Mechanisms underlying the development of eating disorders and disordered eating in adolescent females with type 1 diabetes.

OBJECTIVE: People with Type 1 diabetes (T1D) face an increased risk of eating disorders/disordered eating (ED/DE), with adolescents being particularly vulnerable. Empirical knowledge on the mechanisms underlying development of ED/DE in T1D is crucial for evolving prevention strategies. RESEARCH DESIGN AND METHODS: Fourteen semi-structured interviews with adolescent females with T1D and ED/DE between 14 and 18 years were conducted and analyzed using reflexive thematic analysis. RESULTS: Analyses identified four main themes; 'Interconnected afflictions', 'Judgment', 'Feeling Different', and 'Chaos & Control', These themes explore the interconnectedness of T1D and ED/DE, with shame and guilt emerging as common underlying mechanism. The development of a biopsychosocial model was based on the integration of these data with existing models. CONCLUSIONS: The study extends previous developmental pathways of ED/DE in adolescents with T1D. We propose a biopsychosocial model that incorporates various factors: predisposing factors such as parental management of T1D and weight gain during adolescence; precipitating factors including comments on weight, frequency of weighing, perceptions of surveillance; the perpetuating bilateral influence of ED/DE and T1D and finally highlighting the protective mechanisms of disease acceptance encompassing parental handling of diagnosis and the contribution of healthcare professionals (HCP's) role in psychoeducation. The present study highlight the vulnerability of adolescence in the presence of T1D, particularly concerning issues related to eating, weight, and body. It offers clinically relevant insights, with the aim to improve communication and management strategies for this very specific group.

Psychometric properties of the Diabetes Eating Problem Survey-Revised among Dutch adults with type 1 diabetes and implications for clinical use.

AIMS: Disordered eating behaviour (DEB) in people with type 1 diabetes (T1D) can be screened with the Diabetes Eating Problem Survey-Revised (DEPS-R). This study aimed to investigate the psychometric properties of the DEPS-R among Dutch adults with T1D and to explore the individual items alongside the standard cut-off score of ≥20 for clinical use. METHODS: The construct validity of the DEPS-R was assessed with an exploratory factor analysis, through principal axis factoring and with Spearman correlations between clinical variables and the DEPS-R. Backward logistic regression identified clinical predictors for DEPS-R scores above the cut-off. DEPS-R item responses were summarized with frequencies, means and standard deviations. RESULTS: Participants were 145 adults with T1D, of whom 79.3% were women and 35.9% presented with DEB based on the cut-off. A single-factor solution of the DEPS-R showed good internal consistency, while a three-factor solution showed acceptable to good internal consistency within the factors. A younger age, a higher BMI and more diabetes distress were predictors for a DEPS-R cut-off score of ≥20. Clinically relevant items were identified that contributed minimally to the DEPS-R score. CONCLUSIONS: This study supports a single-factor and a three-factor structure of the DEPS-R while also suggesting an item-specific or factor-specific approach in clinical practice.

Eating disorders in narcolepsy type 1: Evidence from a cross-sectional Italian study.

Narcolepsy type 1 is a chronic central disorder of hypersomnolence, and it is frequently accompanied by overweight, but the association between narcolepsy type 1 and eating disorders is controversial. Our study aims to compare patients with narcolepsy type 1 and controls on the symptomatology of eating disorders and to evaluate the association between clinical factors. This is a cross-sectional study, with consecutive recruitment of patients with narcolepsy type 1 attending the Outpatient Clinic for Narcolepsy at the IRCCS Istituto delle Scienze Neurologiche di Bologna (Italy) for routine follow-up visits. Healthy subjects from general populations were recruited as controls. Patients underwent a questionnaire-based assessment using the Eating Disorder Examination Questionnaire (EDE-Q), Binge Eating Scale (BES), Italian Night Eating Questionnaire (I-NEQ), Epworth Sleepiness Scale (ESS), and Narcolepsy Severity Scale (NSS). One hundred and thirty-eight patients with narcolepsy type 1 and 162 controls were enrolled. This study showed that individuals with narcolepsy type 1 reported higher scores on the EDE-Q, I-NEQ, and a higher body mass index (BMI) than the controls. The logistic regression analysis results, with EDE-Q positivity as a dependent variable, demonstrate a significant association with antidepressant drugs, female sex, and the use of sodium oxybate. We found an association between antidepressant drug consumption, the NSS total score, and female sex with BES positivity as the dependent variable. The logistic regression analysis for I-NEQ positivity found an association with antidepressant drug use. This study shows that patients with narcolepsy type 1 frequently present with comorbid eating disorder symptomatology, mainly night eating syndrome. Investigating the possible presence of eating disorders symptomatology through questionnaires is fundamental during the assessment of patients with narcolepsy type 1.

