Psychometric Evaluation of the Food Life Questionnaire-Short Form among Brazilian Adult Women.

Measures of beliefs and attitudes toward food have generally been limited to the measurement of more pathological eating attitudes (e.g., disordered eating). The Food Life Questionnaire (FLQ) and its short form (FLQ-SF) were developed to examine attitudes toward a broader range of foods; however, the factor structure of the FLQ-SF was not confirmed in any study with young women. In the present study, we performed a psychometric evaluation of the Brazilian Portuguese translation of the FLQ-SF in a sample of 604 women. We evaluated the factor structure using a two-step, split-sample exploratory and confirmatory factor analytic approach. Results supported a four-factor structure (i.e., weight concern, diet-health orientation, belief in a diet-health linkage, and food and pleasure) with 18 items (χ2/df = 2.09; CFI = 0.95; TLI = 0.94; RMSEA = 0.05 (90% CI = 0.04; 0.06; p > 0.05); and SRMR = 0.08). Additionally, we found good internal consistency for all FLQ-SF subscales (McDonald's ω = 0.79-0.89) and convergent validity with measures of feelings, beliefs, and behaviors involved in food attitudes. Collectively, these results support the use of the FLQ-SF in Brazilian women and provide a foundation to expand the literature on beliefs and attitudes toward food in this population.

Food healthiness judgements among Brazilian and German lay adults.

This study investigated which foods are most saliently judged as healthy and unhealthy in Brazil and Germany and the reasons for these judgements. Dietary guidelines in the two countries differ in that those in Brazil are based on a food processing classification rather than nutrient profiling, whereas dietary guidelines in Germany do not include the processing level of food. In an online study with 355 lay adults (Brazil n = 205, Germany n = 150), we explored which foods are listed as healthy and unhealthy using a free-listing method. The main reasons for these healthiness judgements were then identified with a one or two-word phrase and compared between countries. Saliency analysis was conducted to identify the 15 most salient healthy and unhealthy foods in each country. Principles of content analysis were used to assess the reasons why these 15 items were listed as most salient by the participants. Results showed that both Brazilians and Germans listed mostly natural or minimally processed food (e.g. fruits, vegetables, grains, fish and milk) as healthy, whereas types of convenience and fast food, sweets and other ultra-processed foods (e.g. chocolate, soda, French fries, pizza and hamburger) were the most salient unhealthy items listed in both countries. Differences in culturally relevant items listed in each country are discussed. Further, in both countries, despite differences in their dietary guidelines, food healthiness judgements for the most salient items listed relied heavily on the nutritional content of food, reinforced the 'good/healthy' and 'bad/unhealthy' dichotomy, and were centred on benefits or harms to the body (e.g. prevention or cause of diseases and weight control). The similarity of food healthiness judgements between the two countries, together with their agreement with conventional health claims and dietary guidelines, suggest that lay Brazilian and German adults are knowledgeable about the general concepts of 'healthy' and 'unhealthy' food. Finally, these findings suggest that rather than just providing more nutritional information, policymakers and health professionals need to take into account the multiple psychosocial and environmental determinants of eating in these countries.

Effect of nutrient, processing and hedonic claims on food-related perceptions: An experimental online study in Brazil and Germany.

Prior studies on perceived healthiness of foods have often compared nutrient and hedonic claims, neglecting comparisons to a control condition. The effect of food claims focusing on the food processing level has received considerably less research attention, although food processing has been included in dietary guidelines in Brazil. Thus, the present study aimed to explore the effect of a control and processing claim, additionally to the effects of a nutrient. and hedonic claim, on perceptions related to a food item typically considered "less healthy" (chocolate cake). We further compared these effects between Brazil and Germany, a country where food processing is currently not included in dietary guidelines. A total of 634 lay adults were recruited in a cross-sectional online study and randomised to see the photo of a piece of cake with one of the four different claim conditions and to report their health-related perceptions of the cake. The main analyses included two-way ANCOVAs (4 claims x 2 countries) for each dependent variable controlled for gender, age and level of hunger; followed by post hoc tests. Overall, results revealed that in both countries, the claims highlighting nutrients or processing aspects rendered the perceptions of the cake healthier compared to the control claim. These effects were more pronounced among Brazilian than among German participants. Food-related perceptions mostly did not differ between the hedonic and control claim and did not differ at all between the nutrient and processing claims. In conclusion, it is noteworthy that, even for an inherently considered "less healthy food item" (chocolate cake) nutrient and processing claims increase healthiness perceptions. While our findings may imply that in both countries lay people are highly susceptible to nutrient claims, food processing aspects seem to be similarly relevant.

[Psychosocial Influence Scale of Fruit and Vegetable Consumption among Adolescents: Adaptation and Factorial Validity]. / Escala de Influência Psicossocial da ingestão de Frutas, Verduras e Legumes do Adolescente: Adaptação e Validade Fatorial.

