The Power of Food: Self-control moderates the association of hedonic hunger with overeating, snacking frequency and palatable food intake.

The purpose of the study was to explore whether self-control moderates the associations between hedonic hunger and overeating frequency, snacking frequency and palatable food intake. Data from the first wave of the Swiss Food Panel 2.0 study was analyzed (N = 4774), from the German- and French-speaking part of Switzerland (52% men). Measures included hedonic hunger assessed with the Power of Food Scale (PFS), the short form Self-Control Scale, overeating frequency, snacking frequency, intake of high-fat salty snack foods, and intake of high-sugar foods assessed with a semiquantitative food frequency questionnaire. Higher scores on the PFS and lower self-control capacities were correlated with higher intakes of both high-fat salty snack foods and high-sugar foods (referred to here as palatable foods), higher overeating frequency and higher snacking frequency. Four separate moderation analyses revealed that the positive associations of hedonic hunger with overeating frequency, snacking frequency and palatable food intake were significantly attenuated by self-control. Results of the present study indicate that people who are highly sensitive to the ready availability of palatable foods but also have high levels of self-control exhibit less frequent overeating and snacking, including less frequent intake of unhealthy palatable foods, than those low in self-control. Consequently, self-control may prevent overeating and thus may serve as a protective factor that decreases the risk of becoming overweight in individuals who are highly sensitive to the food environment.

Dietary Intake Nutritional Status and Lifestyle of Adolescent Vegetarian and Nonvegetarian Girls in New Zealand (The SuNDiAL Project): Protocol for a Clustered, Cross-Sectional Survey.

BACKGROUND: Anecdotally, vegetarian eating patterns seem to be increasing in parallel with growing concerns about environmental sustainability. While this pattern of eating is widely believed to be associated with benefits for the planet and individual health, it may increase the risk of inadequate intakes and nutrient deficiency if not planned carefully. Adolescent girls may be particularly at risk, as they have increased requirements for nutrients such as iron, zinc, calcium, and vitamin B12 during growth and development. OBJECTIVE: The objective of the SuNDiAL Project (Survey of Nutrition, Dietary Assessment, and Lifestyles) is to compare the dietary intakes and habits, nutrition status, motivations, attitudes, and physical activity of a sample of vegetarian and nonvegetarian adolescent girls in New Zealand. METHODS: A clustered, cross-sectional, nationwide study of adolescents aged 15-18 years was conducted. Secondary schools were recruited throughout New Zealand, and pupils (n=290) were invited to participate in data collection in either the first (February to April) or third (August to October) school term of 2019 (New Zealand schools operate on a 4-term year). Sociodemographic and health information; vegetarian status; dietary habits; and attitudes, motivations, and beliefs regarding food choices were assessed via an online self-administered questionnaire. Dietary intakes were collected via two 24-hour diet recalls on nonconsecutive days and will be adjusted for within-person variation using the Multiple Source Method, to represent usual intakes. Nutrient adequacy will be assessed by the estimated average requirement cut-point method or probability approach as appropriate. Height and weight were measured, and blood and urine samples collected for micronutrient status assessment. Participants wore an accelerometer for 7 days to assess 24-hour activity patterns (time spent asleep, sedentary, or engagement in light-intensity or moderate-to-vigorous intensity physical activity). RESULTS: Recruitment and data collection were conducted in 2019. Data are currently being cleaned and analyzed, with publication of the main results anticipated at the end of 2020. CONCLUSIONS: The SuNDiAL Project will provide a meaningful and timely description of diet, nutrition status, and motivational factors associated with vegetarianism and identify any risks this pattern of eating may pose for female adolescents. The results of this study will support the development of targeted recommendations and interventions aimed at enhancing the health, growth, and development of adolescent girls. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12619000290190; https://tinyurl.com/yaumh278. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/17310.

Intuitive eating and gestational weight gain.

