Reliability and validity of the abbreviated version of the Mindful Eating Questionnaire in Turkish adults / Confiabilidade e validade de uma versão abreviada do questionário de alimentação consciente em adultos turcos

ABSTRACT Objective To adapt the abbreviated version of the Mindful Eating Questionnaire to Turkish for the Turkish adult population. Methods This cross-sectional study includes 709 participants aged between 18-65 years living in the province of Elazig. The data was collected through a voluntary face-to-face survey. The questionnaire was included their general characteristics and the Mindful Eating Questionnaire -18 and Eating Attitude Test-26. Confirmatory factor analysis was used to test the validity of the Mindful Eating Questionnaire -18. Statistical analyzes were conducted using the R-Project program and IBM®SPSS® version 26.0. Results The overall content validity index was 0.93. A confirmatory factor analysis was conducted for the two sub-scales and reduced the abbreviated of Mindful Eating Questionnaire to 18 items. The Cronbach's alpha coefficient was 0.718 for the Mindful Eating Questionnaire-18 total factor scores and Cronbach alpha values for awareness, and disinhibition were found to be 0,843 and 0,789, respectively. The minimum discrepancy per degree of freedom=4.914 and the fit indices were at an acceptable level (RMSEA=0.074, CFI=0.934, SRMR=0.079, TLI=0.925, GFI=0.968, AGFI=0.959). Conclusion The findings of study showed that the psychometric properties of the abbreviated Mindful Eating Questionnaire adapted into Turkish were acceptable through construct and internal consistency reliability for adults.

RESUMO Objetivo Adaptar e validar uma versão abreviada do Mindful Eating Questionnaire para a língua turca para uma população turca adulta. Métodos Este estudo transversal incluiu 709 participantes com idades compreendidas entre os 18 e os 65 anos, residentes na província de Elazig. Os dados foram recolhidos através de um inquérito presencial voluntário. O questionário incluía as suas caraterísticas gerais e o Mindful Eating Questionnaire-18 e o Eating Attitude Test-26. Foi utilizada a análise fatorial confirmatória para testar a validade do Mindful Eating Questionnaire-18. As análises estatísticas foram efectuadas utilizando o programa R-Project e o IBM®SPSS® versão 26.0. Resultados O índice geral de validade de conteúdo foi de 0,93. Uma análise fatorial confirmatória foi realizada para as duas subescalas e reduziu a abreviação do Mindful Eating Questionnaire para 18 itens. O coeficiente alfa de Cronbach foi de 0,718 para os escores de fatores totais do Mindful Eating Questionnaire-18 e os valores alfa de Cronbach para consciência e desinibição foram 0,843 e 0,789, respectivamente. A discrepância mínima por grau de liberdade = 4,914 e o modelo geralmente se ajustam bem à estrutura (RMSEA=0,074, CFI=0,934, SRMR=0,079, TLI=0,925, GFI=0,968, AGFI=0,959). Conclusão Os resultados do estudo mostraram que as propriedades psicométricas do Mindful Eating Questionnaire abreviado adaptado para o turco eram aceitáveis por meio da confiabilidade de construção e consistência interna.

The role of mindful eating, and intuitive eating on the relationship with orthorexia nervosa in University Students: a cross-sectional study / O papel da alimentação consciente e da alimentação intuitiva na relação com a ortorexia nervosa em estudantes universitários: um estudo transversal