Instruments to evaluate psychosocial determinants of fruit and vegetable (F&V) consumption among adolescents are scarce, and there appears to be only one instrument - unnamed and unvalidated - that investigates determinants derived from theories of social psychology targeting the frequency of F&V consumption among adolescents. The scope of this paper was to present the process of cultural adaptation and factor validation of this instrument al-lowing its use in studies with Brazilian adolescents. The cross-cultural adaptation process was accomplished and the final version - named Psychosocial Influence Scale for Fruit and Vegetable Consumption among Adolescents (PSI-FAVES) - was tested with 429 students (58% female) using McDonald's omega (ω) reliability and Confirmatory Factor Analysis (CFA) as analytical methods. The final version required refinement and the instrument showed adequate overall reliability (ω=0.86) and good fit of the data to the previously elaborated model (CFI=0.955; TLI=0.951 and RMSEA (90%CI) =0.043 (0.038-0.049)), being the first systematically validated instrument to investigate psychosocial determinants of F&V consumption among adolescents.

Instrumentos para avaliar determinantes psicossociais da ingestão de frutas, verduras e legumes (FLV) de adolescentes são escassos, e há um instrumento - sem nome e validação - que investiga estes determinantes oriundos de teorias da psicologia social e direcionado à frequência de ingestão semanal de FLV de adolescentes. O objetivo foi apresentar o processo de adaptação e validação fatorial deste instrumento para ser aplicado em estudos na população brasileira. Realizou-se equivalência conceitual e de itens; equivalência semântica por tradutores e especialistas e semântica e operacional por entrevistas dirigidas com público-alvo. A versão final - denominada Escala de Influências Psicossociais da ingestão de Frutas, Verduras e Legumes de Adolescentes (PSI-FAVES) - foi testada com 429 estudantes (58% mulheres) utilizando confiabilidade por ômega de McDonald (ω) e Análise Fatorial Confirmatória (AFC) como métodos analíticos. A versão final demandou refinamento e o instrumento apresentou confiabilidade total adequada (ω=0,86) e bom ajuste dos dados ao modelo previamente conjecturado (CFI=0,955; TLI=0,951 e RMSEA (90%IC)=0,043 (0,038-0,049), sendo o primeiro instrumento sistematicamente validado para investigar determinantes psicossociais da ingestão de FLV de adolescentes.

Escala de Influência Psicossocial da ingestão de Frutas, Verduras e Legumes do Adolescente: Adaptação e Validade Fatorial / Psychosocial Influence Scale of Fruit and Vegetable Consumption among Adolescents: Adaptation and Factorial Validity

Resumo Instrumentos para avaliar determinantes psicossociais da ingestão de frutas, verduras e legumes (FLV) de adolescentes são escassos, e há um instrumento - sem nome e validação - que investiga estes determinantes oriundos de teorias da psicologia social e direcionado à frequência de ingestão semanal de FLV de adolescentes. O objetivo foi apresentar o processo de adaptação e validação fatorial deste instrumento para ser aplicado em estudos na população brasileira. Realizou-se equivalência conceitual e de itens; equivalência semântica por tradutores e especialistas e semântica e operacional por entrevistas dirigidas com público-alvo. A versão final - denominada Escala de Influências Psicossociais da ingestão de Frutas, Verduras e Legumes de Adolescentes (PSI-FAVES) - foi testada com 429 estudantes (58% mulheres) utilizando confiabilidade por ômega de McDonald (ω) e Análise Fatorial Confirmatória (AFC) como métodos analíticos. A versão final demandou refinamento e o instrumento apresentou confiabilidade total adequada (ω=0,86) e bom ajuste dos dados ao modelo previamente conjecturado (CFI=0,955; TLI=0,951 e RMSEA (90%IC)=0,043 (0,038-0,049), sendo o primeiro instrumento sistematicamente validado para investigar determinantes psicossociais da ingestão de FLV de adolescentes.

Abstract Instruments to evaluate psychosocial determinants of fruit and vegetable (F&V) consumption among adolescents are scarce, and there appears to be only one instrument - unnamed and unvalidated - that investigates determinants derived from theories of social psychology targeting the frequency of F&V consumption among adolescents. The scope of this paper was to present the process of cultural adaptation and factor validation of this instrument al-lowing its use in studies with Brazilian adolescents. The cross-cultural adaptation process was accomplished and the final version - named Psychosocial Influence Scale for Fruit and Vegetable Consumption among Adolescents (PSI-FAVES) - was tested with 429 students (58% female) using McDonald's omega (ω) reliability and Confirmatory Factor Analysis (CFA) as analytical methods. The final version required refinement and the instrument showed adequate overall reliability (ω=0.86) and good fit of the data to the previously elaborated model (CFI=0.955; TLI=0.951 and RMSEA (90%CI) =0.043 (0.038-0.049)), being the first systematically validated instrument to investigate psychosocial determinants of F&V consumption among adolescents.