Obesity-induced tissue alterations resist weight loss: A mechanistic review.

Interventions aimed at weight control often have limited effectiveness in combating obesity. This review explores how obesity-induced dysfunction in white (WAT) and brown adipose tissue (BAT), skeletal muscle, and the brain blunt weight loss, leading to retention of stored fat. In obesity, increased adrenergic stimulation and inflammation downregulate ß-adrenoreceptors and impair catecholaminergic signalling in adipocytes. This disrupts adrenergic-mediated lipolysis, diminishing lipid oxidation in both white and brown adipocytes, lowering thermogenesis and blunting fat loss. Emerging evidence suggests that WAT fibrosis is associated with worse weight loss outcomes; indeed, limiting collagen and laminin-α4 deposition mitigates WAT accumulation, enhances browning, and protects against high-fat-diet-induced obesity. Obesity compromises mitochondrial oxidative capacity and lipid oxidation in skeletal muscle, impairing its ability to switch between glucose and lipid metabolism in response to varying nutrient levels and exercise. This dysfunctional phenotype in muscle is exacerbated in the presence of obesity-associated sarcopenia. Additionally, obesity suppresses sarcolipin-induced sarcoplasmic reticulum calcium ATPase (SERCA) activation, resulting in reduced oxidative capacity, diminished energy expenditure, and increased adiposity. In the hypothalamus, obesity and overnutrition impair insulin and leptin signalling. This blunts central satiety signals, favouring a shift in energy balance toward energy conservation and body fat retention. Moreover, both obese animals and humans demonstrate impaired dopaminergic signalling and diminished responses to nutrient intake in the striatum, which tend to persist after weight loss. This may result in enduring inclinations toward overeating and a sedentary lifestyle. Collectively, the tissue adaptations described pose significant challenges to effectively achieving and sustaining weight loss in obesity.

Investigating oral somatosensory perception and oral symptoms of head and neck cancer patients: insights on eating behaviour.

PURPOSE: Sensory alterations and oral manifestations are prevalent among head and neck cancer (HNC) patients. While taste and smell alterations have been thoroughly investigated, studies on their oral somatosensory perception remain limited. Building upon our previous publication that primarily focused on objective somatosensory measurements, the present work examined self-reported sensory perception, including somatosensation and oral symptoms, in HNC patients and evaluated their link with eating behaviour. METHODS: A cross-sectional study was conducted using self-reported questionnaires on sensory perception, oral symptoms, sensory-related food preference, and eating behaviour among HNC patients (n = 30). Hierarchical clustering analysis was performed to categorise patients based on their sensory perception. Correlations between oral symptoms score, sensory perception, sensory-related food preference, and eating behaviour were explored. RESULTS: Two distinct sensory profiles of patients were identified: no alteration (n = 14) and alteration (n = 16) group. The alteration group showed decreased preference towards several sensory modalities, especially the somatosensory. Concerning eating behaviour, more patients in the alteration group agreed to negatively connotated statements (e.g. having food aversion and eating smaller portions), demonstrating greater eating difficulties. In addition, several oral symptoms related to salivary dysfunction were reported. These oral symptoms were correlated with sensory perception, sensory-related food preference, and eating behaviour. CONCLUSION: This study presented evidence demonstrating that sensory alterations in HNC patients are not limited to taste and smell but cover somatosensory perception and are linked to various aspects of eating. Moreover, patients reported experiencing several oral symptoms. Those with sensory alterations and oral symptoms experienced more eating difficulties.