ABSTRACT Objective The study aimed to determine the relationship between mindful eating, intuitive eating, eating attitudes, and orthorexia nervosa in university students. Methods In the current cross-sectional study, 320 students (59.4% female) were enrolled. An online questionnaire including demographic characteristics, Orthorexia Nervosa Questionnaire-11, Eating Attitudes Test-40, Intuitive Eating Scale-2nd edition, and Mindful Eating Questionnaire was performed. Additionally, some anthropometric measurements (body weight, height, waist, and hip circumferences) were taken with the participants' declaration. Data were analyzed using IBM®SPSSNo-Break®No-Break 24.0. Results In participants with orthorexia nervosa , the scores of "eating discipline" and "interference" scores, which are Mindful Eating Questionnaire sub-factors, were higher than those who do not have orthorexia nervosa (p<0.05). There was a negative correlation between Mindful Eating Questionnaire and Orthorexia Nervosa Questionnaire-11 scores (r = -0.137; p:0.014). Additionally, the one-point increase in the Orthorexia Nervosa Questionnaire-11 scores of participants led to a 0.101 increase in Eating Attitudes Test-40 scores (B: 0.101, SE: 0.024, p<0.001), and a 1.667 decrease in Mindful Eating Questionnaire scores (B: -1.667, SE: 0.667, p:0.014). The body mass index, Eating Attitudes Test-40, and Mindful Eating Questionnaire scores affected Orthorexia Nervosa Questionnaire-11 scores by 6.3% (R2: 0.063). Conclusions Our study demonstrated a negative correlation between the Orthorexia Nervosa Questionnaire-11 and Mindful Eating Questionnaire total scores, whereas no correlation was found between Orthorexia Nervosa Questionnaire-11 and Intuitive Eating Scale-2nd edition scores. However, further research is needed to classify orthorexia nervosa as a separate eating disorder and to establish criteria for diagnosis and treatment.

RESUMO Objetivo O objetivo do estudo foi determinar a relação entre o mindful eating, o comer intuitivo, as atitudes alimentares e a ortorexia nervosa em estudantes universitários. Métodos No presente estudo transversal, foram inscritos 320 estudantes (59,4% do sexo feminino). Foi realizado um questionário online que incluía características demográficas, Orthorexia Nervosa Questionnaire-11, Eating Attitudes Test-40, Intuitive Eating Scale-2nd edition e Mindful Eating Questionnaire. Adicionalmente, foram tomadas algumas medidas antropométricas (peso corporal, altura, circunferências da cintura e da anca) com a declaração dos participantes. Os dados foram analisados através do IBM®SPSS® 24.0. Resultados Nos participantes com ortorexia nervosa, as pontuações de "disciplina alimentar" e "interferência", que são subfactores do Mindful Eating Questionnaire, foram mais elevadas do que naqueles que não possuíam ortorexia nervosa (p<0,05). Houve uma correlação negativa entre os escores do Mindful Eating Questionnaire e do Orthorexia Nervosa Questionnaire-11 (r = -0,137; p:0,014). Além disso, o aumento de um ponto nas pontuações do Orthorexia Nervosa Questionnaire-11 dos participantes levou a um aumento de 0,101 nas pontuações do Eating Attitudes Test-40 (B: 0,101, SE: 0,024, p<0,001) e a uma diminuição de 1,667 nas pontuações do Mindful Eating Questionnaire (B: -1,667, SE: 0,667, p:0,014). As pontuações do índice de massa corporal, do Eating Attitudes Test-40 e do Mindful Eating Questionnaire afetaram as pontuações do Orthorexia Nervosa Questionnaire-11 em 6,3% (R2: 0,063). Conclusão O estudo demonstrou uma correlação negativa entre as pontuações totais do Orthorexia Nervosa Questionnaire-11 e do Mindful Eating Questionnaire, enquanto que não foi encontrada qualquer correlação entre as pontuações do Orthorexia Nervosa Questionnaire-11 e do Intuitive Eating Scale-2nd. No entanto, é necessário maior investigação para classificar a ortorexia nervosa como uma perturbação alimentar distinta e para estabelecer critérios de diagnóstico e tratamento.