Cross-cultural adaptation of the Eating Beliefs Questionnaire into Brazilian Portuguese.

OBJECTIVE: The aim of this study was the cross-cultural adaptation of the Eating Belief Questionnaire (EBQ)-an instrument that assesses positive, negative, and permissive eating beliefs in relation to binge eating episodes-in its shorted version of 18 questions, into Brazilian Portuguese, for female teenagers. METHODS: Conceptual, semantic, cultural and operational equivalence of the items were evaluated. The semantic and cultural equivalence involved 12 bilingual people and 12 experts in eating behavior. Operational equivalence consisted of applying the transcultural adapted version of the EBQ-18 to 20 girls with a mean age of 17.55 (SD=1.00) years. Item's clarity and understanding were assessed by the Content Validity Coefficient. RESULTS: Questions 5, 6, 11, 14, 15, 16, 17 and 18, with adequate classification percentage for all equivalences, were not altered. The other items were adapted according to the committee's suggestions and by consensus among researchers. The adapted version of the EBQ-18 in Brazilian Portuguese displayed good content validity coefficient for clarity (CVC=0.975) and comprehension (CVC=0.971); except for item 3, all items had values between 0.88 and 1.00. CONCLUSION: The Brazilian Portuguese version of the EBQ-18 had a good understanding by the adolescent public when it comes to investigate the role of dietary beliefs in the maintenance of binge eating episodes. Future studies with adolescents are recommended, jointly assessing risk for and presence of eating disorders in significant clinical and non-clinical samples, as well as its psychometrics properties.

Effect of a Nutritional Behavioral Intervention on Intuitive Eating in Overweight Women With Chronic Kidney Disease.

OBJECTIVES: This study aimed to evaluate the impact of a nutritional behavioral intervention on intuitive eating (IE) scores of overweight non-dialysis-dependent women with chronic kidney disease and to investigate the relationship of IE scores with demographic, nutritional, and quality of life parameters in this group. DESIGN AND METHODS: This is a prospective noncontrolled clinical trial of a behavioral multisession group intervention for dietary management. Each group comprised five to eight participants in 14 weekly or biweekly sessions lasting about 90 minutes each. The IE principles were discussed during the meetings. The IE scale 2, translated and adapted to the study population, with a four-factor model was applied to assess IE attitudes. The 36-Item Short-Form Health Survey questionnaire was applied to assess health-related quality of life. RESULTS: Of the 33 patients who began participation in the study, 23 patients (median [interquartile range]: age = 62.0 years [58.0-68.0]; 52.2% with diabetes; body mass index = 32.6 kg/m2 [30.2-39.3]; estimated glomerular filtration rate = 28.0 mL/min/1.73 m2 [22.0-31.0]) completed the intervention. Except for the IE subscale Body-Food Choice Congruence, the IE total score and all its subscales (Unconditional Permission to Eat, Eating for Physical Rather than Emotional Reasons, Reliance on Hunger and Satiety Cues, and Body-Food Choice Congruence) improved after the intervention. In a cross-sectional analysis, more intuitive eaters were older and had better scores for health-related quality of life. CONCLUSIONS: The nutritional behavioral intervention embracing IE principles was effective to improve IE attitudes for this group of chronic kidney disease patients. These results are promising and may contribute to a paradigm change in the strategies to enhance motivation and adherence to dietary recommendations in this population.

Cross-cultural adaptation of the Eating Beliefs Questionnaire into Brazilian Portuguese / Adaptação transcultural do Eating Beliefs Questionnaire para português do Brasil

ABSTRACT Objective: The aim of this study was the cross-cultural adaptation of the Eating Belief Questionnaire (EBQ)—an instrument that assesses positive, negative, and permissive eating beliefs in relation to binge eating episodes—in its shorted version of 18 questions, into Brazilian Portuguese, for female teenagers. Methods: Conceptual, semantic, cultural and operational equivalence of the items were evaluated. The semantic and cultural equivalence involved 12 bilingual people and 12 experts in eating behavior. Operational equivalence consisted of applying the transcultural adapted version of the EBQ-18 to 20 girls with a mean age of 17.55 (SD=1.00) years. Item's clarity and understanding were assessed by the Content Validity Coefficient. Results: Questions 5, 6, 11, 14, 15, 16, 17 and 18, with adequate classification percentage for all equivalences, were not altered. The other items were adapted according to the committee's suggestions and by consensus among researchers. The adapted version of the EBQ-18 in Brazilian Portuguese displayed good content validity coefficient for clarity (CVC=0.975) and comprehension (CVC=0.971); except for item 3, all items had values between 0.88 and 1.00. Conclusion: The Brazilian Portuguese version of the EBQ-18 had a good understanding by the adolescent public when it comes to investigate the role of dietary beliefs in the maintenance of binge eating episodes. Future studies with adolescents are recommended, jointly assessing risk for and presence of eating disorders in significant clinical and non-clinical samples, as well as its psychometrics properties.

