Development and validation of the mindful eating scale (mind-eat scale) in a general population.

BACKGROUND: Mindful eating is a concept that is increasingly being used to promote healthy eating. Observational studies have suggested associations with healthier eating behaviors, lower weight status, and favorable cardiovascular biomarkers. However, existing scales assessing mindful eating have some limitations. Our study aimed to develop and validate a scale assessing the level of mindful eating in a general population. METHODS: The Mind-Eat Scale was developed in four main steps: 1. Generating an initial item pool covering all aspects of mindful eating; 2. Reviewing items with experts and naive individuals; 3. Administering the scale to a large and representative sample from the NutriNet-Santé cohort (N = 3102); 4. Conducting psychometric analyses. Construct validity was assessed using exploratory (EFA) (N1 = 1302) and confirmatory (CFA) (N2 = 1302, N3 = 498) factor analyses. Content, discriminant, convergent, and divergent validity, internal consistency, and test-retest reliability were examined. RESULTS: The initial pool of 95 items was refined to 24 items using EFA. The EFA highlighted six dimensions: Awareness, Non-reactivity, Openness, Gratitude, Non-judgement, and Hunger/Satiety, consisting of four items per dimension. CFAs showed a good fit for first and second-order models. Adequate content validity was confirmed. Discriminant, convergent, and divergent validity were supported by significant differences between subgroups of individuals, and correlations with eating behaviors and psychological well-being scales. The Mind-Eat Scale showed good reliability for all six dimensions, with high McDonald's ω and adequate intraclass correlation coefficients (ICC). CONCLUSIONS: This study validated the first tool assessing a total mindful eating score and its sub-dimensions in a general population. This scale can be an asset for clinical and epidemiological research on dietary behavior and related chronic diseases.

The association between consideration of future consequences and food intake is mediated by food choice motives in a French adult population.

OBJECTIVES: Consideration of future consequences (CFC) distinguishes individuals who adopt behaviours based on immediate needs and concerns from individuals who consider the future consequences of their behaviours. We aimed to assess the association between CFC and diet, and testing the mediating role of food choice motives on this relationship. DESIGN: Individuals (aged ≥ 18 years) completed the CFC-12 questionnaire in 2014, at least three 24-h dietary records, and a food choice motive questionnaire. A multiple mediator analysis allowed to assess the mediating effect of food choice motives on the cross-sectional association between CFC and diet, adjusted for socio-demographic factors. SETTING: Data from the NutriNet-Santé cohort study. PARTICIPANTS: 27 330 participants. RESULTS: CFC was associated with all food choice motives (P < 0·001), with the strongest positive associations for avoidance for environmental reasons, absence of contaminants and health motives and the strongest negative associations for innovation and convenience. Positive total effects were found between CFC and the consumption of healthy food groups (fruits and vegetables, whole-grain foods, legumes), and negative total effects for alcohol, meat and poultry and processed meat (P < 0·001). CFC was positively associated with diet quality (P < 0·001). Across food groups, major mediators of these relationships were higher health (8·4-32·6%), higher environmental (13·7-22·1 %) and lower innovation (7·3-25·1 %) concerns. CONCLUSIONS: CFC was associated with healthier dietary intake, essentially mediated by a greater motivation of future-oriented participants for self-centred and altruistic outcomes, including health and environment. Focusing on the awareness of future benefits in public health interventions might lead to healthier dietary behaviours.

Cross-sectional and longitudinal associations between self-esteem and BMI depends on baseline BMI category in a population-based study.

BACKGROUND: Some studies have reported associations between self-esteem and weight status, but longitudinal data on adults remain scarce. The aim of this population-based study was to analyze the cross-sectional and longitudinal association between self-esteem and body mass index (BMI) and to investigate whether baseline BMI has an impact on this association. METHODS: In 2016, 29,735 participants aged ≥ 18 years in the NutriNet-Santé cohort completed the Rosenberg Self-Esteem Scale. BMI was self-reported yearly over a 4-year period. Association between self-esteem and BMI was assessed using mixed models and logistic regressions. Analyses were stratified by BMI (categorical) at baseline and adjusted on sociodemographic and lifestyle characteristics. RESULTS: At baseline, higher self-esteem was associated with higher BMI in normal weight individuals(p = 0.32), and with lower BMI in obese class II and III individuals (p = 0.13). In addition, higher baseline self-esteem was associated with BMI increase over time in normal weight individuals (p = 0.15). Among normal weight individuals, those with higher self-esteem were less likely to show a decrease in their BMI (p = 0.005), while no association was observed with BMI increase (p = 0.81). DISCUSSION: Our findings suggest that the association between self-esteem and BMI depends on the initial category of BMI, with a negligible effect of self-esteem.