This observational study was designed to establish whether there is a relationship between intuitive eating and gestational weight gain. Intuitive eating involves eating according to hunger and satiety cues, rather than following diet rules or eating in response to external triggers or emotions. Higher levels of intuitive eating are associated with bodyweight in the normal range in women during young and middle adulthood. Excess gestational weight gain is associated with an increased incidence of adverse health outcomes for mothers and children, including many pregnancy related conditions and, following pregnancy, an increased likelihood of obesity among mothers and children. Pregnant women were recruited at their nuchal translucency scan (11-14 weeks gestation), in Dunedin, New Zealand, between 2013 and 2015. A cohort of 218 women completed questionnaires at four times during their pregnancies. Intuitive eating was measured using a version of the Intuitive Eating Scale (IES) adapted for pregnant women and revalidated with this population. Gestational weight gain was calculated at the term visit (>35 weeks gestation) and babies' birth weight was established from the electronic maternity system. Mean total IES scores (and all IES subscales) increased across pregnancy. For every one point greater total IES score at baseline, there was a 1.7 (0.5, 2.9) kg lower gestational weight gain. There was no association between babies' birth weight and intuitive eating. Intuitive eating appears to be associated with lower gestational weight gain but not babies' birth weight. It remains to be seen whether intuitive eating can be increased by educational interventions during pregnancy and thus have an impact on gestational weight gain.

Learning to eat intuitively: A qualitative exploration of the experience of mid-age women.

Qualitative studies examining women's experiences of learning to eat more intuitively are scarce. We aimed to explore the experience of learning intuitive eating among mid-age women (n = 11) who participated in a web-based intuitive eating programme. Motivation to learn intuitive eating, perceptions of the experience of attempting to eat more intuitively, and facilitators and barriers to intuitive eating were explored using inductive thematic analysis. Findings suggest that women were able to learn to eat more intuitively; however, they encountered social and environmental barriers, and the 'unconditional permission to eat' aspect of intuitive eating was experienced as the most challenging.

Weight-Focused Physical Activity Is Associated with Poorer Eating Motivation Quality and Lower Intuitive Eating in Women.

BACKGROUND: Evidence suggests that physical activity may be related to improved eating regulation, helping people self-regulate their eating in a healthier way. Yet the positive associations between physical activity and eating-related behaviors appear to depend on the goals pursued by individuals when they engage in physical activity. OBJECTIVE: This study investigated differences in eating motivations (informed by Self-Determination Theory) and intuitive eating between women who did physical activity to lose weight (PA-Wt) vs for non-weight goals (PA-NWt), and explores whether eating motivations mediate associations between weight-focused physical activity and intuitive eating. DESIGN/PARTICIPANTS: A sample of 1,435 physically active women (40 to 50 years) participated in a nationally representative survey conducted in 2009 in New Zealand. Women were asked whether they did physical activity predominantly to lose weight and were dichotomized into PA-Wt and PA-NWt groups. MAIN OUTCOME MEASURES: Questions assessing eating in response to hunger and satiety cues (intuitive eating) and eating-related motivations were completed by participants. STATISTICAL ANALYSES: Analyses of covariance, t tests, correlations, and mediation analyses were conducted to test the study hypotheses. RESULTS: PA-Wt participants reported lower levels of intuitive eating than did PA-NWt (0.26

Intuitive eating and food intake in men and women: Results from the Swiss food panel study.

Although intuitive eating (IE) interventions have consistently shown benefits for psychological wellbeing and some have shown improvements in physical wellbeing, there is scarce information on the relationship between IE and food intake. Given the popularity of IE as an alternative to dieting, it's important to explore its relationship with food intake. The relationships between IE, Body Mass Index (BMI), diet quality, self-evaluation of dietary intake and physical activity were investigated. A randomly selected sample of adults from the German and French-speaking parts of Switzerland (N = 5,238, 51% men, 20-100 years, BMI 15-62 kg/m2) completed a self-administered questionnaire comprising measures of a diverse range of eating related variables. Intuitive Eating was assessed with the IES-2. Food intake was measured with a semiquantitative food frequency questionnaire. Pearson correlations between the IES-2 and variables of interest were calculated for men and women separately. Although total IES-2 scores showed moderate negative correlations with BMI in men and women, the four IES-2 subscales showed different relationships with food intake. In contrast to the other subscales, unconditional permission to eat moderately correlated with poorer diet quality scores, and consistently showed associations with a more negative self-evaluation of eating behavior. The other three IES-2 subscales showed a few small positive and negative correlations with food intake, including small positive associations of diet quality scores in women, but not men, with eating for physical rather than emotional reasons and reliance on hunger and satiety cues. Further studies are needed to determine the impact of IE interventions on food intake.