RESUMO Objetivo: Conduzir adaptação transcultural, para o português brasileiro, da versão reduzida de 18 questões do Eating Belief Questionnaire (EBQ) ao público de meninas adolescentes. O instrumento avalia crenças positivas, negativas e permissivas do comer com relação a episódios de compulsão. Métodos: Realizou-se avaliação das equivalências conceitual, semântica, cultural e operacional dos itens. A equivalência semântica e cultural envolveu 12 bilíngues e 12 especialistas em comportamento alimentar. A equivalência operacional consistiu na aplicação da versão transcultural adaptada do EBQ-18 em 20 meninas, com média de idade de 17,55 anos (DP=1,00). O grau de clareza e compreensão das questões foi avaliado pelo coeficiente de validade de conteúdo. Resultados: Na avaliação semântica e cultural, 8 itens tiveram classificação adequada para todas as equivalências e não sofreram alterações; 10 itens foram alterados de forma mínima, conforme sugestões dos especialistas e mediante consenso entre pesquisadoras; e apenas o item 3 sofreu adaptação após resultados da equivalência operacional. O modelo adaptado para o português apresentou bom coeficiente de validade de conteúdo para clareza (CVC=0,975) e compreensão (CVC=0,971); com exceção do item 3, todos os itens foram avaliados com valores entre 0,88 e 1,00. Conclusão: A versão em português do EBQ-18 apresentou-se com boa compreensão do público adolescente para investigação do papel de crenças alimentares na manutenção de episódios de compulsão. Recomendam-se trabalhos futuros avaliando conjuntamente risco e presença de transtornos alimentares em amostras significativas clínicas e não clínicas, bem como suas propriedades psicométricas.

Similar or different? Comparing food cultures with regard to traditional and modern eating across ten countries.

Food cultures can play a role in health and well-being. This raises the questions of whether nation boundaries unite the food cultures of different regions and ethnic groups, what characterises food cultures from very different parts of the world, and what similarities and differences exist. The present study aimed to investigate these questions with regard to eating traditions and modern eating practices. In this cross-sectional study, we recruited 3722 participants from ten countries - Brazil, China, France, Germany, Ghana, India, Japan, Mexico, Turkey, and the USA. Participants represented 25 regional and ethnic groups. They were queried about 86 traditional and modern facets of their food cultures in interviews, paper-pencil and online questionnaires. First, hierarchical cluster analysis suggested nine distinct clusters of food cultures - the food cultures of the Brazilian, Chinese, Ghanaian, Indian, Japanese, Mexican, Turkish, African and Latin US American samples, and of European descendants. Interestingly, for seven of the ten investigated countries, nation boundaries united food cultures. Second, each of the nine food culture clusters was characterised by a unique pattern of traditional and modern eating practices. Third, the nine food culture clusters varied more in their traditional eating practices than their modern eating practices. These results might promote a better understanding of the link between food cultures and health and well-being that goes beyond nutrients. For instance, food cultures might be linked to well-being via strengthening people's sense of cultural identity. Moreover, the present results contribute to a better understanding of the complex interplay between food and culture, and could help in developing culturally competent interventions to improve diet and reduce the risk of eating-related diseases.

Anti-fat attitudes of Nutrition undergraduates in Brazil toward individuals with obesity.

Obesity-related prejudice and discrimination may have a source in health professionals and students. The objective was to assess anti-fat attitudes among Brazilian nutrition undergraduates who reported demographic data, weight, height and responded the Antifat Attitudes Test (AFAT) and the Brazilian Silhouette Scales to assess body image satisfaction and perception. Total and subscales of AFAT scores were compared among categories using the Mann-Whitney U test. Associations of participants' characteristics with the AFAT were analyzed using multiple linear regression. Total AFAT score was positively associated with male sex (ß: .13; p < .001), age (ß: .06; p < .001), educational institution outside capital (ß: .03; p < .05), private institutions (ß: .08; p < .001); and negatively associated with income (ß: -.05; p = .006), participants who perceived themselves with increased BMI (ß: -.15; p < .001) and those at the third year of course (ß: -.05; p = .041). Subscales scores were positively associated with male sex and age; and negatively associated with those who perceived themselves heavier. They have anti-fat attitudes especially if they were man, older, from private institutions, are at the beginning of the course, and have lower household income - and less weight bias if they perceived with increased BMI.

