The NutriAct Family Study: a web-based prospective study on the epidemiological, psychological and sociological basis of food choice.

BACKGROUND: Most studies on food choice have been focussing on the individual level but familial aspects may also play an important role. This paper reports of a novel study that will focus on the familial aspects of the formation of food choice among men and women aged 50-70 years by recruiting spouses and siblings (NutriAct Family Study; NFS). METHODS: Data is collected prospectively via repeatedly applied web-based questionnaires over the next years. The recruitment for the NFS started in October 2016. Participants are recruited based on an index person who is actively participating in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study. This index person was asked to invite the spouse, a sibling or an in-law. If a set of family members agreed to participate, access to individualized web-based questionnaires assessing dietary intake, other health related lifestyle habits, eating behaviour, food responsiveness, personality, self-regulation, socio-economic status and socio-cultural values was provided. In the first phase of the NSF, recruitment rates were monitored in detail and participants' comments were analysed in order to improve the feasibility of procedures and instruments. DISCUSSION: Until August 4th 2017, 4783 EPIC-Participants were contacted by mail of which 446 persons recruited 2 to 5 family members (including themselves) resulting in 1032 participants, of whom 82% had started answering or already completed the questionnaires. Of the 4337 remaining EPIC-participants who had been contacted, 1040 (24%) did not respond at all, and 3297 (76%) responded but declined, in 51% of the cases because of the request to recruit at least 2 family members in the respective age range. The developed recruitment procedures and web-based methods of data collection are capable to generate the required study population including the data on individual and inter-personal determinants which will be linkable to food choice. The information on familial links among the study participants will show the role of familial traits in midlife for the adoption of food choices supporting healthy aging.

Psychometric evaluation of the German version of the Intuitive Eating Scale-2 in a community sample.

Intuitive eating is based on a strong physical connection with the body, aligned to internal cues of hunger and satiety, and a low preoccupation with food. The aim of this study was to provide a German version of the Intuitive Eating Scale-2 (IES-2) and to examine its psychometric properties with data collected from 532 participants aged 18-91 years. The IES-2 was translated into German following the World Health Organization guidelines (2016). Cronbach's alpha as a measure of internal consistency was 0.89 for the IES-2 total score, as well as 0.73 - 0.92 for the IES-2 subscale scores. For group differences, the results were as hypothesized: men had higher IES-2 scores than women, and participants with under- and average weight showed higher IES-2 scores than participants with overweight and obesity. Participants without a dieting history had higher IES-2 scores than former or current dieters. In line with our hypotheses regarding construct validity, the IES-2 score had negative associations with emotional eating, restraint eating, external eating, binge eating and eating disorder symptomatology, as well as positive associations with self-efficacy and mental health-related quality of life. Second-order confirmatory factor analysis replicated the four-factor solution, with intuitive eating as a higher-order factor. These findings demonstrate that the German version of the IES-2 is a useful tool to assess intuitive eating in the general German population.

How is intuitive eating related to self-reported and laboratory food intake in middle-aged adults?

As intuitive eating (IE) is characterized by eating in response to internal cues of hunger and satiety and by monitoring the effect of food on the body, it has been hypothesized to lead to healthy food intake. Evidence concerning its link to food intake is scarce. This experimental study investigated the relationship between IE and food intake in middle-aged adults. Fifty-five participants aged 50-70 years completed the Intuitive Eating Scale-2 to measure IE. Usual consumption frequency of fruits, vegetables, snacks and sweets was assessed as a measure of healthy self-reported food intake. A taste test of apples, carrots, coated peanuts and chocolate was conducted as a measure of healthy and total laboratory food intake. Regression analyses were performed using Frequentist and Bayesian methods of inference. In line with our hypothesis, IE was associated with healthier self-reported food intake (medium effect size: f2 = 0.24). The data were 49.80 times more likely under H1 than under H0. Contrary to our hypotheses, IE was neither associated with healthy nor total laboratory food intake in classical regression analyses. The accompanying Bayes factors revealed inconclusive evidence. Data only allow drawing cautious conclusions about the different relationship between IE and the self-reported consumption frequency of the foods vs. the amount of these foods consumed in a single test situation. Future studies combining different measures of IE (e.g., behavioral paradigms) and self-reported (e.g., diet quality, portion sizes) and laboratory (e.g., repeated taste tests with pre-selected foods) food intake are warranted to further explore their relationship.

Intuitive eating mediates the relationship between self-regulation and BMI - Results from a cross-sectional study in a community sample.

Self-regulation is a dispositional skill of regulating attention and emotion to attain a certain goal. Poor self-regulation is associated with a higher body mass index (BMI) and is a risk factor for the development of obesity. Intuitive eating, an adaptive eating style characterized by eating in response to internal cues of hunger and satiety, is associated with a lower BMI. Using cross-sectional data, this study examined whether intuitive eating mediates the relationship between self-regulation and BMI in a community sample of adults. Participants (N = 530) completed the Self-Regulation Scale, the Intuitive Eating Scale-2 with its facets Unconditional Permission to Eat (UPE), Eating for Physical Rather Than Emotional Reasons (EPR), Reliance on Hunger and Satiety Cues (RHSC) and Body-Food Choice Congruence (B-FCC). They also self-reported their height and weight. Using percentile bootstrap resampling procedures, the simple mediation analysis showed an indirect relationship between self-regulation and BMI through intuitive eating. The multiple mediation analysis revealed that EPR and B-FCC, but not UPE and RHSC, mediated the relationship between self-regulation and BMI. Intuitive eating seems to play an important intermediating role in the relationship between self-regulation and BMI. Regarding weight management interventions, it could be useful to promote intuitive eating, especially for individuals with low self-regulation. Prospective studies are needed to explore the causal and temporal relationships among self-regulation, intuitive eating and BMI.

Measuring negative attitudes towards overweight and obesity in the German population - psychometric properties and reference values for the German short version of the Fat Phobia Scale (FPS).

OBJECTIVE: Obesity is one of the leading public health problems worldwide. Obese individuals are often stigmatized and the psychosocial consequences of overweight and obesity are the subject of current research. To detect stigmatizing attitudes towards obese people, the Fat Phobia Scale (FPS) was developed in the USA in the early nineties. In addition, the 14-item short form of the FPS was constructed. The FPS belongs to the most commonly used instruments for measuring negative attitudes towards obese people because of its good psychometric properties. For the recently developed German short form of the FPS, however, the comprehensive investigation of the psychometric properties and the determination of reference values are still pending. Thus, the main objectives of this study were the evaluation of the psychometric quality of the scale as well as the calculation of reference values. METHODS: The study was based on a representative survey in the German general population. A sample of 1,657 subjects (18-94 years) was assessed via structured telephone interviews including the 14-item German version of the FPS. Descriptive statistics and inference-statistical analyses were conducted. Reference values in terms of percentage ranks were calculated. RESULTS: Substantial evidence for the reliability and validity of the German short version of the FPS was found. This study, for the first time in Germany, provides age-specific reference values for the German short form of the FPS allowing the interpretation of individual test scores. CONCLUSION: Facing the far-reaching consequences of experienced stigmatization of obese individuals, these study results provide an important basis for further studies aiming at the investigation of negative attitudes towards overweight and obesity.