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Kinkel-Ram SS, Hunger J, Smith AR. Testing interoceptive dysfunction as a mediator of the relation between weight stigma and disordered eating. Appetite 2025; 213:108060. [PMID: 40383154 DOI: 10.1016/j.appet.2025.108060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2024] [Revised: 04/07/2025] [Accepted: 05/07/2025] [Indexed: 05/20/2025]
Abstract
Interoceptive dysfunction could be one mechanism that facilitates the weight stigma-disordered eating association. Hence, the aim of this study was to experimentally test whether interoceptive dysfunction mediates the relation between weight stigma and disordered eating. Participants (n = 135; 80.7 % White; 72.6 % women) were college students aged 18 to 25 who reported binge eating symptoms. Participants (n = 66) were randomly assigned to interact with a confederate showing weight stigmatizing attitudes or a control condition (n = 69) where the confederate did not show stigma towards any groups. Participants then completed a behavioral measure of gastric interoception, completed an ad-lib test meal of yogurt, and lastly completed self-report measures for gastric interoception, body trust, and urges to engage in future binge eating and restriction. We tested a path model including our condition variable, behavioral and self-report measures of interoception, and disordered eating urges. Contrary to our hypotheses, exposure to weight stigma was not related to increased binge eating or restriction urges, and was related to less caloric consumption. Hence, it is possible that weight stigma leads to short-term restriction immediately following the event, which could increase risk for downstream binge eating at a later time. Regardless of condition, lower levels of self-reported body trust and gastric interoception were related to higher intentions for binge eating as well as restriction. To mitigate the potential societal harms of weight stigma, clinicians should consider incorporating interoception assessments and weight-neutral approaches to their clinical work.
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Affiliation(s)
| | - Jeffrey Hunger
- Miami University, Department of Psychology, Oxford, OH, USA
| | - April R Smith
- Auburn University, Department of Psychological Sciences, Auburn, AL, USA
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Tiemann A, Ortmann J, Rubo M, Meyer AH, Munsch S, Vögele C, van Dyck Z. The relevance of cardiac and gastric interoception for disordered eating behavior. J Eat Disord 2025; 13:114. [PMID: 40524251 DOI: 10.1186/s40337-025-01284-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2025] [Accepted: 05/05/2025] [Indexed: 06/19/2025] Open
Abstract
BACKGROUND Gastric interoception (i.e., the perception of gastrointestinal signals such as hunger, satiety or nausea) in the context of eating has recently gained increasing research attention. Nevertheless, it remains poorly understood how different interoceptive dimensions (e.g., self-report) and organ systems (e.g., cardiac, gastric) relate to each other and to disordered eating behaviors such as emotional, external and restrained eating. We assessed multiple dimensions (behavioral, self-reported, and physiological) in the cardiac domain (interoceptive accuracy, interoceptive self-report, interoceptive insight and objective physiological state) and in the gastric domain (gastric interoceptive sensitivity, gastric attribution of interoceptive sensations, interoceptive self-report, interoceptive insight and objective physiological state). The first goal of this study was to examine the relationship between cardiac and gastric interoception measured via multiple dimensions (behavioral, self-reported, and physiological). The second goal was to investigate whether multidimensional gastric interoception was a more important predictor of emotional, external and restrained eating than multidimensional cardiac interoception. METHODS Our sample (n = 128) was predominantly female (n = 116), included healthy individuals (n = 87) and individuals with an eating disorder or sub-clinical eating disorder (n = 41). Instruments included a heartbeat counting task, the two-step Water Load Test, electrocardiogram, electrogastrogram and the Dutch-Eating Behaviour Questionnaire. We used correlation analysis, multiple regressions, and LASSO regressions. The final sample included in the multiple regression and LASSO regressions resulted in N = 89. RESULTS Results showed cardiac and gastric interoception to be distinguishable, yet not to be entirely independent processes. Results further suggest gastric and not cardiac interoception to be the most important predictor of emotional, external and restrained eating. Specifically gastric attribution of interoceptive sensations played the most important role in all disordered eating behaviors. CONCLUSIONS Our findings highlight the importance of the gastric system in the assessment and targeted treatment of disordered eating behaviors. Future research should consider adding additional interoceptive dimensions.
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Affiliation(s)
- Aline Tiemann
- Department of Clinical Psychology and Psychotherapy, University of Fribourg, Av. de L'Europe 20, 1700, Fribourg, Switzerland.
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, 2, place de l'Université, L-4365, Esch-Sur-Alzette, Luxembourg.
| | - Julie Ortmann
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, 2, place de l'Université, L-4365, Esch-Sur-Alzette, Luxembourg
| | - Marius Rubo
- Department of Cognitive Psychology, Perception and Methodology, Institute of Psychology, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland
| | - Andrea H Meyer
- Department of Clinical Psychology and Psychotherapy, University of Fribourg, Av. de L'Europe 20, 1700, Fribourg, Switzerland
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Missionsstrasse 60/62, 4055, Basel, Switzerland
| | - Simone Munsch
- Department of Clinical Psychology and Psychotherapy, University of Fribourg, Av. de L'Europe 20, 1700, Fribourg, Switzerland
| | - Claus Vögele
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, 2, place de l'Université, L-4365, Esch-Sur-Alzette, Luxembourg
| | - Zoé van Dyck
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, 2, place de l'Université, L-4365, Esch-Sur-Alzette, Luxembourg
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Albajri E, Naseeb M. Assessment of intuitive eating in Saudi Arabia and its relationship with sociodemographic factors and nutritional indicators using an Arabic version of the Intuitive Eating Scale-2. Front Nutr 2025; 12:1585856. [PMID: 40557241 PMCID: PMC12185536 DOI: 10.3389/fnut.2025.1585856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2025] [Accepted: 05/19/2025] [Indexed: 06/28/2025] Open
Abstract
Background Intuitive eating (IE) is an eating style where the person responds to the bodily signals of satiety and hunger. This study assessed IE in Saudi Arabia using the newly validated Saudi Arabic Intuitive Eating Scale 2 (IES-2). It also examined the influence of sociodemographic factors, sex, and BMI on the scale and subscale scores. Methods This cross-sectional study gathered data online, using the Saudi Arabic IES-2, from individuals aged 18 years and older with a BMI of 18.5 kg/m2 or higher residing in Saudi Arabia. Results There were 387 respondents (57.9% women) with an average age of 31.83 ± 11.06 years. BMI showed a significant negative association with the total scale and subscale scores (p < 0.05). The total IE score was significantly influenced by age, sex, BMI, educational level, employment status, and recent weight change. Sex specifically affected the scores for the "Eating for Physical Rather than Emotional Reasons "(EPR) and "Reliance on Hunger and Satiety Cues for Eating subscales" (RHSC). Employment status was a significant predictor for the RHSC subscale score. Age and recent weight change specifically influenced the Unconditional Permission to Eat subscale score. Conclusion Our findings emphasize the multidimensional impact of sociodemographic factors on IE behaviors among Saudis, and the importance of culturally customized interventions to promote IE practices in the region. Preliminary findings support the promotion of IE in public health and prevention initiatives. Future research should explore the longitudinal relationships and intervention strategies aimed at enhancing IE practices.
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Joshi V, Graziani P, Del-Monte J. Interoceptive sensibility, intuitive eating, binge, and disordered eating behavior among individuals with obesity: A comparative study with the general population. J Health Psychol 2025; 30:199-211. [PMID: 38532256 DOI: 10.1177/13591053241237900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024] Open
Abstract
The present study assessed the links between interoceptive sensibility, binge, disordered (emotional, restrained, and external) and intuitive eating among individuals with obesity (n = 57) and normal weight (n = 29). Individuals with obesity presented lower "attention regulation," "body-listening," and "trusting" interoceptive dimensions. When age was controlled, group differences on "trusting" remained significant. Individuals with obesity showed lower intuitive eating, higher emotional, and binge eating compared to controls. Higher "body listening," "eating for physical rather than emotional reasons," and "reliance on hunger and satiety cues" predicted lower binge eating whereas "external eating" predicted higher binge eating among individuals with obesity. Eating for physical reasons and reliance on hunger and satiety had protective mediating roles in the relationship between external and binge eating in both groups. Interoceptive sensibility and intuitive eating should conjointly serve as psychotherapeutic targets for disordered eating, obesity, and weight management.