Avaliação preliminar das propriedades psicométricas do Fat Talk Questionnaire em uma amostra de mulheres jovens / Preliminary assessment of the psychometric properties of the Fat Talk Questionnaire in a sample of young women

Fat talk (FT) é um termo utilizado para descrever um comportamento caracterizado pela fala, pensamento e sentimentos pejorativos em relação ao próprio corpo e ao corpo de outra pessoa. Ele é predominante no sexo feminino e se relaciona com pior imagem corporal e pior autoestima. O Fat Talk Questionnaire (FTQ) é instrumento previamente adaptado transculturalmente para jovens mulheres no Brasil. O objetivo desse estudo foi realizar a avaliação preliminar de suas propriedades psicométricas. O FTQ foi aplicado em 99 jovens do sexo feminino (18 a 19 anos e 11 meses), juntamente com questões sociodemográficas, a Escala de Autoestima de Rosenberg (EAR) e o Body Shape Questionnaire (BSQ8) para avaliação da validade convergente (pelo teste correlação de Pearson). Foi realizada a análise fatorial confirmatória utilizando-se do modelo de equações estruturais com técnica de amostragem por alocação. A consistência interna foi avaliada por meio do Alpha de Cronbach e MacDonald Ômega. O modelo de equações estruturais sustentou uma escala unidimensional (x2/gl = 1,62; CFI = 0,953; TLI = 0,935 e RMSEA = 0,079 [IC95%: 0,051-0,176]). O instrumento apresentou α-Cronbach de 0,89 [IC95%: 0,85-0,92] e ω-MacDonald de 0,89; houve alta correlação com o BSQ8 (0,70) e correlação média (0,42) com o EAR. O instrumento apresentou adequada consistência interna, a análise fatorial confirmatória do FTQ sustentou um instrumento unidimensional com cargas fatoriais satisfatórias, e encontrou-se correlação de mais comportamento de Fat Talk com maior preocupação com a forma do corpo e pior autoestima.

Fat Talk (FT) is a term used to describe a behavior characterized by speech, thinking, and derogatory feelings towards one's own body and the body of another person. It is predominant in females and is related to worse body image and worse self-esteem. The Fat Talk Questionnaire (FTQ) is an instrument previously adapted cross-culturally for young women in Brazil. The aim of this study was to carry out a preliminary assessment of its psychometric properties. The FTQ was applied to 99 young females (18 to 19 years and 11 months), along with sociodemographic questions, the Rosenberg Self-Esteem Scale (RSS) and the Body Shape Questionnaire (BSQ8) to assess convergent validity (through the test Pearson's correlation). Confirmatory factor analysis was performed using the structural equation model with the allocation sampling technique. Internal consistency was assessed using Cronbach's Alpha and MacDonald's Omega. The structural equation model supported a one-dimensional scale (x2/gl = 1.62; CFI = 0.953; TLI = 0.935 and RMSEA = 0.079 [95%CI: 0.051-0.176]). The instrument presented an α-Cronbach of 0.89 [95%CI: 0.85-0.92] and an ω-MacDonald of 0.89; there was a high correlation with the BSQ8 (0.70) and a mean correlation (0.42) with the RSS. The instrument presented an adequate internal consistency, the confirmatory factor analysis of the FTQ supported a unidimensional instrument with satisfactory factor loadings, and a correlation was found between more Fat Talk behavior with greater concern with body shape and worse self-esteem.

Anti-fat attitudes of Nutrition undergraduates in Brazil toward individuals with obesity / Atitudes negativas em relação à obesidade por estudantes de Nutrição do Brasil

Abstract Obesity-related prejudice and discrimination may have a source in health professionals and students. The objective was to assess anti-fat attitudes among Brazilian nutrition undergraduates who reported demographic data, weight, height and responded the Antifat Attitudes Test (AFAT) and the Brazilian Silhouette Scales to assess body image satisfaction and perception. Total and subscales of AFAT scores were compared among categories using the Mann-Whitney U test. Associations of participants' characteristics with the AFAT were analyzed using multiple linear regression. Total AFAT score was positively associated with male sex (ß: .13; p < .001), age (ß: .06; p < .001), educational institution outside capital (ß: .03; p < .05), private institutions (ß: .08; p < .001); and negatively associated with income (ß: -.05; p = .006), participants who perceived themselves with increased BMI (ß: -.15; p < .001) and those at the third year of course (ß: -.05; p = .041). Subscales scores were positively associated with male sex and age; and negatively associated with those who perceived themselves heavier. They have anti-fat attitudes especially if they were man, older, from private institutions, are at the beginning of the course, and have lower household income - and less weight bias if they perceived with increased BMI.

Resumo O preconceito e a discriminação relacionados à obesidade podem vir de profissionais de saúde e estudantes. O objetivo foi avaliar as atitudes negativas em relação à obesidade entre universitários brasileiros de nutrição que relataram dados demográficos, peso, altura e responderam o Antifat Attitudes Test (AFAT) e a Escala de Silhuetas Brasileira para avaliar a satisfação e percepção da imagem corporal. Os escores total e das subescalas da AFAT foram comparados entre as categorias usando o teste U de Mann-Whitney. As associações das características dos participantes com a AFAT foram analisadas por meio de regressão linear múltipla. A pontuação total da AFAT foi positivamente associada ao sexo masculino (ß: 0,13; p < 0,001), idade (ß: 0,06; p < 0,001), instituições de ensino fora da capital (ß: 0,03; p < 0,05) e instituições privadas (ß: 0,08; p < 0,001); e negativamente associada à renda (ß: -0,05; p = 0,006), participantes que se percebiam acima do IMC real (ß: -0,15; p < 0,001) e do terceiro ano do curso (ß: -0,05; p = 0,041). As pontuações das subescalas foram positivamente associadas com sexo masculino e idade; e negativamente associadas com aqueles que se percebiam mais pesados. Os estudantes tinham atitudes antigordura especialmente se eram homens, mais velhos, de instituições privadas, no começo do curso e baixa renda - e menos se percebiam seu IMC maior.