Breaking prolonged sitting increases 24-h physical activity and self-perceived energy levels but does not acutely affect cognition in healthy adults.

INTRODUCTION: It is unknown whether predetermined (un)interrupted sitting within a laboratory setting will induce compensatory changes in human behaviours (energy intake and physical activity) once people return to a free-living environment. The effects of breaking up prolonged sitting on cognition are also unclear. METHODS: Twenty-four (male = 13) healthy participants [age 31 ± 8 y, BMI 22.7 ± 2.3 kg/m2 (mean ± SD)] completed 320 min mixed-feeding trials under prolonged sitting (SIT) or with 2 min walking at 6.4 km/h every 20 min (ACTIVE), in a randomised crossover design. Human behaviours were recorded post-trial under free-living conditions until midnight. Cognitive performance was evaluated before and immediately after SIT and ACTIVE trials. Self-perceived sensations (appetite, energy and mood) and finger prick blood glucose levels were collected at regular intervals throughout the trials. RESULTS: There were no differences between trials in eating behaviour and spontaneous physical activity (both, p > 0.05) in free-living conditions, resulting in greater overall total step counts [11,680 (10740,12620) versus 6049 (4845,7253) steps] and physical activity energy expenditure (PAEE) over 24-h period in ACTIVE compared to SIT (all, p < 0.05). Greater self-perceived levels of energy and lower blood glucose iAUC were found in ACTIVE trial compared to SIT trial (both, p < 0.05). No differences were found in cognitive performance between trials (all, p > 0.05). CONCLUSION: Breaking up sitting does not elicit subsequent behavioural compensation, resulting in greater 24-h step counts and PAEE in healthy adults. Breaking up sitting reduces postprandial glucose concentrations and elicits greater self-perceived energy levels, but these positive effects do not acutely translate into improved cognitive function.

Does social-norm messaging influence expected satiety and ideal portion-size selection?

A person's perception of how long a food will stave off hunger (expected satiety) and the ideal amount to consume (ideal portion size) are both influenced by food-to-mealtime norms. Here, we examine whether social norms can modulate this effect, in three experimental studies. In study 1 (n = 235) participants were exposed to a social norm suggesting most people enjoyed consuming pasta for breakfast. There was a main effect of food-to-mealtime congruence for expected satiety and ideal portion size (p < 0.001) - participants selected a smaller portion of pasta for breakfast (vs. lunch) - but there were no other main effects/interactions (p ≥ 0.15). Study 2 (n = 200) followed the same approach as study 1, but sought to examine whether the typical volume of food consumed at breakfast and lunch needed to be controlled. Again, there was a main effect of congruence (the same pattern) (p ≤ 0.02) but no other main effects/interactions (p ≥ 0.73). Study 3 (n = 208) followed the same approach as study 2, but the social-norm message was changed to suggest that most people who eat pasta for breakfast found it effectively reduced their hunger. Again, there was a main effect of congruence (the same pattern) (p < 0.001) but no other main effects/interaction (p ≥ 0.26). These studies provide further evidence for the food-to-mealtime effect, but do not provide any evidence that a single, simple social-norm statement can modulate expected satiety or ideal portion size, or interact with the food-to-mealtime effect.

Associations between parent and child latent eating profiles and the role of parental feeding practices.