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Affiliation(s)
- Vrutti Joshi
- Université de Nîmes, France
- Aix-Marseille Université, France
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Yu S, Birtill P, Fildes A, Tang T, Hetherington MM. Towards developing a "baby translator" - An exploration of how infant appetite cues are understood. Appetite 2025; 206:107850. [PMID: 39798930 DOI: 10.1016/j.appet.2025.107850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 12/31/2024] [Accepted: 01/03/2025] [Indexed: 01/15/2025]
Abstract
Caregivers' feeding practices shape their child's eating patterns and subsequent health. Research shows that sensitive feeding is linked to healthy development and self-regulation but depends on caregiver responsiveness to infant needs and appetite cues. Responsive feeding (RF) is influenced both by characteristics of the caregiver and expressiveness of the infant. To investigate how infant communication is understood and whether recognition of appetite cues is associated with the viewer's eating traits, mental health and wellbeing, an online study was conducted. Participants (N = 200) aged 18-55 years were recruited in June 2022 via Prolific. Recognition of infant appetite cues was measured by participant responses to video clips of infants (N = 10) being fed during mealtimes (sampled at the start and end of a meal). Caregiver satiety responsiveness, intuitive eating, alexithymia, autism spectrum disorder, and mental health were assessed by validated questionnaires. Results showed a high consensus in identifying infant appetite cues, with no significant correlations with parenting status, eating traits or mental health, except for one subscale of alexithymia - Difficulty Describing Feelings (r = -.15, p = .03). Open-ended descriptions of mealtime cues showed that positive affect was observed early in the meal and more negative affect at the end of the meal. Infant cues signalling interest in eating were generally well recognised and were not significantly correlated with individual differences of the viewer except alexithymia. Further research to assess the association between alexithymia, responsiveness to infant communication cues and RF practices is warranted.
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Affiliation(s)
- Shihui Yu
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Pam Birtill
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Alison Fildes
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Tang Tang
- School of Design, University of Leeds, Leeds, LS2 9JT, UK
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Mulder J, Boelens M, van der Velde LA, Brust M, Kiefte-de Jong JC. The role of interoception in lifestyle factors: A systematic review. Neurosci Biobehav Rev 2025; 169:106018. [PMID: 39855405 DOI: 10.1016/j.neubiorev.2025.106018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Revised: 01/11/2025] [Accepted: 01/15/2025] [Indexed: 01/27/2025]
Abstract
BACKGROUND Interoception, the perception of the internal state of the body, offers an underrepresented and intriguing potential avenue for altering lifestyle-related behaviors. Interoception is intrinsically related to maintaining homeostasis and the flexible allostatic regulation of complex demands. Internal bodily states may also be influenced by lifestyle factors and related problems. This systematic review aimed to provide insight into the current state of evidence about the role of interoception in lifestyle factors. METHODS Studies from three databases (PubMed, Embase, and Web of Science) were screened for eligibility based on two inclusion criteria: 1) at least one measure of interoception (e.g., interoceptive accuracy, attention, or awareness), and 2) at least one measure of a lifestyle factor (i.e., alcohol consumption, cognitive leisure and relaxation activities, eating behavior, exercise, sleep, or smoking). Risk of bias was assessed using an adjusted quality score checklist, consisting of five items related to study design, population size, exposure measurement, outcome measurement, and adjustment for confounders. RESULTS The review included 73 studies. Out of the included studies, 51 measured interoceptive accuracy and 36 measured interoceptive attention. Six studies quantified interoceptive awareness. In terms of lifestyle factors, 26 studies on cognitive leisure and relaxation activities, 19 studies on eating behavior, 12 studies focused on alcohol consumption, 10 studies on exercise, five studies on smoking, and four studies on sleep were identified. Findings show positive relations between interoceptive domains and cognitive leisure and relaxation activities, eating behavior, and exercise. Conversely, the consumption of alcohol is negatively related to interoceptive domains. Studies in the smoking and sleep lifestyle factors were sparse and of varying methodological quality. DISCUSSION The findings of this review show that interoceptive domains are associated with various lifestyle factors, but the quality of the evidence is limited. Future longitudinal studies with more objective measures of interoception are needed in order to better understand the interrelations between interoception and lifestyle factors.
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Affiliation(s)
- Jesper Mulder
- Health Campus the Hague, Department of Public Health and Primary Care, Leiden University Medical Center, The Hague, the Netherlands; Department of Human Movement Sciences, University of Groningen, Groningen, the Netherlands.
| | - Mirte Boelens
- Health Campus the Hague, Department of Public Health and Primary Care, Leiden University Medical Center, The Hague, the Netherlands.
| | - Laura A van der Velde
- Health Campus the Hague, Department of Public Health and Primary Care, Leiden University Medical Center, The Hague, the Netherlands.
| | - Michelle Brust
- Health Campus the Hague, Department of Public Health and Primary Care, Leiden University Medical Center, The Hague, the Netherlands.
| | - Jessica C Kiefte-de Jong
- Health Campus the Hague, Department of Public Health and Primary Care, Leiden University Medical Center, The Hague, the Netherlands.
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Jeune S, Graziano P, Campa A, Coccia C. The Mediating Effect of Eating Behaviors on Interoception, Self-Regulation and Weight Status Among College Students. Nutrients 2024; 16:3986. [PMID: 39683379 DOI: 10.3390/nu16233986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2024] [Revised: 11/15/2024] [Accepted: 11/18/2024] [Indexed: 12/18/2024] Open
Abstract
BACKGROUND/OBJECTIVES Obesity among college students has been consistently high in the recent decades. Regulatory processes such as interoception and self-regulation have been studied to identify specific health behaviors that lead to weight gain. Reduced interoception and self-regulation may lead to increased body mass index (BMI), however, various eating styles may indirectly affect this relationship. It is proposed that poor interoception and self-regulation can increase the incidence of maladaptive eating styles, such as emotional or external eating, which may indirectly contribute to weight gain. Conversely, eating styles like cognitive restraint and intuitive eating may indicate an opposing indirect effect, exhibiting eating behaviors likely to maintain optimal weight status. To date, it is unknown which eating styles mediate the relationship between interoception and self-regulation on BMI. Additionally, study variables were examined throughout time to identify any potential influences throughout a typical semester. METHODS There were 104 female participants who completed the study measures. Participants were primarily identified as Hispanic (75.1%), mean age = 23.39 (SD = 6.312), and mean BMI = 25.45 (SD = 5.48) at baseline. Preliminary statistics and longitudinal mediation analyses were conducted to examine the relationships among eating styles, interoception, self-regulation, and BMI. RESULTS Intuitive eating was the only eating style that was found to be a significant mediator among both interoception and self-regulation, and BMI. It is theorized that these regulation skills occur more commonly among college females who intuitively eat, thus accurately explaining the associations with BMI. CONCLUSIONS The study has provided foundational evidence on the indirect effect of eating behaviors on one's relationship with interoception and self-regulation on BMI and can be useful in future interventions regarding college students and their associated risk for obesity.
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Affiliation(s)
- Shanté Jeune
- Department of Health Sciences, University of Central Florida, Orlando, FL 32816, USA
| | - Paulo Graziano
- Department of Psychology, Florida International University, Miami, FL 33199, USA
| | - Adriana Campa
- Department of Dietetics and Nutrition, Florida International University, Miami, FL 33199, USA
| | - Catherine Coccia
- Department of Dietetics and Nutrition, Florida International University, Miami, FL 33199, USA
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Wardzinski EK, Richter J, Moenikes S, Duysen KU, Oltmanns KM. Nondietary psychological app program leads to sustained weight loss due to trained physiological satiety perception. Appl Psychol Health Well Being 2024; 16:2129-2146. [PMID: 39095995 DOI: 10.1111/aphw.12581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 07/15/2024] [Indexed: 08/04/2024]
Abstract
Obese people are mostly unable to maintain successful weight loss after the end of a dietary change. One reason is that conventional weight reduction concepts neglect physiological hunger and satiety perception, leading to a relapse to previous eating habits on the long run. We examined the long-term efficacy of a psychological smartphone weight loss program, which avoids any dietary instructions and aims at relearning of satiety perception. Parameters of body weight alterations and psychological features, for example, satiety perception, food cravings, and emotional eating, were explored in a nonrandomized experimental study comprising 75 obese participants. Measurements occurred at baseline, two times during program application, as well as at 6- and 12-month follow-up. Participants displayed significant weight loss during the entire study period (p = .029) and showed an improved body composition at the 6-month follow-up (p = .018). These effects were associated with increased satiety perception, as well as reduced food cravings, and emotional eating habits. Notably, all improvements in measured parameters significantly sustained between the end of the program and the 12-month follow-up (p < .005 for all). Psychological relearning of satiety perception may outclass dietary approaches in terms of long-term efficiency.
