclusion of subjects with and without atopy in epidemiological studies.

Are there differences in eating behaviour between obese and non-obese children? Using the parent version of the Dutch Eating Behaviour Questionnaire (DEBQ-parent version), the results of the present study suggest an affirmative answer to this question. The scores for obese children were significantly higher on the scales for emotional, external and restrained eating behaviour. Relationships were found between emotional eating and negative feelings of physical competence; between external eating and negative feelings of self-worth; and between both eating styles and various aspects of problem behaviour. No relationship was found between external eating and locus of control. Higher scores on both scales were associated with greater caloric intake. These findings suggest that DEBQ can be used as a screening instrument for assessing eating styles of obese children.

Since Ogden's 1993 study, the concept of restrained eating as measured by the restrained eating scale of the Dutch Eating Behaviour Questionnaire (DEBQ-R) has been further explored. In the present study, as in Ogden's study, most subjects did not differentiate between items relating to attempts at dieting and actual dieting. Ogden's conceptualization of the confounding of successful and failed restraint in the measurement of restraint, however, was not supported. First, there was no indication that trying to eat less is associated with unsuccessful dieting and actually eating less with successful dieting. Secondly, in contrast to Ogden, in our study the highest restraint score was found in subjects with low susceptibility toward failure of restraint. The results are discussed in terms of an alternative interpretation of the confounding of success and failure in the measurement of restraint. Instead of a confounding of success and failure within a subject (successful restraint is followed by failure of restraint), it would be better interpreted in terms of a difference in eating behaviour between subjects. Within the population of restraint eaters there are two subpopulations: those with a low versus those with a high tendency toward overeating - successful and failed dieters, respectively.

It has been experimentally shown that the population of high restrained eaters consists of two subpopulations, i.e., those with a low and those with a high susceptibility toward failure of restraint. Only those who combined high restraint with high scores on the disinhibition scale of the TFEQ (Three-Factor Eating Questionnaire) showed overeating after a preload. The aim of the present study was to assess the concurrent validity of a two-factorial classification using the Dutch Eating Behavior Questionnaire (DEBQ) scales for restraint, emotional and external eating, as well as the bulimia scale of the Eating Disorder Inventory (EDI) for locating dieters with low or high susceptibility toward failure. It was examined whether the resulting two-group classification is associated with self-reported behaviors and features of psychopathology, which are generally thought to differentiate both groups of dieters. The results indicated that the two-group classification was indeed associated with many of these behaviors and features of psychopathology. It was concluded that this classification has a good concurrent validity.

Relationships were studied between emotional, external and restrained eating behavior, and bulimia, and also between these types of eating behavior and body dissatisfaction and drive for thinness.The sample consisted of female adolescents. Eating behavior and body evaluation were measured with scales of the Dutch Eating Behaviour Questionnaire (DEBQ) and the Eating Disorders Inventory (EDI).Significant and high relationships were found between emotional and external and bulimic eating behavior. The same was true for restrained eating, and body dissatisfaction and drive for thinness. However, results from factor analyses suggest that the three types of overeating do not point to one and the same construct. Further, also restrained eating was found to point at a different construct than the construct associated with body dissatisfaction and drive for thinness. Finally, no high relationships were found between restrained eating and "obese" or bulimic eating patterns. DISCUSSION. The low relationship between restrained eating and various types of overeating is in line with earlier results with the DEBQ Restraint scale and offers further support for the contention that the excessive food intake found in subjects with high scores on the Herman and Polivy's Restraint Scale (RS) may be an artefact of the RS, as a result of its bias towards the selection of a counterregulating sample.

Although there is a strong relationship between emotional and external eating, separate subscales for these behaviors have been constructed in the Dutch Eating Behavior Questionnaire. This study tries to establish whether this distinction is justified. We studied relationships among self-reported ( 1) degree of emotional and external eating behavior and (2) problems with (a) emotional distress and relationships, (b) stimulus-boundness (inappropriate amounts of either too much or too little exercise, work, leisure activities, and spending money), and (c) problems with substance use (alcohol, illicit drugs, nicotine, or caffeine) in a sample of female students. No relationships were found between either type of eating behavior and problems with substance use. Furthermore, the significant relationship between emotional and external eating behavior and stimulus-boundness disappeared in the subsample who had problems with overeating. The fact that in all samples emotional eating was significantly related to problems with emotional distress and relationships (anxiety, depression, phobias, suicidal acts or ideations, intimate relations, and sexual contacts) but external eating was not, suggests that the two types of eating behaviors refer to independent constructs. Thus, the use of separate scales to measure these theoretically different aspects of overeating seems warranted.

This article analyses Allison and Heshka's (Internal Journal of Eating Disorders, 13, 289-295, 1993.) critical analysis of studies supporting psychosomatic theory. Questionned first is, Allison and Heshka's contention that the obese overreport emotional eating as a result of effects of demand characteristics, social desirability, and interpersonal expectancies. These effects, however, indicate that a more plausible response would be an underreport of emotional eating. Also addressed is Allison and Heshka's (Eating Disorders: The Journal of Treatment and Prevention, 1, 31-38, 1993.) contention that a high correlation between a measurement instrument and a measure of social desirability invalidates that measurement instrument. Finally, in a rebuttal of Allison and Heshka's critical analysis of studies supporting psychosomatic theory, it is elaborated why emotional eating explains so little variance in weight gain and obesity.