Prediction of Physical Activity Level Using Processes of Change From the Transtheoretical Model: Experiential, Behavioral, or an Interaction Effect?

PURPOSE: The purpose of the present study was to compare prediction of physical activity (PA) by experiential or behavioral processes of change (POCs) or an interaction between both types of processes. DESIGN: A cross-sectional study. SETTING: This study was conducted using an online questionnaire. PARTICIPANTS: A total of 394 participants (244 women, 150 men), with a mean age of 35.12 ± 12.04 years and a mean body mass index of 22.97 ± 4.25 kg/m2 were included. MEASURES: Participants completed the Processes of Change, Stages of Change questionnaires, and the International Physical Activity Questionnaire to evaluate self-reported PA level (total, vigorous, and moderate PA). ANALYSIS: Hierarchical multiple regression models were used to test the prediction of PA level. RESULTS: For both total PA (ß = .261; P < .001) and vigorous PA (ß = .297; P < .001), only behavioral POCs were a significant predictor. Regarding moderate PA, only the interaction between experiential and behavioral POCs was a significant predictor (ß = .123; P = .017). CONCLUSION: Our results provide confirmation that behavioral processes are most prominent in PA behavior. Nevertheless, it is of interest to note that the interaction between experiential and behavioral POCs was the only element predicting moderate PA level. Experiential processes were not associated with PA level.

Teaching Intuitive Eating and Acceptance and Commitment Therapy Skills Via a Web-Based Intervention: A Pilot Single-Arm Intervention Study.

BACKGROUND: Middle-aged women are at risk of weight gain and associated comorbidities. Deliberate restriction of food intake (dieting) produces short-term weight loss but is largely unsuccessful for long-term weight management. Two promising approaches for the prevention of weight gain are intuitive eating (ie, eating in accordance with hunger and satiety signals) and the development of greater psychological flexibility (ie, the aim of acceptance and commitment therapy [ACT]). OBJECTIVES: This pilot study investigated the usage, acceptability, and feasibility of "Mind, Body, Food," a Web-based weight gain prevention intervention prototype that teaches intuitive eating and psychological flexibility skills. METHODS: Participants were 40 overweight women (mean age 44.8 [standard deviation, SD, 3.06] years, mean body mass index [BMI] 32.9 [SD 6.01] kg/m2, mean Intuitive Eating Scale [IES-1] total score 53.4 [SD 7.46], classified as below average) who were recruited from the general population in Dunedin, New Zealand. Module completion and study site metrics were assessed using Google Analytics. Use of an online self-monitoring tool was determined by entries saved to a secure online database. Intervention acceptability was assessed postintervention. BMI, intuitive eating, binge eating, psychological flexibility, and general mental and physical health were assessed pre- and postintervention and 3-months postintervention. RESULTS: Of the 40 women enrolled in the study, 12 (30%) completed all 12 modules (median 7.5 [interquartile range, IQR, 2-12] modules) and 4 (10%) used the self-monitoring tool for all 14 weeks of the intervention period (median 3 [IQR 1-9] weeks). Among 26 women who completed postintervention assessments, most women rated "Mind, Body, Food" as useful (20/26, 77%), easy to use (17/25, 68%) and liked the intervention (22/25, 88%). From pre- to postintervention, there were statistically significant within-group increases in intuitive eating (IES-2 total score P<.001; all IES-2 subscale scores: P ≤.01), psychological flexibility (P=.01), and general mental health (P<.001) as well as significant decreases in binge eating (P=.01). At the 3-month follow-up, IES-2 improvements were maintained, and there were further improvements in binge eating (P<.001) and general mental health (P=.03), and a marginal yet nonsignificant tendency for further improvement in psychological flexibility (P=.06). There were no significant within-group changes in BMI from pre- to postintervention and postintervention to 3-month follow-up (P=.46 and P=.93, respectively). CONCLUSIONS: The "Mind, Body, Food" prototype Web-based intervention is appealing to middle-aged women and may be a useful tool to help women learn intuitive eating and ACT skills, reduce binge eating, and maintain weight over 3 months. Further work to improve the user experience and engagement is required before testing the online intervention in a randomized controlled trial.