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Affiliation(s)
- Ewelina K Wardzinski
- Section of Psychoneurobiology, Center of Brain, Behavior and Metabolism, University of Luebeck, Luebeck, Germany
| | - Juliane Richter
- Section of Psychoneurobiology, Center of Brain, Behavior and Metabolism, University of Luebeck, Luebeck, Germany
| | - Sophia Moenikes
- Section of Psychoneurobiology, Center of Brain, Behavior and Metabolism, University of Luebeck, Luebeck, Germany
| | - Kai U Duysen
- Section of Psychoneurobiology, Center of Brain, Behavior and Metabolism, University of Luebeck, Luebeck, Germany
| | - Kerstin M Oltmanns
- Section of Psychoneurobiology, Center of Brain, Behavior and Metabolism, University of Luebeck, Luebeck, Germany
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Lovan P, Prado G, Lee T, Coccia C. A snapshot of eating behaviors in undergraduate college students living in South Florida. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:2567-2576. [PMID: 36084262 DOI: 10.1080/07448481.2022.2119402] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 07/18/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
Objective: To examine a) whether college students' eating behaviors are different by students' sex and/or body mass index (BMI) categories and b) the correlations between college students' eating behaviors and the degree to which they rely on internal bodily signals for food intake. Participants: Undergraduate college students 18-24 years old at a public university located in South Florida. Methods: Eligible students answered questionnaires to examine interoception, intuitive eating, and eating behaviors including emotional eating, restrained eating, cognitive restraint, external eating, and uncontrolled eating. Pearson correlation and independent t test were used (significance: p < 0.05). Results: Females reported lower interoception, intuitive eating, and higher emotional eating than males. Students with lower BMI had higher intuitive eating and lower restrained eating. Interoception was positively correlated with intuitive eating and negatively correlated with emotional, uncontrolled, restrained, and external eating. Conclusion: College students who have a better connection with their bodily signals have healthier eating behaviors and lower BMI.
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Affiliation(s)
- Padideh Lovan
- Department of Psychology, University of Miami, Miami, Florida, USA
| | - Guillermo Prado
- School of Nursing and Health Studies, University of Miami, Miami, Florida, USA
| | - Tae Lee
- Department of Child Psychology and Education, Sungkyunkwan University, Seoul, South Korea
| | - Catherine Coccia
- Department of Dietetics and Nutrition, Florida International University, Miami, Florida, USA
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Wang WL, Liu JK, Sun YF, Liu XH, Ma YH, Gao XZ, Chen LM, Zhou ZH, Zhou HL. Interoception mediates the association between social support and sociability in patients with major depressive disorder. World J Psychiatry 2024; 14:1484-1494. [DOI: 10.5498/wjp.v14.i10.1484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 08/20/2024] [Accepted: 09/02/2024] [Indexed: 10/17/2024] Open
Abstract
BACKGROUND Interoception dysfunction has an important impact on the onset and development of major depressive disorder (MDD). Social support serves as a protective factor against MDD, and sociability also plays a significant role in this condition. These interconnected constructs-social support and sociability-play pivotal roles in MDD. However, no research on the mechanisms underlying the associations between social support and sociability, particularly the potential role of interoception, have been reported.
AIM To investigate the mediating effect of interoception between social support and social ability and to explore the independent role of social support in sociability.
METHODS The participants included 292 patients with MDD and 257 healthy controls (HCs). The patient health questionnaire 9, the multidimensional assessment of interoception awareness, version 2 (MAIA-2), the social support rating scale (SSRS), and the Texas social behavior inventory (TSBI) were used to assess depression, interoception, social support, and sociability, respectively. A mediation analysis model for the eight dimensions of interoception (noticing, not distracting, not worrying, attention regulation, emotional awareness, self-regulation, body listening, and trust), social support, and sociability were established to evaluate the mediating effects.
RESULTS A partial correlation analysis of eight dimensions of the MAIA-2, SSRS, and TSBI scores, with demographic data as control variables, revealed pairwise correlations between the SSRS score and both the MAIA-2 score and TSBI score. In the major depression (MD) group, the SSRS score had a positive direct effect on the TSBI score, while the scores for body listening, emotional awareness, self-regulation, and trust in the MAIA-2C had indirect effects on the TSBI score. In the HC group, the SSRS score had a positive direct effect on the TSBI score, and the scores for attention regulation, emotional awareness, self-regulation, and trust in the MAIA-2C had indirect effects on the TSBI score. The proportion of mediators in the MD group was lower than that in the HC group.
CONCLUSION Interoceptive awareness is a mediating factor in the association between social support and sociability in both HCs and depressed patients. Training in interoceptive awareness might not only help improve emotional regulation in depressed patients but also enhance their social skills and support networks.
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Affiliation(s)
- Wen-Liang Wang
- Department of Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi 214151, Jiangsu Province, China
| | - Ji-Kang Liu
- Department of Psychiatry, The Affiliated Mental Health Center of Nanjing Medical University, Wuxi 214151, Jiangsu Province, China
| | - Yi-Fan Sun
- Department of Psychiatry, The Affiliated Mental Health Center of Nanjing Medical University, Wuxi 214151, Jiangsu Province, China
| | - Xiao-Hong Liu
- Department of Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi 214151, Jiangsu Province, China
| | - Yu-Hang Ma
- Department of Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi 214151, Jiangsu Province, China
| | - Xue-Zheng Gao
- Department of Psychiatry, The Affiliated Mental Health Center of Nanjing Medical University, Wuxi 214151, Jiangsu Province, China
| | - Li-Min Chen
- Department of Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi 214151, Jiangsu Province, China
| | - Zhen-He Zhou
- Department of Psychiatry, The Affiliated Mental Health Center of Nanjing Medical University, Wuxi 214151, Jiangsu Province, China
| | - Hong-Liang Zhou
- Department of Psychology, The Affiliated Hospital of Jiangnan University, Wuxi 214151, Jiangsu Province, China
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Eaton M, Probst Y, Foster T, Messore J, Robinson L. A systematic review of observational studies exploring the relationship between health and non-weight-centric eating behaviours. Appetite 2024; 199:107361. [PMID: 38643903 DOI: 10.1016/j.appet.2024.107361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/22/2024] [Accepted: 04/13/2024] [Indexed: 04/23/2024]
Abstract
Eating behaviour that does not centralise weight, otherwise known as weight-neutral, is associated with improved physical and psychological health, and greater health promoting behaviours. However, consolidated evidence is lacking. This study aimed to systematically evaluate 'health-centric' eating behaviour reflective of weight-neutral approaches, and their relationship with health (physical and mental) and health promoting behaviours. A systematic search was performed, identifying observational studies with adult populations, ≥1 physical/mental health outcome(s), and ≥1 validated measure(s) of health-centric eating behaviour. Study design, sample characteristics and outcomes were extracted and characterised into four domains. Our search identified 8281 records, with 86 studies, 75 unique datasets, and 78 unique exposures including 94,710 individuals. Eating behaviours included intuitive eating (n = 48), mindful eating (n = 19), and eating competence (n = 11). There were 298 outcomes identified for body composition, size, and physical health (n = 116), mental health and wellbeing (n = 123), health promoting behaviours (n = 51) and other eating behaviour (n = 8). Higher levels of intuitive eating, mindful eating and eating competence were significantly related to a lower BMI, better diet quality and greater physical activity. Higher intuitive and mindful eating were significantly related to lower levels of disordered eating, and depressive symptoms, and greater body image, self-compassion, and mindfulness. Greater eating competence and intuitive eating were significantly related to higher fruit and vegetable intake, and greater eating competence to higher fibre intake and better sleep quality. Our results demonstrate that 'health-centric' eating behaviours are related to a range of favourable health outcomes and engagement in health promoting behaviours. These findings help to enhance our understanding of eating behaviours that do not centre around body weight, providing support for health-centric eating behaviour in healthcare. Future research should focus on intervention studies and more diverse population groups.
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Affiliation(s)
- Melissa Eaton
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia.
| | - Yasmine Probst
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia
| | - Tiarna Foster
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia
| | - Julia Messore
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Laura Robinson
- School of Psychology, University of Wollongong, Wollongong, Australia
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Baer NR, Grissmer NV, Schenk L, Wortmann HR, Warschburger P, Gisch UA. Practicing Interoceptive Sensitivity as a Couple: A Mixed-Methods Acceptance Analysis of a Dyadic vs. Single Pilot Randomized Controlled Trial. Nutrients 2024; 16:1949. [PMID: 38931304 PMCID: PMC11206497 DOI: 10.3390/nu16121949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Training interoceptive sensitivity (IS) might be a first step in effectively promoting intuitive eating (IE). A dyadic interoception-based pilot randomized controlled trial was conducted to increase IE among couples aged 50+. The training consisted of three exercises, a Body Scan (BS), a hunger exercise (HU), and a satiety (SA) exercise. This study explored how spouses accepted the (dyadic vs. single) training. In a mixed-methods convergence design, the findings of a survey (n = 68 couples) and focus groups (n = 4) were synthesized. Moderate general acceptance (e.g., regarding feasibility and low burden) and a hierarchical gradient in favor of the BS (e.g., pleasantness and improved sleep quality) emerged. Barriers concerned a perceived lack of the exercises' usefulness and a limited understanding of the training purpose. A wish for regular feedback and exchange with the study stuff and other participants was expressed. Spousal training involvement was experienced as being rather beneficial. Previously harmonized dietary practices and daily routines appeared as constructive pre-conditions for the joint training. This study highlights the potential and implications of training couples in IS. Future interventions should involve a regular exchange and closer guidance by study staff to promote a better understanding of the processes and goals of IS and IE.