Contains fulltext : 28694.pdf (Publisher’s version ) (Open Access) This article analyses Allison and Heshka's (International Journal of Eating Disorders, 13, 289–295, 1993.) critical analysis of studies supporting psychosomatic theory. Questionned first is, Allison and Heshka's contention that the obese overreport emotional eating as a result of effects of demand characteristics, social desirability, and interpersonal expectancies. These effects, however, indicate that a more plausible response would be an underreport of emotional eating. Also addressed is Allison and Heshka's (Eating Disorders: The Journal of Treatment and Prevention, 1, 31–38, 1993.) contention that a high correlation between a measurement instrument and a measure of social desirability invalidates that measurement instrument. Finally, in a rebuttal of Allison and Heshka's critical analysis of studies supporting psychosomatic theory, it is elaborated why emotional eating explains so little variance in weight gain and obesity.

Two studies experimentally tested the effects of television food commercials on concurrent snack food intake while watching television in young children (8–12 years old). In the first study, children (N = 120) watched a movie interrupted by two commercial breaks, that contained either child-targeted food commercials or neutral commercials. While watching, the children could freely eat palatable food. An interaction effect was found between commercial type and sex of the child. Food intake in boys was higher when they watched the food commercials than when they watched the neutral commercials, whereas food intake in girls was slightly lower when they watched the food commercials than when they watched the neutral commercials. The results suggest that boys are susceptible to food cues in commercials. The second study (N = 121) tested the effects of adult-targeted food commercials (energy-dense and light food products), using the exact same design. Furthermore, the moderating role of maternal behaviors was investigated. The commercial breaks contained commercials promoting either energy-dense foods, low energy versions of the same energy-dense foods (light food commercials), or neutral commercials. Children who perceived maternal encouragement to be thin ate slightly more when exposed to energy-dense food commercials and especially when exposed to light food commercials than when exposed to neutral commercials. This was not found for children who perceived no maternal encouragement to be thin. These findings might suggest that exposure to adult-targeted light food cues induced disinhibition in children who experienced maternal encouragement to be thin.

To determine the relationship between mite allergen (Der p I) concentrations in house dust and presence of chronic respiratory symptoms in children.Case control study.The provinces of Gelderland and North-Holland in the Netherlands.Questionnaires were handed to pupils of 38 schools to take home; about 6000 were returned (80% response). A home visit was paid to 259 children with chronic respiratory symptoms ('cases') and to 257 symptom-free 'control' children. Using an enzyme immunoassay the Der p I concentrations of living room floor dust, bedroom floor dust and mattress dust were determined. Specific IgE was determined in serum.Der p I concentrations higher than 2000 ng/g were found in 86% of the dwellings and concentrations higher than 10,000 ng/g in 55%. Cases were exposed to lower Der p I concentrations than controls. However, cases sensitised to dust mites were exposed to higher Der p I concentrations than non-sensitised cases, both living in homes where no allergen avoidance measures had been taken in the past.Exposure to Der p I in the home was associated with sensitisation to dust mites in children with chronic respiratory symptoms living in homes where no allergen avoidance measures had been taken.

In an exploratory study in women, the relationships between scales of emotional eating, external eating, and restrained eating, and body mass index (BMI = weight/height2) were studied, as well as the interrelationships between these three eating behavior components. In addition, the relationships between the three eating behavior scales and 19 personality scales were examined. Finally, differences between obese and latent obese women with respect to eating behavior and personality were investigated. Significant relationships were found between BMI and emotional eating, and between BMI and external eating/perceived hunger, but not between BMI and Restrained Eating. Also, restrained eating was found not to be related to the other two eating behavior components. Of the three eating behavior components, emotional eating was shown to have the clearest relationships with a number of personality traits. No difference was observed between the eating behavior of latent obese and obese women, but these groups differed as to a number of personality traits. These results are discussed in terms of consequences for prevalent theories on restrained, external, and emotional eating.

Within the framework of a large-scale research project on overweight, relationships between body mass index (BMI; weight/height) and two types of eating behaviour (restrained eating and emotional eating) were determined. All results obtained on one assessment date in a longitudinal study within this project were found to differ significantly from those of a cross-sectional study. The present study aimed to replicate these results on another assessment date of the same longitudinal study, and in another cross-sectional sample. The two types of studies were found to differ systematically. This difference may well be attributable to greater prevalence in the longitudinal study of the response set, acquiescence in the women of normal weight, and social desirability in the overweight women. These response biases may have resulted from sensitization of the subject to the questionnaires, and also from the intensive contact between subject and investigator due to repeated measurements. Thus in further studies use of independent response-set marker scales is recommended to improve identification and control of response sets.

The results are reported of a longitudinal study on effects of negative life events on change in body mass index (BMI; weight/height2 (kg/m2)) in men and women classified as either low or high emotional eaters. It was predicted that emotional eating and negative life events would have an interaction effect on change in BMI. Low emotional eaters would gain less weight and high emotional eaters would gain more weight after experiencing negative life events, than those who had not experienced such events. For men, emotional eating and negative life events were found to have a significant interaction effect on change in BMI 6 months after the assessment of life events on the first, but not on the second assessment date in the same study. Data on the long-term effects of negative life events indicate that the significant interaction effect found was not an artefact. For women, no such interaction effects were found. Thus, it is concluded that the hypothesis was confirmed to some extent in the men, but not in the women.