The brain, obesity and addiction: an EEG neuroimaging study.

Obesity is among the greatest challenges facing healthcare systems with 20% of the world's population afflicted. Great controversy exists whether obesity can be regarded as an addictive disorder or not. Recently the Yale Food Addiction Scale questionnaire has been developed as a tool to identify individuals with traits of addiction towards food. Using clinical and source localized EEG data we dichotomize obesity. Brain activity in food-addicted and non-food-addicted obese people is compared to alcohol-addicted and non-addicted lean controls. We show that food addiction shares common neural brain activity with alcohol addiction. This 'addiction neural brain activity' consists of the dorsal and pregenual anterior cingulate cortex, parahippocampal area and precuneus. Furthermore, common neural obesity neural brain activity exists as well. The 'obesity neural brain activity' consists of dorsal and pregenual anterior cingulate cortex, posterior cingulate extending into the precuneus/cuneus as well as the parahippocampal and inferior parietal area. However food-addicted differ from non-food-addicted obese people by opposite activity in the anterior cingulate gyrus. This food addiction and non-food-addiction obesity dichotomy demonstrates there is at least 2 different kinds of obesity with overlapping network activity, but different in anterior cingulate cortex activity.

Weight-Control Methods, 3-Year Weight Change, and Eating Behaviors: A Prospective Nationwide Study of Middle-Aged New Zealand Women.

BACKGROUND: The effectiveness of women's weight-control methods and the influences of dieting on eating behaviors remain unclear. OBJECTIVES: Our aim was to determine the association of various weight-control methods at baseline with weight change to 3 years, and examine the association between baseline weight-control status (trying to lose weight, trying to prevent weight gain or no weight-control attempts) and changes in intuitive eating and binge eating at 3 years. DESIGN: A nationally representative sample of 1,601 New Zealand women (40 to 50 years) was recruited and completed a self-administered questionnaire at baseline regarding use of variety of weight-control methods. Information on demographic characteristics, weight, height, food habits, binge eating, and intuitive eating were collected at baseline and 3 years. STATISTICAL ANALYSES: Linear and logistic regression models examined associations between both weight status and weight-control methods at baseline and weight change to 3 years; and baseline weight-control status and change in intuitive eating from baseline to 3 years and binge eating at 3 years. χ(2) tests were used to cross-sectionally compare food habits across the weight status categories at both baseline and 3 years. RESULTS: Trying to lose weight and the use of weight-control methods at baseline were not associated with change in body weight to 3 years. There were a few differences in the frequency of consumption of high-energy-density foods between those trying to lose or maintain weight and those not attempting weight control. Trying to lose weight at baseline was associated with a 2.0-unit (95% CI 0.7 to 3.4, P=0.003) reduction in intuitive eating scores by 3 years (potential range=21 to 105), and 224% (odds ratio=3.24; 95% CI 1.69 to 6.20; P<0.001) higher odds of binge eating at 3 years. CONCLUSIONS: The apparent ineffectiveness of dieting and weight-control behaviors may reflect misconceptions about what constitutes healthy eating or energy-dense foods. Dieting may reduce women's ability to recognize hunger and satiety cues and place women at increased risk of binge eating.

Speed of eating and 3-year BMI change: a nationwide prospective study of mid-age women.

OBJECTIVE: To conduct the first nationwide population survey to examine the associations between changes in speed of eating and weight gain over 3 years. The study also explored whether faster eating at baseline was related to healthy-weight women becoming overweight after 3 years. DESIGN: Longitudinal. At baseline, participants were randomly selected from a nationally representative sampling frame to participate in a prospective study. Women completed self-administered baseline questionnaires on demographic and health measures. Self-reported speed of eating, smoking status, physical activity, menopause status, and height and weight were collected at baseline and again 3 years later. SETTING: Nationwide study, New Zealand. SUBJECTS: Women (n 1601) aged 40-50 years were recruited at baseline from New Zealand electoral rolls. RESULTS: There was no evidence of associations between 3-year BMI adjusting for baseline BMI and either baseline speed of eating (slower and faster; P=0.524) or change in speed of eating (consistently faster eating, consistently slower eating, slower eating at baseline but not at 3 years, faster eating at baseline but not at 3 years; P=0.845). Of the 488 women with healthy BMI (18.5 to <25.0 kg/m2) at baseline, seventy-seven (15.8%) became overweight (BMI≥25.0 kg/m2) after 3 years. Compared with those who were slower eaters at baseline, faster eating at baseline did not increase the risk of becoming overweight 3 years later (P=0.958) nor did change in speed of eating (P=0.236). CONCLUSIONS: Results suggest that once women have reached mid-life, faster eating does not predict further weight gain.