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Affiliation(s)
- Nadja-R. Baer
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Institute for Medical Sociology and Rehabilitation Science, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Noemi Vanessa Grissmer
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Institute for Medical Sociology and Rehabilitation Science, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Liane Schenk
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Institute for Medical Sociology and Rehabilitation Science, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Hanna R. Wortmann
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Counseling Psychology, Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
| | - Petra Warschburger
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Counseling Psychology, Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
| | - Ulrike A. Gisch
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Counseling Psychology, Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
- Department of Nutritional Psychology, Institute of Nutritional Science, Justus Liebig University Giessen, Senckenbergstr. 3, 35390 Giessen, Germany
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Lucherini Angeletti L, Spinelli MC, Cassioli E, Rossi E, Castellini G, Brogioni G, Ricca V, Rotella F. From Restriction to Intuition: Evaluating Intuitive Eating in a Sample of the General Population. Nutrients 2024; 16:1240. [PMID: 38674930 PMCID: PMC11053871 DOI: 10.3390/nu16081240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
Intuitive eating (IE) is a non-dieting approach that promotes listening to internal cues of hunger and satiety, rather than adhering to external dietary restrictions aimed at weight loss. However, the role of IE in dieting behaviors related to weight-loss approaches is still unclear. To address this issue, the aim of this study was to compare IE levels between dieting and non-dieting individuals, exploring the relationship between IE and dieting-related psychological and physical factors. A sample of 2059 females was recruited via social media and self-reported questionnaires were administered to measure IE, eating psychopathology, self-efficacy, and quality of life. Individuals with a history of dieting exhibited lower IE levels, a higher BMI, and a greater eating psychopathology, as well as a reduced self-efficacy and quality of life, compared to non-dieters. IE showed a protective effect against dieting behaviors, with higher IE levels being associated with a lower likelihood of dieting. Additionally, higher BMI and eating psychopathology were predictors of dieting. Promoting IE could represent a relevant clinical target strategy to address disordered eating and enhance overall well-being, underscoring the need for interventions that foster a healthier relationship with food and bodily internal sensations.
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Affiliation(s)
- Lorenzo Lucherini Angeletti
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla, 3, 50134 Florence, Italy; (L.L.A.); (M.C.S.); (E.C.); (G.C.); (V.R.)
- The Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, ON K1Z 7K4, Canada
| | - Maria Chiara Spinelli
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla, 3, 50134 Florence, Italy; (L.L.A.); (M.C.S.); (E.C.); (G.C.); (V.R.)
| | - Emanuele Cassioli
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla, 3, 50134 Florence, Italy; (L.L.A.); (M.C.S.); (E.C.); (G.C.); (V.R.)
| | - Eleonora Rossi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla, 3, 50134 Florence, Italy; (L.L.A.); (M.C.S.); (E.C.); (G.C.); (V.R.)
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla, 3, 50134 Florence, Italy; (L.L.A.); (M.C.S.); (E.C.); (G.C.); (V.R.)
| | - Giulietta Brogioni
- Psychiatry Unit, AOU Careggi Hospital, Largo Brambilla, 3, 50134 Florence, Italy;
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla, 3, 50134 Florence, Italy; (L.L.A.); (M.C.S.); (E.C.); (G.C.); (V.R.)
| | - Francesco Rotella
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla, 3, 50134 Florence, Italy; (L.L.A.); (M.C.S.); (E.C.); (G.C.); (V.R.)
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Chammas N, Brytek-Matera A, Tornquist D, Barreto Schuch F, Bitar Z, Malaeb D, Fawaz M, Fekih-Romdhane F, Hallit S, Obeid S, Soufia M. Profiles of intuitive eating in adults: the role of self-esteem, interoceptive awareness, and motivation for healthy eating. BMC Psychiatry 2024; 24:288. [PMID: 38632564 PMCID: PMC11022488 DOI: 10.1186/s12888-024-05722-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 03/26/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE Intuitive eating is an eating behavior that has recently come to use mainly in the young population. Knowing that the Lebanese cultural diet differs from other countries, the purpose of this study was to investigate if there is a relationship between self-esteem, interoceptive awareness, and motivation for healthy eating in a sample of Lebanese adults using a Latent Profile Analysis approach. DESIGN Cross-sectional study. SETTING Lebanese governorates. PARTICIPANTS 359 Lebanese participants enrolled in this study (mean age: 22.75 ± 7.04 years, 40.1% males), through convenience sampling in several Lebanese governorates. Participants were asked to fill anonymously the following scales: The Intuitive Eating Scale (IES-2), the Rosenberg Self-Esteem Scale, the Multidimensional Assessment of Interoceptive Awareness Scale (MAIA), and the Motivation for Healthy Eating Scale (MHES). RESULTS Our findings revealed four profiles: profile 1 (n = 67; 18.66%) characterized by high SE and intermediate interoceptive awareness and motivation for healthy eating; profile 2 (n = 86; 23.97%) presented high SE, interoceptive awareness, and motivation for healthy eating; profile 3 (n = 86; 23.96%) characterized by high SE, interoceptive awareness, and motivation for healthy eating; class 4 (n = 108; 30.08) described by low SE, intermediate interoceptive awareness, and motivation for healthy eating One-way analysis of variance did not observe a significant difference between the four profiles based on intuitive eating (F = 1.810; p = 0.145; ɳp2 = 0.015). CONCLUSIONS Among a sample of Lebanese people, four profiles of interoceptive awareness, motivation for healthy eating, and self-esteem were observed, with no difference concerning intuitive eating.
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Affiliation(s)
- Nancy Chammas
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, P.O. Box 446, Lebanon
| | - Anna Brytek-Matera
- Eating Behavior Laboratory (EAT Lab), Institute of Psychology, University of Wrocław, 50-527, Wrocław, Poland
| | - Debora Tornquist
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Felipe Barreto Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Institute of Health Sciences, Universidad Autónoma de Chile, Providência, Chile
| | - Zeinab Bitar
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé environnement et travail)-, UMR_S 1085, F-35000, Rennes, France
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Mirna Fawaz
- College of Health Sciences, American University of the Middle East, Kuwait, Kuwait
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, P.O. Box 446, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
| | - Michel Soufia
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, P.O. Box 446, Lebanon
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15
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Mai-Lippold SA, Schultze J, Pollatos O. Interoceptive abilities impairment correlates with emotional eating and taste abnormalities in children with overweight and obesity. Appetite 2024; 194:107182. [PMID: 38154574 DOI: 10.1016/j.appet.2023.107182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/28/2023] [Accepted: 12/21/2023] [Indexed: 12/30/2023]
Abstract
Weight problems in children are associated with emotional eating, which has been linked to interoceptive abilities. Previous research also shows altered olfactory and gustatory perception in children with obesity and overweight. Therefore, we aimed to investigate the connection of alterations in olfactory and gustatory perception to interoceptive abilities and emotional eating among children with obesity and overweight. 23 children with overweight and obesity and age-matched controls with normal weight (12-16 years old) underwent olfactory and gustatory testing. Interoceptive abilities were assessed, focusing on interoceptive accuracy and interoceptive sensibility. Children with overweight and obesity showed significantly higher accuracy for detection of sweet taste, but descriptively lower accuracy for all other taste qualities compared to normal weight children. We found no changes in olfactory abilities in children with overweight and obesity. Emotional eating scores were elevated for children with overweight and obesity, and interoceptive accuracy scores were significantly lower. In both groups, interoceptive accuracy was inversely correlated with emotional eating. Our results support prior findings of altered gustatory abilities in children with overweight and obesity. The observed link between impaired interoceptive processes and heightened emotional eating in this group implies that interventions for overweight in children could benefit from targeting interoceptive abilities. This study provides meaningful grounds for further investigations into the roles of taste, emotional eating, and interoceptive abilities for overweight in children and adolescents.
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Affiliation(s)
- Sandra A Mai-Lippold
- Clinical and Health Psychology, Institute of Psychology, Ulm University, Germany
| | - Jasmin Schultze
- Clinical and Health Psychology, Institute of Psychology, Ulm University, Germany
| | - Olga Pollatos
- Clinical and Health Psychology, Institute of Psychology, Ulm University, Germany.