Associations of overall and specific carbohydrate intake with anxiety status evolution in the prospective NutriNet-Santé population-based cohort.

We investigated the association between carbohydrate intake and anxiety evolution within the general-population NutriNet-Santé cohort (N = 15,602; 73.8% female; mean age = 53.8y; mean follow-up = 5.4y). Carbohydrate intake was estimated at baseline from ≥ 2 24-h dietary records. Trait anxiety (STAI-T) was measured once at baseline (2013-2016) and once at follow-up (2020), resulting in 4 groups: "None" = absence of high anxiety (STAI-T > 40 points) at any time point; "Transient" = high anxiety only at baseline; "Onset at follow-up" = high anxiety only at follow-up; "Persistent" = high anxiety at baseline and follow-up. Polytomous logistic regression models revealed that sweetened beverage intake was associated with higher odds of "Transient" anxiety (ORQ4vsQ1 = 1.11; 95% CI 1.02-1.21). Intake of complex carbohydrates (ORQ4vsQ1 = 1.12; 1.01-1.25) was associated with higher odds of anxiety "Onset at follow-up." The % energy from carbohydrates (ORQ4vsQ1 = 1.11; 1.03-1.19), intakes of total carbohydrates (ORQ4vsQ1 = 1.10; 1.03-1.18) and complex carbohydrates (ORQ4vsQ1 = 1.09; 1.02-1.17) were associated with higher odds of "Persistent" anxiety, whereas 100% fruit juice intake showed lower odds of "Persistent" anxiety (ORQ4vsQ1 = 0.87; 0.81-0.94). This prospective study found significant associations between dietary carbohydrate intake and anxiety status evolution among French adults. The findings could help inform dietary interventions aimed at anxiety prevention and management.

Validation of the Flexible and Rigid Cognitive Restraint Scales in a General French Population.

Distinguishing between flexible and rigid cognitive restraint (CR) may be useful for understanding the role of CR in dietary behavior and weight status. This study aimed to translate and adapt the flexible and rigid CR scales to the French context and test their psychometric properties. Construct validity, internal consistency, and test-retest reliability were examined in a sample of 620 individuals. Confirmatory factor analysis of the scales found a two-factor structure (flexible CR: 12 items; rigid CR: 15 items) that provided a good fit and supported the initial solution (χ2 = 584.7, df = 322, CFI = 0.96, RMSEA = 0.052 [0.045, 0.059], TLI = 0.95). Higher flexible and rigid CR were associated with higher CR overall, emotional eating (TFEQ-R21) and eating disorders (SCOFF), and lower intuitive eating (IES-2). In addition, higher flexible CR was associated with lower impulsivity (BIS-11) while higher rigid CR was associated with higher uncontrolled eating (TFEQ-R21) and lower self-esteem (RSES), satisfaction with life (SWLS), and optimism (LOT-R). Flexible and rigid CR internal consistency was satisfactory (McDonald ω = 0.77 and 0.74, respectively) and test-retest reliability was good (ICC = 0.81 and 0.79, respectively). This study validated a flexible and rigid CR tool in a French population and confirmed that these two types of CR represent distinct eating behaviors.

Mastery Is Associated With Weight Status, Food Intake, Snacking, and Eating Disorder Symptoms in the NutriNet-Santé Cohort Study.

Mastery is a psychological resource that is defined as the extent to which individuals perceive having control over important circumstances of their lives. Although mastery has been associated with various physical and psychological health outcomes, studies assessing its relationship with weight status and dietary behavior are lacking. The aim of this cross-sectional study was to assess the relationship between mastery and weight status, food intake, snacking, and eating disorder (ED) symptoms in the NutriNet-Santé cohort study. Mastery was measured with the Pearlin Mastery Scale (PMS) in 32,588 adults (77.45% female), the mean age was 50.04 (14.53) years. Height and weight were self-reported. Overall diet quality and food group consumption were evaluated with ≥3 self-reported 24-h dietary records (range: 3-27). Snacking was assessed with an ad-hoc question. ED symptoms were assessed with the Sick-Control-One-Fat-Food Questionnaire (SCOFF). Linear and logistic regression analyses were conducted to assess the relationship between mastery and weight status, food intake, snacking, and ED symptoms, controlling for sociodemographic and lifestyle characteristics. Females with a higher level of mastery were less likely to be underweight (OR: 0.88; 95%CI: 0.84, 0.93), overweight [OR: 0.94 (0.91, 0.97)], or obese [class I: OR: 0.86 (0.82, 0.90); class II: OR: 0.76 (0.71, 0.82); class III: OR: 0.77 (0.69, 0.86)]. Males with a higher level of mastery were less likely to be obese [class III: OR: 0.75 (0.57, 0.99)]. Mastery was associated with better diet quality overall, a higher consumption of fruit and vegetables, seafood, wholegrain foods, legumes, non-salted oleaginous fruits, and alcoholic beverages and with a lower consumption of meat and poultry, dairy products, sugary and fatty products, milk-based desserts, and sweetened beverages. Mastery was also associated with lower snacking frequency [OR: 0.89 (0.86, 0.91)] and less ED symptoms [OR: 0.73 (0.71, 0.75)]. As mastery was associated with favorable dietary behavior and weight status, targeting mastery might be a promising approach in promoting healthy behaviors. Clinical Trial Registry Number: NCT03335644 at Clinicaltrials.gov.