Cross-cultural adaptation of the Fat Talk Questionnaire for Brazilian Portuguese language. / Adaptação transcultural do Fat Talk Questionnaire para o Português do Brasil.

OBJECTIVE: To perform the cross-cultural adaptation of the Fat Talk Questionnaire into Brazilian Portuguese with focus on adolescent girls. METHODS: The steps taken in this research were: conceptual and item equivalence, semantics, operational. The conceptual and item equivalence was performed by researchers in the field of Nutrition and body image; semantics involved translators fluent in English and Portuguese (n=3) and experts (n=19) in body image and eating behavior. Step 3 included 32 female adolescents (15 and 18 years), who answered the translated and adapted version to assess comprehension by the target audience. RESULTS: Of the 14 items, six were considered adequate by the experts and 3 items required minimal language adjustments. Five items needed broader changes for cultural and idiomatic adaptation. The back-translation was approved by the original authors. The average response time by the adolescents was 3.5 minutes, with no queries. CONCLUSION: The scale was translated and adapted to Brazilian Portuguese aimed at female adolescents, showing satisfactory results in the translation process, conceptual, semantic and operational equivalence. Analyses of external validity, measurement equivalence and reproducibility were also required.

OBJETIVO: Realizar a adaptação transcultural do Fat Talk Questionnaire para o português do Brasil com foco no grupo de meninas adolescentes. MÉTODOS: O trabalho seguiu as etapas de equivalência conceitual e de itens, semântica e operacional. A avaliação conceitual e de itens foi realizada por pesquisadores da área de nutrição e imagem corporal; a semântica envolveu tradutores fluentes em inglês e português (n = 3) e experts (n = 19) em imagem corporal e comportamento alimentar. A terceira etapa contou com 32 adolescentes do sexo feminino (de 15 a 18 anos) que responderam à versão traduzida e adaptada para avaliação da compreensão pelo público-alvo. RESULTADOS: Dos 14 itens do instrumento, seis foram considerados adequados pelos experts, três necessitaram de adequações mínimas de linguagem e cinco careciam de alterações mais amplas para adequações cultural e idiomática. A retrotradução foi aprovada pelos autores originais. O tempo médio de resposta pelas adolescentes foi de 3,5 minutos, não sendo apontadas dúvidas. CONCLUSÃO: A escala encontra-se traduzida e adaptada para o português para aplicação em adolescentes do sexo feminino, demonstrando resultados satisfatórios no processo de tradução e equivalências conceitual, semântica e operacional. São necessárias ainda análises de validade externa, equivalência de mensuração e reprodutibilidade.

Comportamento alimentar e imagem corporal em universitários da área de saúde / Eating behavior and body image in health sciences university students

OBJETIVO: Avaliar a associação da imagem corporal e o comportamento alimentar de universitários de uma capital do Nordeste do Brasil. MÉTODOS: Participaram da pesquisa universitários (n = 1570) da área da saúde de ambos os sexos, de quatro instituições de ensino superior. As dimensões da imagem corporal (i.e., perceptiva e atitudinal) foram avaliadas por meio da Escala de Silhuetas para adultos brasileiros; e o comportamento alimentar por meio da versão brasileira do Dutch Eating Behavior Questionnaire (DEBQ). Para a avaliação do estado nutricional, foram coletados peso corporal e estatura de modo autorreportado. A análise de associação foi feita pela regressão linear múltipla, após estratificação por sexo. RESULTADOS: Notou-se maior prevalência de universitárias do sexo feminino (72,9%), com idade média de 21,8 (DP = 4,1) anos. Foi encontrada associação entre percepção e (in)satisfação corporal com o comportamento alimentar em ambos os sexos. As mulheres que superestimaram o tamanho corporal obtiveram associação inversa com a dimensão alimentar restritiva (p = 0,001); e as insatisfeitas por magreza, associação direta entre alimentação restritiva; e inversa com o comportamento emocional (p < 0,001). Os homens que superestimaram seu tamanho corporal evidenciaram associação direta com a alimentação emocional; e entre os insatisfeitos por excesso de peso houve associação direta com a dimensão emocional (p = 0,032) e global (p = 0,046) do comportamento alimentar. CONCLUSÕES: O presente estudo demonstra que a imagem corporal negativa, considerando as duas dimensões avaliadas (i.e., perceptiva e atitudinal), foi associada ao comportamento alimentar entre universitários de ambos os sexos.