Token monetary incentives improve mail survey response rates and participant retention: results from a large randomised prospective study of mid-age New Zealand women.

AIM: To examine if a small token monetary incentive (NZ$5) increases mail survey response rates and participant retention of 40-50 year old New Zealand women. METHOD: In 2009, 2500 women were randomly selected from the New Zealand electoral rolls for a prospective study investigating factors related to the prevention of weight gain. At baseline, 400 women were randomly assigned to receive NZ$5 with the initial survey mail-out in addition to nonmonetary gifts to encourage participation (pen, tea bag, entry in lottery draw) received by all women. At 2 years, 400 women (200 received NZ$5 at baseline and 200 had not) were randomly assigned to receive the same token monetary incentive. At 3 years, all women identifying as an ethnic minority (n=234) and 300 randomly selected women of other ethnicities received the token monetary incentive with the initial mail out. RESULTS: The baseline response rate for women who received NZ$5 was significantly higher than for women who did not (76% vs 64%, p<0.001). At 2 years, retention rate for all women who received NZ$5 was significantly higher than for women who did not (88% vs 80%, p<0.001). At 3 years, among those women not identifying as an ethnic minority, the retention rate for those who received NZ$5 was significantly higher than for those who did not (84% vs 77%, p=0.014). CONCLUSION: Inclusion of a small token monetary incentive significantly increases mail survey response rates and participant retention in mid-age New Zealand women.

Access to environmental resources and physical activity levels of adults in Hawaii.

PURPOSE: Examine associations between physical activity (PA) and spatial accessibility to environmental PA resources in Hawaii. METHODS: Metabolic equivalents (METs) of mild, moderate, and strenuous PA were compared for accessibility with environmental PA resources within a population-based sample of Hawaiian adults (n = 381). Multiple linear regression estimated differences in PA levels for residing further from a PA resource or residing in an area with a greater number of resources. RESULTS: No associations were found in the total sample. Analyses within subsamples stratified by ethnicity revealed that greater spatial accessibility to a PA resource was positively associated with strenuous PA among Caucasians (P = .04) but negatively associated with moderate PA among Native Hawaiians (P = .00). CONCLUSION: The lack of association in the total sample may be a consequence of Hawaii's unique environment. Results of stratified sample analyses are unique, providing groundwork for future examinations within parallel environments and among similar ethnic groups.

A nationwide survey of weight control practices among middle-aged New Zealand women.

AIM: To examine the prevalence of weight control practices in a nationwide representative sample of 40-50 year old New Zealand women. METHODS: In May 2009, a cross-sectional mail survey was conducted among 2500 women randomly selected from nationwide electoral rolls who were each mailed a self-administered questionnaire about their weight control practices, demographics and anthropometry. RESULTS: After excluding ineligible recipients, a 66% participation rate was achieved (n=1601). Thirty-nine percent of the sample (n=630) reported trying to control their weight, and among those who were not, 69% (n=674) were attempting to prevent weight gain. The weight control practices most commonly used were cutting down on meal/snack size (42%) and cutting down on fats/sugars (45%). Smoking, exercising in a driven or compulsive way, and fasting were used at least once a week as weight control strategies by 14%, 22% and 5% of women, respectively. Other potentially health-damaging practices (i.e. laxatives, diuretics, diet pills, vomiting) were employed by 1-4% of women. CONCLUSIONS: Most women reported weight control practices that were consistent with public health messages, however the use of smoking and exercising in a driven or compulsive way are of particular concern.

Does the transtheoretical model of behavior change provide a useful basis for interventions to promote fruit and vegetable consumption?