Previous research employing the person-centred approach of Latent Profile Analysis (LPA) with parent-reported data of their child's eating behaviour identified four distinct eating profiles in 3-6-year-old children: typical, avid, happy, and avoidant eating (Pickard et al., 2023). In this follow-up study, the same parents were asked to self-report their own eating behaviour (N = 785) and LPA was conducted to determine the latent eating profiles of the parents/caregivers. The LPA showed that a four-profile solution best represented the sample of parents, termed: typical eating (n = 325, 41.4%), avid eating (n = 293, 37.3%), emotional eating (n = 123, 15.7%) and avoidant eating (n = 44, 5.6%). Multiple mediation analysis was then conducted to examine both the direct associations between parents' eating profiles and the child's probability of eating profile membership, as well as the indirect associations through the mediatory role of specific parental feeding practices. The results suggested direct links between parent and child eating profiles, with the 'avid eating' and 'avoidant eating' profiles in parents predicting similar profiles in their children. Feeding practices, such as using food for emotional regulation, providing balanced and varied food, and promoting a healthy home food environment, mediated associations between parent and child eating profiles. This research provides novel evidence to reinforce the need for interventions to be specifically tailored to both the parent's and child's eating profiles. The work also provides an interesting avenue for future longitudinal examination of whether the parents' provision of a healthy home food environment could protect against intergenerational transmission of less favourable eating behaviours.

Relation of preconception eating behaviours to dietary pattern trajectories and gestational weight gain from preconception to late pregnancy.

Studies examining preconception eating behaviours with longitudinal dietary patterns from preconception to late pregnancy as well as gestational weight gain (GWG) are limited. We derived dietary pattern trajectories from preconception to late-pregnancy, and related preconception eating behaviours to these trajectories and GWG. Preconception eating behaviours were assessed using the Three-Factor Eating Questionnaire measuring cognitive restraint (CR) - conscious restriction of food intake, emotional eating (EE) - overeating in response to negative emotions, and uncontrolled eating (UE) - overeating with a feeling of lack of control. Dietary intakes were measured at preconception, 20-21 and 34-36 weeks' gestation with food frequency questionnaires. Dietary patterns were determined using factor analysis, and trajectories derived using group-based trajectory modelling. Inadequate and excessive GWG were defined according to Institute of Medicine guidelines based on weights at preconception and the last antenatal visit (median: 38 weeks' gestation). Two dietary patterns were derived: 'Fast Food, Fried Snacks and Desserts (FFD)' and 'Soup, Fish and Vegetables (SFV)'. Adherence trajectories from preconception to late-pregnancy were characterised as consistently high ("stable-high") and low ("stable-low"). Women with higher UE scores had higher odds of being in the "stable-high" trajectory (n = 34) of the FFD pattern [Odds Ratio (OR): 1.25, 95% Confidence Interval (CI): 1.03, 1.51], compared to "stable-low" (n = 260). Percentages of women with inadequate, adequate or excessive GWG were 21.7% (n = 70), 25.8% (n = 83), and 52.5% (n = 169), respectively; women with higher EE scores had a higher likelihood of excessive GWG [Relative Risk Ratio (RRR): 1.35, 95% CI: 1.02, 1.80], but this association was attenuated after adjusting for preconception body mass index. Eating behaviour interventions to improve dietary patterns among pregnant women may need to start as early as preconception, incorporating strategies to manage UE.

Social norms and young adults' self-reported meat and plant-based meal intake: Findings from two online cross-sectional studies.

Plant-based eating is beneficial for human and planetary health. It is important to identify factors which may encourage people to reduce meat, and increase plant-based meal intake. Perceived social norms are associated with meat and plant-based meal intake in adults, however, less is known about the relationship between perceived social norms and young adults' own self-reported meat and plant-based eating in general, and in different social contexts. Across two online studies we examined this. In Study 1 (n = 217 young adults, aged 18-25 years, mean age = 19.50 years, SD = 1.37 years, mean BMI = 24.21, SD = 5.45, 91% cisfemale, 92.0% omnivores), perceived descriptive (the perceived behaviour of others) and injunctive (the perceived approval of others) norms were measured in general. In study 2 (n = 151 young adults aged 18-25 years, mean age = 19.62 years, SD = 1.50 years, mean BMI = 24.32, SD = 4.99, 88.8% cisfemale, 71.1% omnivore), perceived descriptive and injunctive norms were examined in a variety of social contexts. In Study 1, perceived descriptive norms about friends were associated with self-reported meat, and descriptive norms about peers and friends, and injunctive norms about friends were positively associated with self-reported plant-based meal intake. In Study 2, descriptive norms about friends were associated with self-reported meat intake in fast-food restaurants and at friends' houses, and injunctive norms about friends were associated with meat intake in restaurants. There were no other significant associations between either type of social norm and meat or plant-based meal intake. We provide the first evidence that peers and friends may be relevant for plant-based meal intake, and only friends may be relevant for meat intake. Further research is needed to examine people's actual food intake, and in longitudinal studies to rule out reverse causality.