Associations between Resilience and Food Intake Are Mediated by Emotional Eating in the NutriNet-Santé Study.

BACKGROUND: Resilience, the ability to bounce back or recover from stress, has been associated with several health-related behaviors. However, data on food intake and emotional eating are lacking. OBJECTIVES: The objective of this cross-sectional study was to analyze the associations between resilience and diet quality and ultraprocessed food (UPF) and food group consumption, and to assess whether emotional eating was a mediator of these associations. METHODS: In 2017, 17,840 participants (73.5% female, mean age = 55.4 ± 14.0 y) of the NutriNet-Santé study completed the Brief Resilience Scale, the revised 21-item Three-Factor Eating Questionnaire, and ≥3 self-administered 24-h dietary records. Diet quality was assessed with the modified French National Nutrition and Health Program Guideline Score. Foods and beverages consumed were categorized according to their degree of processing by the NOVA classification. We assessed the association between resilience and emotional eating using linear regression models. We also assessed the mediating role of emotional eating in the associations between resilience and diet quality, energy intake, and UPF and food group consumption, controlling for sociodemographic characteristics. RESULTS: In our study, resilience was negatively associated with emotional eating (P < 0.0001). More resilient participants had greater overall diet quality, greater intakes of seafood, whole-grain foods, fats, unsalted oleaginous fruits, and alcoholic beverages, and lower intakes of UPFs, starchy foods, dairy desserts, sugary fatty products, and sugar and confectionery (all P < 0.05). Emotional eating was a mediator of the inverse associations between resilience and intake of energy, UPFs, dairy desserts, sugary fatty products, and of the positive associations between resilience and alcoholic beverages (all P < 0.05), with a 20-70% mediation. CONCLUSIONS: Our findings showed that resilience was associated with an overall better diet quality in the NutriNet-Santé population-based study. These associations were partially explained by emotional eating. These findings suggest that resilience should be considered in the promotion of healthy dietary habits.The study is registered at clinicaltrials.gov as #NCT03335644.

Resilience Is Associated with Less Eating Disorder Symptoms in the NutriNet-Santé Cohort Study.

Resilience is a positive psychological trait associated with a lower risk of some physical and mental chronic diseases and could be an important protective factor against eating disorders (EDs). The aim of this study was to assess cross-sectional and longitudinal associations between resilience and ED in a large cohort of French adults. In 2017, a total of 25,000 adults from the NutriNet-Santé cohort completed the Brief Resilience Scale (BRS). ED symptoms were measured in 2017 and 2020, with the Sick-Control-One-Fat-Food (SCOFF) questionnaire. Cross-sectional and longitudinal associations between resilience and EDs were analyzed using logistic regression, controlling for sociodemographic and lifestyle characteristics. Cross-sectional analyses showed that more resilient participants exhibited EDs less frequently than did less resilient participants (p < 0.0001). Longitudinal analyses showed that, during the three years of follow up, higher resilience was negatively associated with incident EDs (OR: 0.67, 95%CI: 0.61-0.74), persistent EDs (0.46 (0.42-0.51)), and intermittent EDs (0.66 (0.62-0.71)), compared with no ED. More resilient participants were also less likely to have a persistent ED than to recover from EDs (0.73 (0.65-0.82)). This study showed that resilience was associated with less ED symptoms and a higher chance of recovery.

Association between positive psychological traits and changes in dietary behaviour related to first COVID-19 lockdown: A general population-based study.