PURPOSE: To determine whether Transtheoretical Model (TTM) constructs differ between individuals making successful versus unsuccessful stage transitions for consumption of five or more servings of fruit and vegetables each day and thus provide a useful basis for designing health promotion interventions. DESIGN: Longitudinal, observational study. A randomly selected, multiethnic cohort of adults assessed at 6-month intervals over 2 years. SETTING: General community, Hawaii. SUBJECTS: There were 700 participants (62.6% female; mean = 47 ± 17.1 years; 31.1% Asian, 22.1% Native Hawaiian/Pacific Islander, 35.0% Caucasian; 25.1% participation rate). MEASURES: Stage of readiness, experiential and behavioral processes of change, pros, cons, self-efficacy, and self-reported fruit and vegetable consumption. ANALYSIS: The study used t-tests to determine which TTM variable scores differed consistently between those making "successful" versus "unsuccessful " stage transitions from precontemplation, preparation, and maintenance. Sample sizes for contemplation and action prohibited similar analyses. RESULTS: Compared to those remaining in precontemplation, individuals successfully progressing from precontemplation showed significantly greater use of behavioral processes (collectively and self-liberation) and consciousness raising (p < .001). However, only self-liberation demonstrated significant differences consistently over time. CONCLUSION: This longitudinal investigation reveals that TTM behavioral processes, particularly self-liberation, predict successful transition out of precontemplation for adult fruit and vegetable consumption, suggesting that public health messages tailored according to these TTM variables may be effective for this group. However, for adults prepared to adopt or maintain fruit and vegetable consumption, tailoring based on variables from other theories is needed.

Many apples a day keep the blues away--daily experiences of negative and positive affect and food consumption in young adults.

OBJECTIVES: Prior research has focused on the association between negative affect and eating behaviour, often utilizing laboratory or cross-sectional study designs. These studies have inherent limitations, and the association between positive affect and eating behaviour remains relatively unexplored. Therefore, the objective of this study was to investigate the bidirectional relationships between daily negative and positive affective experiences and food consumption in a naturalistic setting among healthy young adults. DESIGN: Daily diary study across 21 days (microlongitudinal, correlational design). METHODS: A total of 281 young adults with a mean age of 19.9 (± 1.2) years completed an Internet-based daily diary for 21 consecutive days. Each day they reported their negative and positive affect, and their consumption of five specific foods. Hierarchical linear modelling was used to test same-day associations between daily affect and food consumption, and next-day (lagged) associations to determine directionality. Moderating effects of BMI and gender were also examined in exploratory analyses. RESULTS: Analyses of same-day within-person associations revealed that on days when young adults experienced greater positive affect, they reported eating more servings of fruit (p = .002) and vegetables (p < .001). Results of lagged analysis showed that fruits and vegetables predicted improvements in positive affect the next day, suggesting that healthy foods were driving affective experiences and not vice versa. Meaningful changes in positive affect were observed with the daily consumption of approximately 7-8 servings of fruit or vegetables. CONCLUSIONS: Eating fruit and vegetables may promote emotional well-being among healthy young adults.

Agreement between measured and self-reported height, weight and BMI in predominantly European middle-aged New Zealanders: findings from a nationwide 1989 survey.

AIM: To examine the agreement between self-reported and measured height, weight and BMI in 40-50 year old New Zealand men and women. METHOD: Self-reported and measured height, weight and derived BMI were examined using data from 345 40-50 year old participants in the 1989/1990 Life In New Zealand Survey. Factors associated with biased reporting were assessed using regression models. RESULTS: Height was overestimated by men (1.08 cm, 95%CI 0.58, 1.59 p<0.001) and women (0.61 cm, 95%CI 0.35, 0.87, p<0.001), contributing to a small but statistically significant underestimation of BMI (men 0.31 kg/m2, 95%CI 0.14, 0.48, p<0.001; women 0.26 kg/m2 95%CI 0.11, 0.41, p<0.001). Weight was not statistically significantly misestimated by either sex. Bias in self-reported BMI did not differ by age, sex, ethnicity, SES or measured BMI category (all p-values <0.231). Agreement between BMI categories based on self-reported and measured data was very good (kappa: men 0.80, women 0.93). CONCLUSION: Self-reported height and weight from New Zealand 40-50 year olds in 1989 produced BMI estimates valid for use in epidemiological studies, especially when used as a continuous variable. Our analyses need to be replicated using data from a current and representative New Zealand sample.