Factors of food choice and nutritional intake of Brazilian older adults according sociodemographic and health characteristics.

The rapid demographic transition in developing countries has always posed a challenge for the social and economic policies of these nations. The increase in longevity poses new challenges for understanding dietary consumption among different age groups at the old age population. The aim of this study was to evaluate the reasons for food choice and the composition of nutritional intake of older adults and its relationship to individual characteristics. Community-living older adults aged 60 and older were interviewed in their homes at the southeastern region of Brazil, between December 2021 and February 2022. The Food Choice Questionnaire and a Food Frequency Questionnaire were administered to obtain data on the reasons for food choice and nutritional intake. A structured interview was employed to gather information on individual characteristics. 168 older adults (mean age of 72.6 ± 8.9; 69.6% women) participated. The reasons for food choice differed significantly, with weight control being one of the least important and health being one of the most important. But older adults aged 80 and over valued the health criterion less than younger participants (60-69 years old). The intake of macronutrients and energy were below nutritional recommendations. Carbohydrate consumption was positively correlated with the mood motive. There was a relationship between the reasons for choosing food and/or the components of nutritional intake with: gender, age, living with a partner, self-report of depression/anxiety, self-perception of health and nutritional status anthropometric. The results are important to be considered in prevention policies and clinical-nutritional management, with special attention to the oldest-old.

Food parenting and Children's eating behaviour: Exploring the role of coparenting.

Parents have primary influence over the development of their children's eating behaviours, however less attention has been given to whether or how their coparenting plays a role in this association. The aim of this study was to investigate the cross-sectional associations between mothers' and fathers' food parenting practices and children's eating behaviour and examine whether coparenting quality moderates or confounds these associations. Parents (222 mothers and 167 fathers) with children 18 months to 5 years completed an online survey that assessed their food parenting practices and coparenting quality. One parent per family (91% mothers) also reported their children's food approach behaviours. We used linear regressions with generalized estimating equations to examine the associations between food parenting practices and children's eating behaviours. To explore moderation by coparenting quality, we included an interaction term in each model (coparenting quality x food parenting practice). To explore confounding, models were adjusted for coparenting quality. All models were stratified by parent gender and included parent educational attainment, child age, and child BMI z-scores as covariates. Among both mothers and fathers, we found that structure and autonomy support food parenting practices were inversely associated with children's food responsiveness, and desire to drink, while coercive control practices were positively associated with these food approach behaviours. We found the opposite direction of association between these food parenting practices and children's enjoyment of food. Among mothers, autonomy support was inversely associated with children's emotional overeating, while coercive control was positively associated with this eating behaviour. Coparenting quality did not moderate or confound the associations. Future studies should continue to explore these associations among families with young children and consider feeding coparenting in the association.

Investigating motivations to eat: Refining and validating a framework of Eating Behaviour Traits in dieters and the general population.