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Vollert B, Yim SH, Görlich D, Beintner I, Gordon G, Musiat P, Schmidt U, Jacobi C. Using web-based, guided self-help to bridge the waiting time for face-to-face out-patient treatment for bulimic-spectrum disorders: randomised controlled trial. BJPsych Open 2024; 10:e53. [PMID: 38404025 PMCID: PMC10897701 DOI: 10.1192/bjo.2023.629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Although effective treatments for bulimic-spectrum eating disorders exist, access is often delayed because of limited therapist availability and lengthy waiting lists. Web-based self-help interventions have the potential to bridge waiting times for face-to-face treatment and overcome existing treatment gaps. AIMS This study aims to assess the effectiveness of a web-based guided self-help intervention (everyBody Plus) for patients with bulimia nervosa, binge eating disorder and other specified feeding and eating disorders who are waiting for out-patient treatment. METHOD A randomised controlled trial was conducted in Germany and the UK. A total of 343 patients were randomly assigned to the intervention 'everyBody Plus' or a waitlist control condition. The primary outcome was the number of weeks after randomisation until a patient achieved a clinically relevant improvement in core symptoms for the first time. Secondary outcomes included eating disorder attitudes and behaviours, and general psychopathology. RESULTS At 6- and 12-month follow-up, the probability of being abstinent from core symptoms was significantly larger for the intervention group compared with the control group (hazard ratio: 1.997, 95% CI 1.09-3.65; P = 0.0249). The intervention group also showed larger improvements in eating disorder attitudes and behaviours, general psychopathology, anxiety, depression and quality of life, compared with the control group at most assessment points. Working alliance ratings with the online therapist were high. CONCLUSIONS The self-help intervention everyBody Plus, delivered with relatively standardised online guidance, can help bridge treatment gaps for patients with bulimic-spectrum eating disorders, and achieve faster and greater reductions in core symptoms.
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Affiliation(s)
- Bianka Vollert
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
| | - See Heng Yim
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, King's College London, UK
| | - Dennis Görlich
- Institute of Biostatistics and Clinical Research, Westfälische Wilhelms-Universität Münster, Germany
| | - Ina Beintner
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
| | - Gemma Gordon
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, King's College London, UK; and Forward College, Lisbon, Portugal
| | - Peter Musiat
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, King's College London, UK
| | - Ulrike Schmidt
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, King's College London, UK; and South London and Maudsley NHS Foundation Trust, London, UK
| | - Corinna Jacobi
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
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17
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Frederiksen C, Byrne DV, Andersen BV. Sensing the Snacking Experience: Bodily Sensations Linked to the Consumption of Healthy and Unhealthy Snack Foods-A Comparison between Body Mass Index Levels. Foods 2024; 13:438. [PMID: 38338573 PMCID: PMC10855362 DOI: 10.3390/foods13030438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/15/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
The World Health Organisation (WHO) has highlighted the need for immediate action regarding the escalating global prevalence of overweight and obesity. Based on the need for long-term strategies supporting dietary behaviour changes, the concept of 'interoception' (i.e., sensing the body's internal state) has been proposed as promising for understanding and controlling food intake behaviours. As eating behaviours are motivated by the need for securing energy demands as well as the desire for pleasure, investigating the bodily sensations perceived in relation to food consumption can support our understanding of human food and eating behaviours. Here, a consumer study was conducted on 286 Danish consumers to explore the interoceptive experience of snack food consumption. This study included an investigation of the consumers' interoceptive capabilities and ability to feel pleasure, intuitive eating behaviours, snack food consumption frequency, the drivers of snack food consumption, food-related pleasure, and post-ingestive sensations linked to snack food consumption. The study was conducted on consumers with different Body Mass Index (BMI) levels to study potential differences between these groups. The study showed normal interoceptive capabilities and abilities to feel pleasure, with no differences between BMI groups. Regarding intuitive eating, the study found intuitive eating to be more prevalent among the group holding normal BMI. No significant differences between BMI groups were found in terms of snack intake frequency. However, differences between BMI groups were found in terms of: the drivers of snack consumption, the aspects bringing food-related pleasure from snack consumption, and the post-ingestive sensations felt after eating snack foods.
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Affiliation(s)
- Chanette Frederiksen
- Food Quality Perception and Society Team, iSense Lab, Department of Food Science, Faculty of Technical Sciences, Aarhus University, 8000 Aarhus, Denmark; (C.F.); (D.V.B.)
- Sino-Danish College (SDC), University of Chinese Academy of Sciences, Beijing 101408, China
| | - Derek Victor Byrne
- Food Quality Perception and Society Team, iSense Lab, Department of Food Science, Faculty of Technical Sciences, Aarhus University, 8000 Aarhus, Denmark; (C.F.); (D.V.B.)
| | - Barbara Vad Andersen
- Food Quality Perception and Society Team, iSense Lab, Department of Food Science, Faculty of Technical Sciences, Aarhus University, 8000 Aarhus, Denmark; (C.F.); (D.V.B.)
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18
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Palazzo CC, Leghi BE, Diez-Garcia RW. Does feeling what you eat change how you eat? Implications of an intervention to promote consciousness of eating experiences. Front Psychol 2024; 14:1229105. [PMID: 38239476 PMCID: PMC10795314 DOI: 10.3389/fpsyg.2023.1229105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 12/06/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction This work aims to understand the experience of participating in the Food and Nutrition Education Program workshops with Sensory and Cognitive Exercises (PESC) and measure its impact on eating behavior. Methods The PESC consists of four workshops with exercises stimulating perception and reflection on bodily sensations triggered in eating situations. It was developed to promote consciousness of eating experiences in women who reported difficulty in controlling their body weight and who increased over 5% of their body weight in the previous year. This is a mixed-methods study designed as a controlled trial. The intervention group (n = 19) was evaluated before the first workshop (T0) and after the last workshop (T1) and the control group (n = 18), which did not participate in the workshops, was evaluated twice (T0 and T1), with an interval of 3 to 4 weeks. At T0 and T1, it was applied the Intuitive Eating Scale (IES-2) and the Three Factor Eating Questionnaire (TFEQ-R21). In T1, the intervention group also participated in a qualitative interview. Results After participating in the PESC, the intervention group showed an increase in the IES-2 total score (95% Confidence Interval = (0.10, 0.39)) and a decrease in the emotional eating scale score (95% Confidence Interval = (-16.03; -3.85)). The interviews' analysis revealed the participants' self-observation process, which led to the perception of their practices, priorities, intentions, eating difficulties, and the connection between these aspects and environmental issues. The following themes were considered: Food management/control, Body dissatisfaction, Reflection/re-signification, and Different ways of being in familiar contexts. Discussion The results allow us to infer that, after participating in the PESC, the intention to manage food intake became more effective, less susceptible to oscillations imposed by the external environment, and more supported by internal resources.
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Affiliation(s)
- Carina Carlucci Palazzo
- Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil
- Laboratory of Food Practices and Behaviour – PrátiCA, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Barbara Esteves Leghi
- Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil
- Laboratory of Food Practices and Behaviour – PrátiCA, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Rosa Wanda Diez-Garcia
- Laboratory of Food Practices and Behaviour – PrátiCA, University of São Paulo (USP), Ribeirão Preto, Brazil
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil
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19
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Gagliardi M. The role of developmental caregiving programming in modulating our affiliation tendency and the vulnerability to social anxiety and eating disorders. Front Psychol 2024; 14:1259415. [PMID: 38239461 PMCID: PMC10794631 DOI: 10.3389/fpsyg.2023.1259415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/01/2023] [Indexed: 01/22/2024] Open
Abstract
Attachment is the evolutionarily-established process through which humans create bonds with others to receive care from them. The phenomenon is as essential to our physical survival as it is to our psychological development. An increasing number of studies demonstrates that in sensitive periods during the early years of life, our brain circuitry is programmed in the interactions with our caregivers, with the imprinting of information over multiple attachment dimensions. Adopting a basic brain-computer analogy, we can think of this knowledge as the psycho-social firmware of our mind. According to a recently proposed extension of the classical three-dimensional view, one attachment dimension - somaticity - concerns the caregiver's task of reflecting and confirming the child's (internal) states - such as sensations, emotions, and representations - to support the child's ability to identify and define those entities autonomously. Relying on multidisciplinary evidence - from neuroscientific, developmental, evolutionary, and clinical sources - we suggest that somaticity (H1) has the adaptive function to modulate our tendency to comply and affiliate with a reference group but also (H2) increases the vulnerability to developing Social Anxiety (SA) and Eating Disorders (EDs). We evaluate H1-H2, (1) indicating the evolutionary role of somaticity in modulating our affiliation tendency to optimize the ancestral threat-opportunity balance coming from infectious diseases and (2) showing the deep connection between SA-EDs and the features most closely related to somaticity - interoception and parenting style. Finally, we discuss three relevant implications of H1-H2: (A) Bringing into research focus the adaptive role of our firmware knowledge system versus the hardware (neural substrate) and software (higher cognition) ones. (B) Complementing the well-grounded Objectification and Allocentric Lock Theories, allowing us to integrate multiple levels of explanation on the etiology of psychopathology. (C) Suggesting the design of new psychological treatments. While not aiming to prove H1-H2, our analysis supports them and encourages their direct testing.