Self-determined, autonomous regulation of eating behavior is related to lower body mass index in a nationwide survey of middle-aged women.

BACKGROUND: The associations among people's level of autonomy in regulating their eating behaviors, food patterns, and degree of obesity have not been investigated in a general adult population. OBJECTIVES: Our objectives were to cross-sectionally examine, in a nationally representative sample of adult New Zealand women, the associations between different styles of eating behavior regulation and body mass index (BMI), with specific food and eating habits as hypothesized mediators. DESIGN: During May 2009, a sample of 2,500 New Zealand women aged 40 to 50 years was randomly selected from the nationwide electoral rolls. A 66% (n=1,601) participation rate was achieved. Potential participants were mailed a self-administered questionnaire containing the Regulation of Eating Behavior scale, questions on specific food and eating habits (frequency of binge eating, speed of eating, usual daily servings of fruits and vegetables, usual frequency of intake of several high-fat and/or high-sugar foods), and height and weight. STATISTICAL ANALYSES: Univariate linear regression models were used to examine the associations among demographic, health and behavioral variables, and BMI. Multivariate linear regression models were developed to investigate the relationships between autonomous and controlled forms of eating behavior regulation and BMI, with specific food and eating habits as mediators. RESULTS: After adjusting for potential confounders as well as specific food and eating habits that were potential mediators, BMI was statistically significantly lower by 2% (95% CI -2.7% to -1.4%; P<0.001) for every 10-unit increase in autonomous regulation, and statistically significantly higher by 1.4% (95% CI 0.4% to 2.3%; P=0.005) for every 10-unit increase in controlled regulation. The relationships between autonomous regulation and BMI as well as controlled regulation and BMI were only partially mediated by the specific food and eating habits measured. CONCLUSIONS: Although the direction of causality requires confirmation, the results provide support for the applicability of Self-Determination Theory, and suggest that developing more autonomous motivation for eating behavior is likely to facilitate healthier food habits and lower BMI in middle-aged women.

Transtheoretical Model Constructs for Physical Activity Behavior are Invariant across Time among Ethnically Diverse Adults in Hawaii.

OBJECTIVES: Physical activity (PA) research applying the Transtheoretical Model (TTM) to examine group differences and/or change over time requires preliminary evidence of factorial validity and invariance. The current study examined the factorial validity and longitudinal invariance of TTM constructs recently revised for PA. METHOD: Participants from an ethnically diverse sample in Hawaii (N=700) completed questionnaires capturing each TTM construct. RESULTS: Factorial validity was confirmed for each construct using confirmatory factor analysis with full-information maximum likelihood. Longitudinal invariance was evidenced across a shorter (3-month) and longer (6-month) time period via nested model comparisons. CONCLUSIONS: The questionnaires for each validated TTM construct are provided, and can now be generalized across similar subgroups and time points. Further validation of the provided measures is suggested in additional populations and across extended time points.

Food outlet accessibility and fruit and vegetable consumption.

PURPOSE: To examine if spatial access to healthy and unhealthy outlets comprising the local food environment was associated with fruit and vegetable consumption. DESIGN: Cross-sectional. SETTING: Population-based sample residing in Hawaii. Subjects . Three hundred and eighty-four adults (36% Asian-American, 33% non-Hispanic white, 31% other/mixed race). MEASURES: A spatial model of the local food environment was constructed using radial buffers extending from participants' place of residence. Fruit and vegetable intake was estimated using the National Cancer Institute Fruit and Vegetable All-Day Screener. ANALYSIS: Mean intakes of fruits and vegetables were compared for spatial access to total, healthy, and unhealthy food outlets at distances of .5 to 3.5 km. Multiple linear regression was used to estimate differences in fruit and vegetable intake for residing further from a food outlet or for residing in an area with a greater number of food outlets. RESULTS: Residing in an area with a greater density of total or healthy food outlets was associated with a higher mean intake of fruits and vegetables (p < .05) at .5 km. No differences in mean intakes were detected for distances beyond .5 km or for regression models. CONCLUSION: Findings suggest that greater spatial accessibility to food outlets comprising the local food environment in Hawaii may not be meaningfully associated with fruit and vegetable consumption; however, associations were detected for the smallest spatial scale examined, warranting further investigation.