Due to relationships between diet and health including obesity, there is a need to examine the explanatory power of factors that motivate people to (over or under) eat. In a previous investigation, a four-factor subscale-based model of eating behaviour traits (EBTs) was developed which identified individual differences in psychological factors influencing motivations to eat and some residual uncertainties. The current study used a data-driven and theory-driven approach, including individual items to refine and extend previous EBT models. The aim was to examine and validate the domain structure of a framework for EBTs. The analysis used two samples including a representative sample of the UK population (n = 2010, 51% female, 49% male, 18-88 years), and members of a weight management program (n = 2317, 96.6% female, 2.8% male, 21-84 years), who completed 5 questionnaires including 10 EBTs. The results found some support for a 6-factor model, encompassing reactive eating, negative emotional eating, positive emotional eating, restricted eating, homeostatic eating, and body-food choice congruence (data-driven model) or eating for health (theory-driven model). There were differences between the data-driven model and the theory-driven model regarding the 6th factor. Additionally, the data-driven model did not distinguish between eating for pleasure and reactive eating. The models demonstrated that the eating behaviour factors were significantly associated with BMI category. Overall, this research contributes to a more structured understanding of the dimensions of motivation underlying EBTs, emphasising the utility of this framework for identifying at-risk individuals and tailoring interventions to meet specific individual needs.

Differences in parental behaviour, emotions, and cognitions and between children's eating profiles.

A variety of parent psychological characteristics (e.g., wellbeing) have been related to children's eating behaviour. However, parent-child feeding interactions are reciprocal and complex, including relationships between parental cognitions, emotions, as well as the influence of children's varying appetitive traits. Using a person-centred approach, children's appetitive traits can be clustered into meaningful eating profiles. To date, no research has examined whether parental behaviours, emotions, and cognitions differ depending on a child's eating profile. Hence, this study recruited parents/primary caregivers from the APPETItE project, whose child had previously been identified as having an avoidant, typical, happy, or avid eating profile. Parents/primary caregivers of children (3-6 years; N = 632) completed online questionnaires examining broader parenting behaviour (parenting styles), parental emotions (stress, wellbeing), and parental cognitions (goals, self-efficacy, time and energy for meal planning and preparation, and perceptions about children's body size). Findings showed significant differences in parent responses to the questionnaires based on children's eating profiles. Parents of children with a happy eating profile reported better psychological wellbeing and greater parenting time and energy for meal planning and preparation, as well as being less likely to report goals of avoiding mealtime stress and conflict. In contrast, parents of children with an avoidant eating profile reported poorer psychological wellbeing. Children with an avid eating profile were perceived by parents as having a higher body weight, whereas children with an avoidant eating profile were perceived as having a lower body weight. Overall, these findings demonstrate that differences in parental characteristics and perceptions exist between children's eating profiles and thus should be considered in the development of tailored interventions to support children's healthy eating.

Exploring the multiple dimensions of perceived food access in the local food environment in Flanders: perceptions of adults in socioeconomically disadvantaged situations.

Persons in socioeconomically disadvantaged situations are more susceptible and disproportionally exposed to unhealthy food environments, which results in limited access to healthy foods and poorer dietary outcomes. This qualitative paper examines the various dimensions of perceived food access to healthy and unhealthy foods (i.e., availability, affordability, accessibility, accommodation, desirability, convenience and acceptability) within the local food environment among persons in socioeconomically disadvantaged situations. A total of 23 participants in socioeconomically disadvantaged situations expressed their perceptions of food access within their local food environment and its role in their eating behaviour through participant-driven photo-elicitation in a focus group context (n=7) and researcher-driven photo-elicitation interviews (n=16). Reflexive thematic analysis has been used to analyse our data through an access framework. Four overarching themes were constructed. The first two themes concern barriers to perceived food access in respectively the home and community food environment - including the importance of kitchen infrastructure, household composition and transport options. The third theme encompasses the interaction of perceived food access with the sociocultural environment, highlighting its dual role as facilitator (e.g., through food sharing practices) and barrier (e.g., through social stigma and shame). The fourth theme concerns awareness and the ability to navigate within the information food environment, which has also been proposed as a novel dimension of food access. This study emphasizes the complexity of food access and the need for a multifaceted approach that integrates perceptions to ensure equitable access to healthy foods.