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20
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Torres S, Vieira AI, Vieira FM, Lencastre L, Guerra MP, Miller KM, Barbosa MR. Psychometric analysis of the body responsiveness questionnaire in the Portuguese population. Sci Rep 2023; 13:22997. [PMID: 38151515 PMCID: PMC10752900 DOI: 10.1038/s41598-023-50530-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/20/2023] [Indexed: 12/29/2023] Open
Abstract
Body responsiveness refers to the tendency to be attuned to the body's needs and use interoceptive information to guide behavior. Despite its potential beneficial effect on the development of positive body image, this construct is currently understudied. To boost research in this area, we examined the factor structure, gender invariance, and psychometric properties of a Portuguese translation of the Body Responsiveness Questionnaire (BRQ). A total of 650 men and women (aged 18-80 years) completed the Portuguese BRQ. To assess its convergent validity, participants also completed measures of body appreciation, emotion regulation, depression symptoms, and psychological quality of life. Exploratory factor analysis indicated a two-factor structure of the BRQ, which was upheld using confirmatory factor analysis: "Importance of Interoceptive Awareness" (ω = .85-.87) and "Perceived Connection" between body and mind (ω = .71-.74). BRQ scores had partial scalar invariance across gender, and no significant gender differences. Convergent and known-groups validity was supported. Participants with overweight/obesity (vs. normal weight) and middle-aged adults (vs. young adults) assigned higher importance to body signals to guide behavior. The Portuguese version of the BRQ is a psychometrically sound measure of body responsiveness and it may contribute to a comprehensive assessment of positive body image to guide intervention.
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Affiliation(s)
- Sandra Torres
- Faculty of Psychology and Education Sciences, University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal.
- Center for Psychology at the University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal.
| | - Ana Isabel Vieira
- Faculty of Psychology and Education Sciences, University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
- Center for Psychology at the University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
| | - Filipa Mucha Vieira
- Faculty of Psychology and Education Sciences, University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
- Center for Psychology at the University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
| | - Leonor Lencastre
- Faculty of Psychology and Education Sciences, University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
- Center for Psychology at the University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
| | - Marina Prista Guerra
- Faculty of Psychology and Education Sciences, University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
- Center for Psychology at the University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
| | - Kylee M Miller
- Institute on Development & Disability, Child Development and Rehabilitation Center (CDRC), Oregon Health and Science University, 901 E. 18th Ave, Eugene, OR, 97403, USA
| | - Maria Raquel Barbosa
- Faculty of Psychology and Education Sciences, University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
- Center for Psychology at the University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
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21
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Longhurst P, Burnette CB. Challenges and opportunities for conceptualizing intuitive eating in autistic people. Int J Eat Disord 2023; 56:2189-2199. [PMID: 37794653 PMCID: PMC10840701 DOI: 10.1002/eat.24057] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 10/06/2023]
Abstract
Although intuitive eating (IE) has become an increasingly adopted intervention target, current conceptualisations of IE have yet to pivot away from (neuro)normative physiology and phenomenology. Autistic individuals commonly report disordered eating behaviours and/or poorer well-being but appear to benefit from adaptive interventions using an affirmative approach. This article uses autism as a case example to summarise challenges related to IE's prevailing conceptualisation, before proposing how future research and current practice can be extended to the autistic population. Scholars are encouraged to evaluate the full 10-principal IE framework while utilising a participatory-led approach. We argue that research using a mixed methods design is urgently needed to comprehensively explore the (re)conceptualisation of IE in autistic people. While IE shows promise for producing positive outcomes in the autistic population, we discuss the potential challenges for research and practice due to its current emphasis on accurate interoception, emotional awareness and processing, and executive functioning. This suggests the need for research and practice to integrate autistic needs and experiences into future developments with an affirmative approach. Public Significance: IE is an effective intervention for reducing disordered eating behaviours. Autistic individuals commonly present disordered eating behaviours and have unique nutritional needs which often require intervention. However, there is limited understanding of IE among the autistic population. Research-informed definitions involving autistic perspectives will support translating the IE framework to this underrepresented population.
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Affiliation(s)
- Phaedra Longhurst
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom
| | - C. Blair Burnette
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
- Department of Psychology, Michigan State University, East Lansing, MI
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Fekih-Romdhane F, Malaeb D, Fawaz M, Chammas N, Soufia M, Obeid S, Hallit S. Psychometric properties of an Arabic translation of the multidimensional assessment of interoceptive awareness (MAIA-2) questionnaire in a non-clinical sample of Arabic-speaking adults. BMC Psychiatry 2023; 23:577. [PMID: 37558996 PMCID: PMC10410825 DOI: 10.1186/s12888-023-05067-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 07/31/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Interoception refers to processes through which the nervous system identifies, analyzes, and integrates the information generated by the physiological state of the body (e.g., from internal organs such as the stomach, heart, or lungs). Despite its potential interest for clinical research and its wide use globally, no Arabic adaptation and validation of the Multidimensional Assessment of Interoceptive Awareness (MAIA-2) questionnaire exists to date. The goal of this study was to examine the psychometric properties of an Arabic translation of the MAIA-2 in a sample of Arabic-speaking community adults from Lebanon. We hypothesized that the Arabic version of the MAIA-2 would yield adequate internal consistency coefficients; the 8-factor structure model would show a good fit to our data, with measurement invariance and good convergent validity. METHOD The Arabic adaptation of the MAIA-2 was developed using the forward-backward translation method. A non-clinical sample of Arabic-speaking adults (n = 359, 59.9% females, mean age = 22.75 years (SD = 7.04)) took part of this validation study. To check if the model was adequate, several fit indices were calculated: the normed model chi-square (χ²/df), the Steiger-Lind root mean square error of approximation (RMSEA), the Tucker-Lewis Index (TLI) and the comparative fit index (CFI). Values ≤ 3 for χ²/df, and ≤ 0.08 for RMSEA, and 0.90 for CFI and TLI indicate good fit of the model to the data. RESULTS Confirmatory Factor Analyses corroborated the validity of the original 8-factor structure of the MAIA-2 [χ2/df = 1603.86/601 = 2.67, RMSEA = 0.068 (90% CI 0.064, 0.072), SRMR = 0.058, CFI = 0.903, TLI = 0.892]. Reliability estimates in our sample revealed good internal consistency, with McDonald's ω coefficients for the subscales ranging from 0.86 to 0.93. Our analyses also revealed measurement invariance of the Arabic MAIA-2 for gender. No statistically significant difference between men and women in all dimensions, except for the not worrying and attention regulation subscales where men scored significantly higher than women. Finally, the Arabic MAIA-2 dimensions showed positive correlations with the intuitive eating dimension "Reliance on Hunger and Satiety Cues", thus providing support for convergent validity. CONCLUSION We contribute the literature by providing the first Arabic adaptation and validation of a measure assessing the multidimensional construct of self-reported interoception. The Arabic MAIA-2 demonstrated good psychometric properties. We thus preliminarily recommend its use to measure the interoceptive awareness construct among Arabic-speaking communities worldwide.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of psychiatry "Ibn Omrane", Razi hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Mirna Fawaz
- Faculty of Health Sciences, Beirut Arab University, Tareek Al Jadida, Afeef Al Tiba, 1105, Beirut, Lebanon
| | - Nancy Chammas
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Michel Soufia
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Psychology Department, College of Humanities, Effat University, 21478, Jeddah, Saudi Arabia.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
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Albajri E, Naseeb M. Sex differences in intuitive eating and its relationship with body mass index among adults aged 18-40 years in Saudi Arabia: a cross-sectional study. Front Nutr 2023; 10:1214480. [PMID: 37538925 PMCID: PMC10395086 DOI: 10.3389/fnut.2023.1214480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
Introduction Intuitive eating (IE) is eating without judgment, relying only on physiological hunger and satiety. Sex differences in IE have been reported; however, none of the studies have explicitly examined IE and its relationship with body mass index (BMI) in the Saudi Arabian population. Thus, this study aimed to investigate sex differences in IE and its relationship with BMI in the Saudi population. Subjects/methods A cross-sectional online survey of 360 participants (18 years or older) with self-reported weight and height was conducted. IE was measured using the Intuitive Eating Scale-2 (IES-2). Separate multiple linear regression analyses were conducted to determine if total IE and its subscale scores differed across sexes. It was also conducted to assess the relationship between IE and BMI across sexes. Results Women had higher total IE score, eating for physical rather than emotional reasons (EPR), and body-food choice congruence (BFCC) scores compared to men (p = 0.013, p = 0.01, p <0.001, respectively). The analysis showed a significant negative association between total IE, BFCC, EPR scores, and BMI in women compared to men (p = 0.023, p = 0.01, p = 0.003, respectively). Conclusion The data on the sex differences in IE and its subscales and their different association with BMI encourage tailing nutrition-related recommendations in the context of intuitive eating based on sexes. Future studies are needed to explore how intuitive eating functions differently in women compared to men and explore the causal relationship between IE and BMI in this population.