Associations between body mass index and physical activity level with mindful eating behaviour among undergraduate medical students of Universiti Sains Malaysia

@#Introduction: Mindful eating is being fully present in the moment of eating and it is critical in preventing poor eating habits. The main objective for this study was to determine the associations of body mass index (BMI) and physical activity level with mindful eating behaviour among undergraduate medical students of Universiti Sains Malaysia (USM), Health Campus, Kubang Kerian, Kelantan. Methods: A cross-sectional study was conducted among 158 students (Years 1-5; 69% females and 31% males) by using a self-administered online questionnaire consisting of socio-demographic data, anthropometric data, short version of the International Physical Activity Questionnaire (IPAQ), and Mindful Eating Questionnaire (MEQ). The associations between BMI and physical activity with MEQ were determined by Spearman’s Correlation and One-Way ANOVA or Kruskal-Wallis Test, respectively. Results: Majority of the students had normal BMI (66.4%, n=105), and 39.9% (n=63) had low physical activity levels. The mean MEQ summary score of the students was considered high (2.82±0.26). There was a significant negative association between MEQ summary score (r=-0.191; p=0.016) and disinhibition subscale score (r=-0.340; p<0.001) with BMI, whereby MEQ summary and disinhibition subscale scores increased as BMI decreased. However, there was no significant association between physical activity level with MEQ score (p>0.05). Conclusion: A student with positive mindful eating behaviour has the potential to lower his/her BMI. However, further research is required to verify this finding.

BariMEP: uma ferramenta para treinar os pacientes de cirurgia bariátrica / Barimep: a tool for training bariatric surgery patients

ABSTRACT BACKGROUND Bariatric surgery patients have symptoms such as "plugging." Therefore, a possible good way to avoid these eating discomforts, typical of the early period after bariatric surgery, is to educate the patient. The Mindful Eating (ME) consists of paying attention to physical signs of hunger and satiety and developing awareness of emotional triggers related to food. In addition, conscious food choices reflect positively on the speed of chewing at mealtime. AIMS Due to the difficulties that patients reported during consultations to controlling their bad eating habits and the lack of tools to help the bariatric patient change eating habits, we elaborated "BariMEP: A Mindful Eating Placemat for bariatric surgery patients." METHODS The BariMEP was written by the multidisciplinary bariatric team based on a study by Russell et al. and ME principles in order to help bariatric patients pay attention to what and how they eat at each meal. RESULTS The BariMEP has some instructions based on Mindful Eating principles: get your seat at the table; do not distract yourself; before starting to eat, try breathing sometimes; recognize the internal hunger and satiety cues; let the fork rest at each bite and chew a lot; pay attention to the smell and taste; and be as present as possible at this time with nonjudgment. CONCLUSIONS For the first time, a tool has been developed with the aim of preparing the patient for bariatric surgery. Since the BariMEP is easy to teach and cheap, we suggest that the BariMEP be included in the bariatric surgery protocol.

RESUMO RACIONAL Pacientes operados de cirurgia bariátrica apresentam sintomas como "entalo". Portanto, uma possível maneira de evitar esses desconfortos alimentares, típicos do período inicial após a cirurgia bariátrica, é educar o paciente. O Mindful Eating (ME) consiste em avaliar aos sinais físicos de fome e saciedade e desenvolver a consciência dos gatilhos emocionais relacionados à alimentação. Além disso, as escolhas alimentares conscientes refletem positivamente na velocidade da mastigação durante as refeições. OBJETIVOS Devido às dificuldades, que os pacientes relataram durante as consultas, para controlar os maus hábitos alimentares e a falta de ferramentas para ajudar o paciente bariátrico na mudança, elaboramos o "BariMEP: um jogo americano de comer com atenção plena para pacientes de cirurgia bariátrica". MÉTODOS O BariMEP foi escrito pela equipe multidisciplinar bariátrica com base no estudo de Russell et al. e nos princípios do Mindful Eating, para ajudar os pacientes submetidos a cirurgia bariátrica a prestar atenção ao que e como comem em cada refeição. RESULTADOS O BariMEP possui algumas instruções baseadas nos princípios do Mindful Eating: Sente-se à mesa; não se distraia; antes de começar a comer, respire algumas vezes; reconheça os sinais de fome e saciedade; deixe o garfo descansar a cada mordida e mastigue bastante; preste atenção ao aroma e sabor; esteja o mais presente possível neste momento e sem julgamentos. CONCLUSÃO Pela primeira vez, foi desenvolvida uma ferramenta com o objetivo de preparar o paciente para a cirurgia bariátrica. Como o BariMEP é fácil de ensinar e barato, sugerimos que o BariMEP seja incluído no protocolo de cirurgia bariátrica.