Country-level sociocultural context and socioeconomic inequalities in adolescent dietary behaviours: A multilevel analysis in 21 European countries.

Studies to date have predominantly focused on countries' socioeconomic conditions (e.g., income inequality) to explain cross-national differences in socioeconomic inequalities in adolescent health (behaviours). However, the potential explanatory role of sociocultural contexts at country-level remains underexamined. This study examined whether the country-level sociocultural context and changes thereof were associated with adolescent socioeconomic inequalities in dietary behaviours. International comparative data of 344,352 adolescents living in 21 countries participating in 2002, 2006, 2010 and 2014 waves of the Health Behaviour in School-aged Children (HBSC) survey were combined with aggregated levels of openness-to-change from the European Social Survey (ESS). Four dietary behaviours (i.e., fruit, vegetable, sweets and soft drink consumption) and two measures of socioeconomic status (SES) on the individual level (i.e., family affluence scale [FAS] and occupational social class [OSC]) were studied. Multilevel logistic regression analyses returned contrasting results for the two SES measures used. In countries with higher levels of openness-to-change, smaller FAS inequalities in daily fruit, sweets and soft drink consumption were observed, but no such inequalities were found for vegetable consumption. Conversely, in these countries, larger OSC inequalities in soft drink consumption were found. Country-specific changes in openness-to-change over time were not associated with the magnitude of adolescent dietary inequalities. Findings underscore the importance of including country-level sociocultural contexts to improve the understanding of cross-national differences in socioeconomic inequalities in adolescents' diets. Future studies, spanning a longer timeframe, are required to examine whether such associations exist within countries over time since our timeframe might have been too small to capture these long-term trends.

Examining parents' experiences and challenges of feeding preschool children with avid eating behaviour.

Avid eating behaviours, including greater responsiveness to food cues and emotional over-eating, have been linked to child overweight and obesity. Parental feeding practices are modifiable components of a child's food environment and may be key levers for behaviour change in tailored interventions to support parents of children with avid eating behaviour. However, there is a lack of research examining parents' experiences in this context. This study aimed to explore parents' experiences of feeding children with avid eating behaviour and to understand any challenges experienced in this context. Semi-structured interviews with parents (N = 15) of a preschool child (3-5 years) identified as having an avid eating behaviour profile explored how children's avid eating manifests, the parental feeding practices used to manage avid eating, and the perceived effectiveness of these strategies. Data were analysed using reflexive thematic analysis. Four core themes were generated. Theme one, 'Have they got worms? Children's insatiable hunger', captures parents' interpretation of the complex ways in which avid eating behaviour manifests. Theme two, 'Parenthood as a duty', illustrates how parents' perceived responsibilities shape their feeding practices. Theme three, 'Lifelong habits', captures parents' use of responsive feeding practices to support children's healthy relationship with food. Theme four, 'Picking battles', captures the structure- and coercive-based feeding strategies commonly used to manage children's avid eating. This novel study provides an in-depth understanding of the complex ways that children's avid eating behaviour manifests, and the strategic and creative parental feeding practices used to manage these behaviours. Such findings are valuable for informing the development of future support resources for parents/caregivers to help their children with avid eating behaviours to develop a healthy relationship with food.

Can eating behaviour traits be explained by underlying, latent factors? An exploratory and confirmatory factor analysis.