OBJECTIVE: To analyze an association of image and eating behavior of university students from a capital city in Northeast Brazil. METHODS: Participated in university research (n = 1570) in the health area of both sexes, from four higher education institutions. The dimensions of body image (that is, perceptual and attitudinal) were assessed using the Brazilian Adult Silhouettes Scale; and eating behavior using the Brazilian version of the Dutch eating behavior questionnaire (DEBQ). For an assessment of nutritional status, body weight and height were collected automatically reported. An association analysis was performed using the selected linear regression, after stratification by sex. RESULTS: There is no higher prevalence of women (72.9%), with a mean age of 21.8 (SD = 4.1) years. An association was found between perception and (in) body satisfaction with eating behavior in both sexes. Women who overestimated body size had an inverse association with the restrictive dietary dimension (p = 0.001); and as dissatisfied by law, direct association between restrictive eating; and inverse with emotional behavior (p < 0.001). Men who overestimate their body size, showed an association with emotional nutrition; among those dissatisfied with excess weight, there was an association with emotional (p = 0.032) and global (p = 0.046) dimensions of eating behavior. CONCLUSIONS: The present study demonstrates that a negative body image, considering two dimensions evaluated (that is, perceptual and attitudinal), was associated with eating behavior among university students of both sexes.

Effects of participation level and physical activity on eating behavior and disordered eating symptoms in the Brazilian version of the New Moves intervention: data from a cluster randomized controlled trial.

BACKGROUND: Childhood and adolescent obesity is a worldwide public health concern. The New Moves program aims to change eating behavior (EB) and physical activity (PA). OBJECTIVE: To evaluate the effectiveness of an intervention and predictors of better outcomes relating to EB and PA levels. DESIGN AND SETTING: Secondary data from a cluster randomized controlled trial in 10 public schools in São Paulo, Brazil. METHODS: 270 female adolescents, aged 12 to 14 years, were analyzed. Participation levels were categorized as presence in 1 to 9 sessions or 10 to 17 sessions, or control. Effectiveness was evaluated through improvement in disordered EB (DEB) and EB. Predictors of better outcomes relating to PA levels were evaluated through clustering of individual characteristics that affected changes in PA scores. RESULTS: Participation level was not significantly associated with changes in DEB or EB. Girls with higher body mass index percentile (BMI-P) percentile tended to have increases in sedentary lifestyles through the program. Girls with less body image dissatisfaction presented higher increases in daily PA. Girls with higher BMI-P percentile and higher self-esteem showed reductions in sedentary lifestyles. The program seemed to have more effect on daily PA among older girls than among younger girls. CONCLUSIONS: This program could be used as a structured action plan in schools, with the aims of improving eating behaviors and physical activity, in addition to promoting self-acceptance. The results indicate the importance of evaluating determinants of adherence, as these metrics might influence the effectiveness and future design of lifestyle programs.

Exploring Psychosocial Determinants of Eating Behavior: Fruit and Vegetable Intake Among Brazilian Adolescents.

In most Western countries, children and adolescents do not eat the recommended amount of fruits and vegetables (FVs). Theoretical frameworks on social psychology of eating, such as the Reason Action Approach, Social Cognitive Theory, and Theory of Normal Conduct have been applied to understand how psychosocial variables can explain FV intake. However, considering those predictors is still rare on the understanding of FV intake among adolescents (particularly in Brazil) despite its importance within eating behavior. Therefore, this study explored important psychosocial determinants of weekly frequency of FV intake among Brazilian adolescents in a model testing socioeconomic status (SES) and body mass index (BMI). A cross-sectional design was performed with 429 students (58% female), mean age 14.45 (SD 1.86). Key variables of theoretical framework on social psychology of food were investigated by structural equation modeling. The model included self-efficacy, attitudes, and social norms (with its subcomponents descriptive and injunctive) as psychosocial predictors of weekly frequency of FV intake along with SES and BMI. An instrument developed for Brazilian Portuguese was used to collect psychosocial variables as well as to verify FV reported intake. The total model explained 45.5% of weekly frequency of FV intake, and self-efficacy was the only significant psychosocial determinant (λ = 0.51, p = 0.001). SES also showed an important effect on the model (λ = 0.21, p = 0.001), while for BMI no significance was observed. In conclusion, the model was adequate to understand psychosocial determinants of weekly frequency of FV intake for Brazilian adolescents, with self-efficacy and SES as the major determinants of this eating behavior.