Fábrica da nutrição neoliberal: elementos para uma discussão sobre as novas abordagens comportamentais / Neoliberal nutrition factory: elements to discuss new behavioral approaches

Resumo A aplicação de teorias do comportamento em diversas áreas tem despertado o interesse em investigar como essas teorias são incorporadas pelo campo da Alimentação e Nutrição, problematizando sua interdisciplinaridade. Este artigo busca contextualizar a Nutrição como ciência e seu desenvolvimento num contexto social em que o neoliberalismo opera como sistema de gestão da vida política, econômica e social. Visam-se reunir elementos teóricos relativos à noção de comportamento extraídos do campo da psicologia a fim de contribuir para o aprofundamento das reflexões acerca da emergência de técnicas baseadas em teorias do comportamento, tais como a Nutrição Comportamental, o Mindful Eating e o Comer Intuitivo, além de apresentar ponderações sobre os limites relacionados à aplicação dessas abordagens na formação e na prática dos profissionais de saúde.

Abstract The application of behavioral theories in several areas has aroused the interest in investigating how these theories are incorporated by the field of Food and Nutrition, problematizing its interdisciplinarity. This paper aims to contextualize Nutrition as a science and its development in a social context in which neoliberalism operates as a system for managing political, economic, and social life. The aim is to gather theoretical elements related to the notion of behavior extracted from the field of Psychology in order to contribute to the deepening of reflections on the emergence of techniques based on theories of behavior, such as Behavioral Nutrition, Mindful Eating and Intuitive Eating, in addition to presenting considerations on the limits related to the application of these approaches in the training and practice of health professionals.

Valoración y aprendizajes atribuidos al taller Mindful Eating en un grupo de mujeres en tratamiento de reducción de peso / EVALUATION AND LEARNINGS IN A GROUP OF WOMEN IN WEIGHT REDUCTION TREATMENT AS MINDFUL EATING

Las intervenciones en mindful eating están siendo cada vez más utilizadas para tratar problemáticas relacionadas con la alimentación. En población con sobrepeso y obesidad esta herramienta busca disminuir los síntomas de atracón, mejorar la regulación emocional y conciencia de los estados internos de hambre y saciedad. Objetivo: conocer la valoración y aprendizajes atribuidos al taller Mindful Eating en un grupo de mujeres en tratamiento de reducción de peso en un centro de salud privado. Método: enfoque metodológico cualitativo, de alcance exploratorio y descriptivo. Para recolectar los datos se utilizaron entrevistas en profundidad semi- estructuradas a 7 mujeres entre 22-54 años, analizadas desde el modelo de la Grounded Theory. Resultados: a partir del taller hubo cambios en el modo de relacionarse con la comida y el sí mismas. Antes del taller las participantes tenían una relación inconsciente con la comida; comer en piloto automático, comer emocional, atracones y modo de relacionarse consigo mismas desde la autocrítica y autocastigo. Posterior al taller, se describen cambios favorables en una relación consciente con la comida, destacándose mayor conexión interna, autocuidado y modo de relacionarse sí mismas autocompasivo. Discusión: las participantes tuvieron una valoración positiva del taller mindful eating, apreciando el rol contendor del grupo, ser una herramienta de utilidad y uso a largo plazo que posibilitaría un cambio hacia una relación más saludable con la comida y si mimas. Sería útil integrar esta herramienta en los programas de control de peso, monitoreando y reforzando continuamente los aprendizajes que los participantes hayan obtenido en el taller. Esta integración podría ayudar a los participantes a continuar utilizando herramienta y, al hacerlo, ayudarlos a integrar hábitos alimenticios más saludables a largo plazo.