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Herrero L, McCrea CE. Hunger modulates perceptions of food health but not taste in restricted eaters. Front Psychol 2023; 14:1212778. [PMID: 37484091 PMCID: PMC10357121 DOI: 10.3389/fpsyg.2023.1212778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/19/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Food taste and health perceptions are of particular interest for their implications on food choice. Most in vivo food choice studies experimentally control for hunger via a set preload or fast. Methods To explore how hunger may interact with these perceptions to impact food decisions, we compared taste and health perceptions of sweet and savory obesogenic food items among hungry or satiated participants with varying restrained eating tendencies. Results In our sample of 232 adults (M BMI = 25.9; M age = 36.4 yrs), highly palatable foods were perceived as tasty but unhealthy. Tastiness ratings were high, consistent across restrained eating groups, and unassociated with hunger. Perceptions of health, however, were impacted by the interaction of restrained eating group and hunger. Amongst hungry participants only, a graded association between restrained eating group and perceptions of health emerged for both food types. Specifically, hungry and highly restrained eaters viewed sweet foods as 2.8x healthier and savory foods as 2.1x healthier than their satiated counterparts. Discussion Our data suggest that hunger predicts differential health perceptions, but not tastiness ratings, among restrained eaters. We argue that the generalization of food perception data-especially among different eater types-may be limited if the continuum of hunger level is experimentally constrained. Therefore, hunger is a critical dynamic to consider in explorations of food perceptions and eating behavior in restrained eaters.
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Pollatos O, Mönkemöller K, Groppe K, Elsner B. Interoceptive accuracy is associated with benefits in decision making in children. Front Psychol 2023; 13:1070037. [PMID: 36743603 PMCID: PMC9893641 DOI: 10.3389/fpsyg.2022.1070037] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/22/2022] [Indexed: 01/20/2023] Open
Abstract
Introduction Decision making results not only from logical analyses, but seems to be further guided by the ability to perceive somatic information (interoceptive accuracy). Relations between interoceptive accuracy and decision making have been exclusively studied in adults and with regard to complex, uncertain situations (as measured by the Iowa Gambling Task, IGT). Methods In the present study, 1454 children (6-11 years) were examined at two time points (approximately 1 year apart) using an IGT as well as a delay-of-gratification task for sweets-items and toy-items. Interoceptive accuracy was measured using a child-adapted version of the Heartbeat Perception Task. Results The present results revealed that children with higher, as compared to lower, interoceptive accuracy showed more advantageous choices in the IGT and delayed more sweets-items, but not toy-items, in a delay-of-gratification task at time point 2 but not at time point 1. However, no longitudinal relation between interoceptive accuracy and decision making 1 year later could be shown. Discussion Results indicate that interoceptive accuracy relates to decision-making abilities in situations of varying complexity already in middle childhood, and that this link might consolidate across the examined 1-year period. Furthermore, the association of interoceptive accuracy and the delay of sweets-items might have implications for the regulation of body weight at a later age.
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Affiliation(s)
- Olga Pollatos
- Clinical and Health Psychology, Institute of Education and Psychology, Ulm University, Ulm, Germany
| | - Karla Mönkemöller
- Clinical and Health Psychology, Institute of Education and Psychology, Ulm University, Ulm, Germany,*Correspondence: Karla Mönkemöller, ✉
| | - Karoline Groppe
- Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany
| | - Birgit Elsner
- Department of Psychology, Faculty of Human Sciences, University of Potsdam, Potsdam, Germany
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Warschburger P, Wortmann HR, Gisch UA, Baer NR, Schenk L, Anton V, Bergmann MM. An experimental approach to training interoceptive sensitivity: study protocol for a pilot randomized controlled trial. Nutr J 2022; 21:74. [PMID: 36529744 PMCID: PMC9761996 DOI: 10.1186/s12937-022-00827-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 11/10/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Eating in absence of hunger is quite common and often associated with an increased energy intake co-existent with a poorer food choice. Intuitive eating (IE), i.e., eating in accordance with internal hunger and satiety cues, may protect from overeating. IE, however, requires accurate perception and processing of one's own bodily signals, also referred to as interoceptive sensitivity. Training interoceptive sensitivity might therefore be an effective method to promote IE and prevent overeating. As most studies on eating behavior are conducted in younger adults and close social relationships influence health-related behavior, this study focuses on middle-aged and older couples. METHODS The present pilot randomized intervention study aims at investigating the feasibility and effectiveness of a 21-day mindfulness-based training program designed to increase interoceptive sensitivity. A total of N = 60 couples participating in the NutriAct Family Study, aged 50-80 years, will be recruited. This randomized-controlled intervention study comprises three measurement points (pre-intervention, post-intervention, 4-week follow-up) and a 21-day training that consists of daily mindfulness-based guided audio exercises (e.g., body scan). A three-arm intervention study design is applied to compare two intervention groups (training together as a couple vs. training alone) with a control group (no training). Each measurement point includes the assessment of self-reported and objective indicators of interoceptive sensitivity (primary outcome), self-reported indicators of intuitive and maladaptive eating (secondary outcomes), and additional variables. A training evaluation applying focus group discussions will be conducted to assess participants' overall acceptance of the training and its feasibility. DISCUSSION By investigating the feasibility and effectiveness of a mindfulness-based training program to increase interoceptive sensitivity, the present study will contribute to a deeper understanding of how to promote healthy eating in older age. TRIAL REGISTRATION German Clinical Trials Register (DRKS), no. DRKS00024903. Retrospectively registered on April 21, 2021.
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Affiliation(s)
- Petra Warschburger
- NutriAct – Competence Cluster Nutrition Research, Potsdam, Berlin Germany ,grid.11348.3f0000 0001 0942 1117Department of Psychology, Counseling Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
| | - Hanna R. Wortmann
- NutriAct – Competence Cluster Nutrition Research, Potsdam, Berlin Germany ,grid.11348.3f0000 0001 0942 1117Department of Psychology, Counseling Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
| | - Ulrike A. Gisch
- NutriAct – Competence Cluster Nutrition Research, Potsdam, Berlin Germany ,grid.11348.3f0000 0001 0942 1117Department of Psychology, Counseling Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
| | - Nadja-Raphaela Baer
- NutriAct – Competence Cluster Nutrition Research, Potsdam, Berlin Germany ,grid.7468.d0000 0001 2248 7639Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Medical Sociology and Rehabilitation Science, Berlin, Germany
| | - Liane Schenk
- NutriAct – Competence Cluster Nutrition Research, Potsdam, Berlin Germany ,grid.7468.d0000 0001 2248 7639Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Medical Sociology and Rehabilitation Science, Berlin, Germany
| | - Verena Anton
- NutriAct – Competence Cluster Nutrition Research, Potsdam, Berlin Germany ,grid.7468.d0000 0001 2248 7639Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Medical Sociology and Rehabilitation Science, Berlin, Germany
| | - Manuela M. Bergmann
- NutriAct – Competence Cluster Nutrition Research, Potsdam, Berlin Germany ,grid.418213.d0000 0004 0390 0098German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
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Long-term changes in insula-mesolimbic structural and functional connectivity in obese patients after laparoscopic sleeve gastrectomy. Clin Auton Res 2022; 32:237-247. [PMID: 35864386 DOI: 10.1007/s10286-022-00877-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 07/04/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Brain imaging studies have shown insula-related functional and structural abnormalities in patients with obesity. Laparoscopic sleeve gastrectomy is currently an effective procedure for treating obesity, which promotes acute recovery of brain functional and structural abnormalities in obese patients. The aim of this study was to investigate the long-term impact of laparoscopic sleeve gastrectomy on insula-related structural and functional connectivity. METHODS Diffusion tensor imaging and resting-state functional magnetic resonance imaging were employed to investigate laparoscopic sleeve gastrectomy-induced changes in insula-related structural connectivity and corresponding resting-state functional connectivity in 25 obese patients prior to (PreLSG) and 12 months post-surgery (PostLSG12). RESULTS Results showed significant increases in fractional anisotropy and axial diffusivity between the right insula and anterior cingulate cortex, and higher fractional anisotropy of left insula-putamen, left insula-caudate and anterior cingulate cortex-right posterior cingulate cortex/precuneus at PostLSG12 compared with PreLSG. There were significant negative correlations between axial diffusivity of right insula-anterior cingulate cortex and body mass index, and fractional anisotropy of right insula-anterior cingulate cortex with scores on external eating at PostLSG12. Anxiety and depressive status ratings were negatively correlated with fractional anisotropy of left insula-putamen at PostLSG12. In addition, there was a significant decrease in resting-state functional connectivity between left insula and left caudate. CONCLUSIONS These findings demonstrate long-term changes in insula-related structural and functional connectivity abnormalities promoted by laparoscopic sleeve gastrectomy, which highlight its strong association with long-term weight loss and improvement in eating behaviors.
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Schmitt CM, Schoen S. Interoception: A Multi-Sensory Foundation of Participation in Daily Life. Front Neurosci 2022; 16:875200. [PMID: 35757546 PMCID: PMC9220286 DOI: 10.3389/fnins.2022.875200] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 05/03/2022] [Indexed: 11/25/2022] Open
Abstract
The purpose of this article is to examine evidence that broadens the clinical perspective on interoception as an imperative consideration for individuals with mental health and sensory processing challenges. The central supposition is that interoception is broader than just signals from the viscera. Rather, interoception refers to perceptions of bodily signals and bodily states that construct a subjective representation of the experience. These representations are then utilized for categorizing the sensory attributes and constructing meaning. Thus, this updated conceptualization presents interoception as a complex multidimensional system, with bidirectional features. The interplay between the brain and the body is necessary to maintain homeostasis as well as respond adaptively to the changes in one's internal and external environment. As a sensory capacity, interoceptive information must be processed and interpreted before it can be integrated into a personal experiential history. Interoception supports both body and mental functions and as such, interoceptive processes support health and wellness by establishing a felt sense of psychological and physiological safety that is foundational to meaningful participation in life. The information presented in this article is central to the pursuit of evidence-based best practices for any professional wishing to integrate consideration of interoception into their clinical practice.