Eating Behaviour Traits (EBTs) are psychological constructs developed to explain patterns of eating behaviour, including factors that motivate people to (over or under) eat. There is a need to align and clarify their unique contributions and harmonise the understanding they offer for human eating behaviour. Therefore, the current study examined whether 18 commonly cited EBTs could be explained by underlying, latent factors (domains of eating behaviour). An exploratory factor analysis (EFA) was used to identify latent factors, and these factors were validated using a confirmatory factor analysis (CFA). 1279 participants including the general public and members of a weight management programme were included in the analysis (957 females, 317 males, 3 others, 2 prefer not to say), with a mean age of 54 years (median = 57 years, SD = 12.03) and a mean BMI of 31.93 kg/m2 (median = 30.86, SD = 6.00). The participants completed 8 questionnaires which included 18 commonly cited EBTs and the dataset was split at random with a 70/30 ratio to conduct the EFA (n = 893) and CFA (n = 383). The results supported a four-factor model which indicated that EBTs can be organised into four domains: reactive, restricted, emotional, and homeostatic eating. The four-factor model also significantly predicted self-reported BMI and weight change. Future research should test whether this factor structure is replicated in more diverse populations, and including other EBTs, to advance these domains of eating as a unifying framework for studying individual differences in human eating behaviour.

How perceptions of meat consumption norms differ across contexts and meat consumer groups.

Social norm perceptions are implicit standards describing what is typically done or seen as acceptable and have shown to be important both in sustaining meat consumption as well as facilitating meat reduction. Norm perceptions depend on individual differences and the contexts (e.g., supermarket, restaurant). Yet, evidence how norm perceptions differ within and across individuals is scarce. The primary aim of this study was to investigate how descriptive, injunctive, and personal norms perceptions favouring meat consumption differ across contexts and meat consumer groups. The second aim was to investigate how generic dynamic norm perceptions vary across meat consumer groups. British meat eaters (n = 1205, 25-65 years) participated in an online cross-sectional survey. Weekly meat, fish and meat substitute consumption was measured with the adapted Oxford Meat Frequency Questionnaire. All but dynamic norm perceptions were measured for the supermarket, restaurant and worksite cafeteria context. Dynamic norms were measured without a specified context. A two-step cluster analysis was conducted to identify meat consumer groups. Descriptive norm perceptions favouring meat consumption were strongest in supermarket and restaurant contexts, compared to the worksite cafeteria. Injunctive and personal norms favouring meat consumption were both perceived strongest in the supermarket, followed by the restaurant, and least in the worksite cafeteria context. Four meat consumer groups were identified and those with higher meat intake (i.e., Meat lovers and Exceeders) perceived norms favouring meat consumption stronger and norms favouring meat avoidance weaker than the groups with lower meat intake (i.e., Flexitarians and Moderates). While norm perceptions differed between meat consumer groups, the pattern of contextual differences is similar for these meat consumer groups. Our findings underscore the importance of considering contexts and meat consumer groups in efforts to reduce meat consumption.

Development and validation of the baby eating behaviour coding system (BEBECS) to assess eating behaviour during complementary feeding.

Eating behaviour in children is a matter of study for which diverse tools have been designed. Coding systems for videotaped meals allow the extraction of detailed in vivo information; however, there is no tool available for infants following a Baby-Led Weaning (BLW) method. This study aimed to create and validate a new tool to assess eating behaviour in infants during weaning, applicable regardless of the complementary feeding method. The Baby Eating Behaviour Coding System (BEBECS) was developed comprising time variables, behaviours, feeder-led actions, and other meal-related variables. Sixty videos of infants aged 6-18 months following spoon-feeding (SF) or BLW methods were coded by two trained coders. These scores were analysed together with intake and maternal ratings of liking and calmness. Additionally, combined analysis and internal comparison assessed the possible differences in BEBECS variables between SF and BLW. Inter-rater and test-retest reliability had good to excellent agreement: Cohen's Kappa >0.75, Lin's CCC >0.70, and Intraclass Correlation Coefficient >0.75, for almost all variables. Infants' liking and intake of the offered food correlated positively with meal duration and total count of mouth approaches but negatively with having leftovers and time between mouth approaches. Infants' calmness and tiredness were negatively correlated. More food than initially offered was available during the meal in BLW but not in SF. There was a tendency towards more autonomous behaviour in BLW infants regarding changes observed in the time the food was in the mouth at each stage (6, 12, and 18 months). In conclusion, BEBECS has the potential to be a valid tool for application in the research of infant eating behaviour during weaning by trained coders.