BACKGROUND: The spread of the coronavirus disease (COVID-19) led many countries to implement lockdown measures, which resulted in changes in dietary behaviours that could persist over the long term and have associated health consequences. Psychological traits may impact these changes given their known association with dietary behaviours. We aimed to investigate in a population-based study, whether positive psychological traits were associated with changes of snacking behaviour and food consumption observed during the first COVID-19 lockdown period. DESIGN: In 2016, levels of optimism, resilience, self-esteem, satisfaction with life, mindfulness and mastery were assessed in 33,766 adults of the French NutriNet-Santé cohort. Snacking and food group consumption were assessed in April-May 2020. Association between psychological traits and changes (no change, increase, decrease) in snacking and food group consumption were assessed using logistic regressions. Multiple correspondence analysis followed by ascending hierarchical classification were used to derive clusters of dietary behaviours. Covariance analyses were used to compare mean scores of psychological traits between clusters. Analyses were adjusted for sociodemographic and lifestyle characteristics, anxiety and depressive symptomatology. RESULTS: Participants with higher levels of optimism, resilience, self-esteem, satisfaction with life, mindfulness or mastery were less likely to change their snacking behaviour and food group consumption of various food groups. Individuals with lower levels were more likely to make changes, with either unhealthy (e.g., less fruits and vegetables, more processed meat) or healthy (e.g., more pasta/rice (whole-grain)) changes. Overall, individuals showed higher levels of positive psychological traits in the "no change" cluster, followed by the "healthy" and the "unhealthy" cluster (all P < 0.05). CONCLUSIONS: Individuals with higher levels of optimism, resilience, self-esteem, satisfaction with life, mindfulness or mastery were less impacted by the lockdown in terms of dietary behaviours.

Dispositional optimism is associated with weight status, eating behavior, and eating disorders in a general population-based study.

OBJECTIVE: The objective of this cross-sectional study was to assess whether optimism is associated with body mass index (BMI), eating behavior and eating disorders (EDs) in a population-based study. METHOD: In 2016, a total of 32,805 participants aged ≥18 years from the NutriNet-Santé cohort completed the Life Orientation Test-Revised, assessing dispositional optimism. Height and weight were self-reported. Eating behavior was assessed with the revised 21-item Three-Factor Eating Questionnaire. Risk of EDs was evaluated with the Sick-Control-One-Fat-Food Questionnaire. Linear and Logistic regression was used to analyze the association between optimism, BMI categories, eating behavior and ED risk, controlling for sociodemographic, lifestyle and depressive symptom characteristics. RESULTS: Our sample was composed of 73.5% women, and the mean age was 55.39 ± 13.70 years. More optimistic participants were less likely to be underweight (OR = 0.82; 95% CI: 0.75, 0.89), or obese, particularly class III obese (BMI ≥40 kg/m2 ) (OR = 0.69; 95% CI: 0.56, 0.84) compared with less optimistic individuals. Optimism was negatively associated with cognitive restraint (ß = -.07; 95%CI: -0.08; -0.06), emotional eating (ß = -.17; 95% CI: -0.19, -0.16) and uncontrolled eating (ß = -.10; 95% CI: -0.11, -0.09). In addition, more optimistic participants had a lower risk of EDs (OR = 0.60; 95% CI: 0.56, 0.64). DISCUSSION: Our findings showed that optimism was associated with weight status, eating behavior and risk of EDs in both women and men. The causal structure of the underlying observed association remains unclear and should be further investigated.

Optimism is associated with diet quality, food group consumption and snacking behavior in a general population.

BACKGROUND: Dispositional optimism is a psychological trait that has been associated with positive health outcomes such as reduced risk of cardiovascular diseases. However, there is little knowledge on the relationship between optimism and dietary intake in the population. The objective of this cross-sectional study was to assess whether optimism was associated with overall diet quality, food group consumption and snacking. METHODS: In 2016, 32,806 adult participants from the NutriNet-Santé study completed the Life-Orientation Test Revised (LOT-R) which assesses dispositional optimism. Overall diet quality (assessed by the mPNNS-Guideline Score) and consumption of 22 food groups were evaluated using at least three self-reported 24-h dietary records. Snacking behavior was evaluated by an ad-hoc question. Logistic and linear regressions were used to analyze the associations between optimism and these dietary behaviors, taking into account socio-demographic, lifestyle and depressive symptomatology characteristics. RESULTS: Optimism was associated with greater overall diet quality (ß (95% CI) = 0.07 (0.004-0.11), P < 0.0001) and higher consumption of fruit and vegetables, seafood, whole grains, fats, dairy and meat substitutes, legumes, non-salted oleaginous fruits, and negatively associated with consumption of meat and poultry, dairy products, milk-based desserts, sugar and confectionery. In addition, optimism was associated with less snacking (OR (95% CI) = 0.89 (0.84, 0.95)). In contrast, optimism was associated with higher consumption of alcoholic beverage (ß (95% CI) = 5.71 (2.54-8.88), P = 0.0004) and appetizers (OR (95% CI) = 1.09 (1.04, 1.14)). Finally, no association was observed between optimism and energy intake. CONCLUSIONS: Optimism was associated with better overall diet quality and less snacking. It was also associated with consumption of healthy food groups as well as unhealthy food groups typically consumed in social eating occasions. These findings suggest that optimism could be taken into account in the promotion of a healthy eating behavior.