Summary Mindful eating interventions are being increasingly used to treat eating behavior problems. In overweight and obese population this tool seeks to reduce symptoms of binge eating, improve emotional regulation, and increase awareness of hunger and satiety.Aim of the study: to investigate how a group of women in weight reduction treatment assessed a mindful eating workshop and what were the main learnings they had from the program. Method: qualitative approach with an exploratory and descriptive scope. Data were collected through semi-structured in-depth interviews. Participants were 7 women between 22-54 years old.  The data analysis was carried out using Grounded Theory model. Results: participants in the workshop reported changes in the way they relate to the food and themselves. Before the workshop, the participants reported not being aware of their relationship to the food, eating on autopilot, eating emotionally, bingeing, and being self-critical and punishing themselves. After the workshop, participants reported changes, experiencing increased awareness of their relationship with food, greater connection to the inner-self, and increased self-care and self-compassion. Discussion: participants had a positive assessment of the  minRPM Nº 11-2019.indd 798 13/12/19 12:50 LA PRENSA MÉDICA ARGENTINA Valoración y aprendizajes atribuidos al taller Mindful Eating en un grupo de mujeres en tratamiento… 799 V.105/Nº11 dful eating  workshop, highlighting the buffering effect of the group, considering mindfulness as a useful and long-term tool that would allow them to have a healthier relationship with food and with one-self. It would be useful to integrate this tool in weight control treatments, monitoring and reinforcing the learnings participants have from the workshop. Having this integration might help participants to continuing using the tool and, by doing that, helping them to integrate healthier eating habits in the long term.

Problematic and adaptive eating in people with obesity after a DBT-based skills training intervention: 3- and 8-month follow-up and mediation analysis

Abstract Background: Dialectical behavior therapy conceptualizes problematic behaviors as attempts to regulate emotions that occur when the individual lacks effective skills with which to manage his or her emotions and cope with distress. Problematic eating behaviors, e.g., binge and emotional eating, may serve to alleviate aversive emotional states, being highly associated with overweight and obesity. Dialectical behavior therapy skills training has been proven effective in reducing binge eating in several clinical studies. However, few studies reveal the effects of DBT on adaptive eating behaviors or the stability of outcomes. Objectives: This study aimed to test the effect of a brief DBT-based skills training intervention, and the stability of outcomes at 3- and 8-month follow-ups. Methods: Self-report measures of binge eating, emotional eating, intuitive eating, and mindful eating were taken on 5 timepoints before and after a 10-session DBT skills training intervention (2 baseline measures, 1 post-test, and 2 follow-ups). Data were analyzed using a mixed-model intention-to-treat approach and mediation analysis was conducted with path analysis. Results: After the intervention, intuitive eating and mindful eating scores were significantly higher than before the intervention, while emotional eating and binge eating scores were lower. The results remained stable during the follow-up period, with minor fluctuations and small trends towards returning to baseline values for binge eating and emotional eating. Mindful eating partially mediated the improvements in all outcomes. Limitations: Given that results are entirely based on self-report measures and that some instruments showed poor reliability, in addition to the high attrition rates, the results should be interpreted as preliminary. Conclusions: The results provide evidence that a brief DBT intervention is effective not only in reducing problematic eating but also in increasing adaptive eating, achieving reasonably stable results. Also, the mediation analysis results support the hypothesis that mindful eating partially explains the effects of the intervention on binge and emotional eating. Future research should address the limitations of this study by investigating a more diverse sample, triangulating different measurement strategies, and including other putative mediators.