Associação entre fontes de informação utilizadas por estudantes de nutrição e percepção da função da alimentação / Association between sources of information used by nutrition students and their perception of the function of food

A atuação dos nutricionistas pode ser baseada na percepção do que é alimentação saudável, por sua vez influenciada pela formação e por diversas fontes de informação. Este estudo tem como objetivo identificar as fontes de informação que os estudantes de Nutrição usam para se atualizar e sua associação com percepção da função da alimentação, fase da graduação e tipo de instituição de ensino. Participaram 497 estudantes de 41 instituições do estado de São Paulo ­ Brasil - que responderam de forma online quais as principais fontes de informação utilizadas para se atualizar, qual a principal função da alimentação e questões de caracterização da amostra. As respostas foram codificadas e a associação entre as fontes de informação com as demais variáveis foram avaliadas pelo teste qui-quadrado de Pearson. Artigos científicos foram citados por 51,7% dos estudantes como principal fonte de informação. A principal função da alimentação foi referida como exclusivamente biológica por 72,4% dos estudantes. O uso da mídia como primeira fonte de informação foi mais frequente entre aqueles que relataram apenas aspectos biológicos como função da alimentação (p=0,024). A fonte de informação esteve associada com percepção de alimentação saudável, tipo de instituição de ensino e fase da graduação. As informações provenientes da mídia devem ser discutidas de forma crítica, especialmente na atual vigência de controvérsias na Nutrição.

The performance of nutritionists can be based on their perception of what healthy eating is, which is in turn influenced by training and different sources of information. This study aims to identify the sources of information that Nutrition students use to update themselves and their association with their perception of the function of food, their academic stage, and type of educational institution. The participants were 497 students from 41 institutions in the state of São Paulo ­ Brazil ­ who answered online what the main sources of information used to update themselves are, what the main function of food is, and questions about the characterization of the sample. The answers were coded and the association between the information sources and the other variables were evaluated using Pearson's chi-squared test. Scientific articles were cited by 51.7% of students as the main source of information. The main function of food was referred to as exclusively biological by 72.4% of students. The use of the media as the primary source of information was more frequent among those who reported only biological aspects such as a function of eating (p=0.024). The source of information was associated with perception of healthy eating, type of educational institution and academic stage. Information from the media must be critically discussed, especially in the present current of controversies in nutrition.

Food choice motives among two disparate socioeconomic groups in Brazil.

Understanding the motives influencing food intake is indispensable for effective dietary recommendations aimed at promoting healthy eating in an integrative way. The objective of this study was to evaluate food choice motives across two socioeconomically different cities in Brazil. A cross-sectional study with a convenience sample (n = 473) of adults living in both places was evaluated. Food choice motives were assessed by The Eating Motivation Survey (TEMS) with 15 dimensions, and economic classifications were made according to the Brazilian Economic Classification Criteria (CCEB). Data analysis used both a general linear model (GLM) and a Structural Equation Model (SEM) adjusted for age, ethnicity, income and educational degree. Participants were mainly women (74.6%) with a mean age of 36.6 years. Cities were not invariant (Δχ2 = 314.165, p < 0.001) and two distinct prediction models for food choice motives emerged. Fit indices indicate acceptable model fit for both low (CFI = 0.911; TLI = 0.898; RMSEA = 0.041) and high socioeconomic status groups (CFI = 0.808; TLI = 0.717; RMSEA = 0.081). Although cities differ in the prediction models for food choice motives, we demonstrated that there are two main networks of predictors: one related to social context predictors of food choice motives and another related to hedonic-oriented ones. Particularly, hedonic-oriented motives (i.e., pleasure) were the most relevant predictors to the group of high socioeconomic status followed by social context predictors (traditional eating and sociability). On the other hand, the group of low socioeconomic status had most of its predictors related to social context (i.e., visual appeal, traditional eating, sociability, social norms and social image) and also price, but this last one was the least important among the most important predictors.

Item Response Theory-based validation of a short form of the Disordered Eating Attitude Scale (DEAS-s) to a Brazilian sample.

This study aimed to validate a short version of the Disordered Eating Attitude Scale (DEAS-s). To this end, 2,902 adult individuals answered the original DEAS and informed age, weight, and height. Data were analyzed using the full-information factor analysis and Item Response Theory (IRT) analysis. Exclusion criteria retained items with adequate values of commonality and factor loadings. Estimation of IRT parameters, the Item Characteristic Curve (ICC), and test information guided the selection of the best quality items. The final model adjustment was evaluated using Root Mean Square Error of Approximation (RMSEA), Standardized Root Mean Square Residual (SRMSR), Comparative Fit Index (CFI), and Tucker-Lewis Index (TLI). The eating attitudes on each level of DEAS-s were described. The analyses were performed on R software and Microsoft Excel version 2013. As results, six items were excluded because of the low communalities and factor loadings, and one more was excluded because of an overlapping on the ICC. The remaining 17 items explained 0.53 of the total variance and had an adequate goodness-of-fit (RMSEA = 0.05; SRMSR = 0.05; CFI = 0.98; TLI = 0.98). The information test is more accurate between the scores 0 and +3. Scores higher or equal to 1.5 identified individuals with disordered eating attitudes. Women, older individuals, and those with a higher body mass index presented more disordered eating; thus, the one-dimensional and short version of DEAS showed a suitable adjustment and may contribute to properly evaluate disordered eating in diverse populations.