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Affiliation(s)
- Carolyn M. Schmitt
- Sensory Therapies and Research (STAR) Institute, Centennial, CO, United States
| | - Sarah Schoen
- Sensory Therapies and Research (STAR) Institute, Centennial, CO, United States
- Rocky Mountain University of Health Professions, Provo, UT, United States
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Campos MB, Menezes IHCF, Peixoto MDRG, Schincaglia RM. Intuitive eating in general aspects of eating behaviors in individuals with obesity: Randomized clinical trial. Clin Nutr ESPEN 2022; 50:24-32. [DOI: 10.1016/j.clnesp.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 05/17/2022] [Accepted: 06/01/2022] [Indexed: 10/18/2022]
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Cheng Z, Gao X, Yang C, Brytek-Matera A, He J. Effects of Online and Face-to-Face Intuitive Eating Interventions on Body Image and Eating Behaviors among Women in China: A Feasibility Study. Nutrients 2022; 14:1761. [PMID: 35565730 PMCID: PMC9100518 DOI: 10.3390/nu14091761] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 04/21/2022] [Accepted: 04/21/2022] [Indexed: 02/04/2023] Open
Abstract
Body dissatisfaction and eating disorders have become major global concerns, including in Asian populations. Few studies have examined intervention effects on body dissatisfaction and disordered eating in China, especially for interventions with positive psychological perspectives (e.g., intuitive eating). In this pilot study, 66 women participated in an eight-module intuitive eating intervention delivered online (n = 42; mean age, 30.74 years) and face-to-face (n = 24; mean age, 19.46 years) for 8 weeks. Measures of body image and eating behaviors were used to assess the intervention's feasibility, acceptability, and initial efficacy. Linear mixed models were used to analyze the data. The intervention had significant effects on both groups, promoting positive body image and intuitive eating and reducing negative body image and disordered eating behaviors. The effects of the online and face-to-face interventions did not differ significantly. Thus, whether delivered online or face-to-face, an intuitive eating intervention may effectively improve Chinese women's body image and eating behaviors. However, the efficacy of the intuitive intervention in the Chinese context should be confirmed in future studies with designs in randomized control trials.
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Affiliation(s)
- Ziyue Cheng
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen 518172, China; (Z.C.); (X.G.); (C.Y.)
| | - Xueyan Gao
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen 518172, China; (Z.C.); (X.G.); (C.Y.)
| | - Chengyang Yang
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen 518172, China; (Z.C.); (X.G.); (C.Y.)
| | | | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen 518172, China; (Z.C.); (X.G.); (C.Y.)
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Cazzato V, Vicario CM, Urgesi C. ‘When hunger makes everything better looking!’: The effect of hunger on the aesthetic appreciation of human bodies, faces and objects. BMC Psychol 2022; 10:98. [PMID: 35410301 PMCID: PMC8996537 DOI: 10.1186/s40359-022-00807-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/08/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Research evidence suggests that physiological state of hunger might affect preference for female body weight, such that hungrier, compared to satiate, men prefer heavier body weight and rate as more attractive heavier female figures. Here, we seek to extend these findings by comparing the effects of fasting and snack on aesthetics judgements of the bodies and faces of conspecifics and of objects in a sample of female and male participants.
Methods
Forty-four participants (women: n = 21, mean age = 23.70 yrs ± 0.62) provided aesthetic liking judgments of round and slim human bodies, faces and objects, under at least 12 h of overnight fasting and immediately after having eaten a snack (i.e., bananas). An anthropometric measure of adiposity (i.e., Body Mass Index, BMI) was also collected from each observer.
Results
Overall, we found that participants’ aesthetic judgements were higher for slim stimuli compared to round ones. However, after fasting, participants rated round stimuli as more attractive compared to when they had a snack. This hunger-based shift in ratings not only was apparent when stimuli depicted a human body or face, but also when they depicted an object, thus suggesting a general modification of observers’ aesthetic preference related to hunger. Importantly, this effect was modulated by participants’ BMI so that only participants with a high BMI provided higher aesthetic judgements for round stimuli after fasting than after a snack.
Conclusions
Our results demonstrated that both the modification of the physiological state and the individual differences in adiposity level of the observers might affect the aesthetic appreciation of the external world.
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Functional gastrointestinal symptoms and increased risk for orthorexia nervosa. Eat Weight Disord 2022; 27:1113-1121. [PMID: 34170490 PMCID: PMC8964559 DOI: 10.1007/s40519-021-01242-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/08/2021] [Indexed: 12/17/2022] Open
Abstract
PURPOSE Recent guidelines point out the possible risk for orthorexia nervosa in functional gastrointestinal disorders, however, to date, no study has investigated this association. The present study aimed to explore the potential relationship between irritable bowel syndrome-related functional gastrointestinal symptoms and certain maladaptive eating behaviours, such as symptoms of orthorexia nervosa and emotional eating. METHODS A sample of 644 Hungarian volunteers (Mage = 22.37; SDage = 3.95) completed a survey with the following questionnaires: the Rome IV Diagnostic Questionnaire (R4DQ) for adults-Irritable bowel syndrome module for the measurement of functional gastrointestinal symptoms, the Hungarian version of the ORTO-15 questionnaire (ORTO-11-Hu) to assess symptoms of orthorexia nervosa, the Three-Factor Eating Questionnaire (TFEQ) Emotional Eating subscale to measure symptoms of emotional eating and the Short Health Anxiety Inventory (SHAI) for the assessment of health anxiety. Spearman's rank correlation was used to explore the associations between the measured variables, and structural equation modeling was used to test the proposed mediation models. RESULTS Functional gastrointestinal symptoms were positively related to symptoms of orthorexia nervosa and emotional eating. The relationship between functional gastrointestinal symptoms and symptoms of orthorexia nervosa was partially mediated by health anxiety, while the association between functional gastrointestinal symptoms and symptoms of emotional eating was partially mediated by symptoms of orthorexia nervosa. CONCLUSION Our findings highlight the possible risk for developing orthorexic symptoms in functional gastrointestinal symptoms, which could lead to other types of disordered eating patterns, such as emotional eating. The results also underscore the potential role of health anxiety in these relationships. LEVEL OF EVIDENCE Level V (descriptive cross-sectional study).
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Food Consciousness Intervention Improves Interoceptive Sensitivity and Expression of Exteroception in Women. Nutrients 2022; 14:nu14030450. [PMID: 35276809 PMCID: PMC8837977 DOI: 10.3390/nu14030450] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/06/2022] [Accepted: 01/10/2022] [Indexed: 02/05/2023] Open
Abstract
The perception of the body’s internal state (interoception) and the perception and processing of environmental sensory stimuli (exteroception) act together to modulate adaptive behaviour, including eating behaviour, and are related to bodyweight control. This study evaluated the impact of the Food and Nutrition Education Program with Sensory and Cognitive Exercises on interoceptive sensitivity and on the expression of exteroceptive perception in women who experienced difficulty in controlling their body weight. Thirty-seven women were randomized into two groups and evaluated at two moments: before and after the intervention or before and after a 3- to 4-week waiting period. A heartbeat tracking task was used for interoception evaluation. Participants were asked to write a text describing three foods after tasting them for exteroception evaluation. After the intervention, the participants showed an increase in interoceptive sensitivity, and an increase in the expression of exteroceptive stimuli perception through a semantic assessment of their writing related to the tasting experience. In addition, the results point to a possible connection between the mechanisms governing interoception and exteroception. This work brings important contributions to the search for strategies capable of promoting the perception and integration of physiological and environmental stimuli in food consumption.
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Desdentado L, Navarrete J, Folgado-Alufre M, de Blas A, Navarro-Siurana J, Ponce F, Molinari G, Jimeno-Martínez A, Rupérez AI, Bueno-Lozano G, Cuenca-Royo A, Corbella E, Agüera Z, Baños RM, Álvarez-Pitti J. Are Peripheral Biomarkers Determinants of Eating Styles in Childhood and Adolescence Obesity? A Cross-Sectional Study. Nutrients 2022; 14:305. [PMID: 35057485 PMCID: PMC8780085 DOI: 10.3390/nu14020305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 02/04/2023] Open
Abstract
Disturbances in eating behaviors have been widely related to obesity. However, little is known about the role of obesity-related biomarkers in shaping habitual patterns of eating behaviors (i.e., eating styles) in childhood. The objective of the present study was to explore the relationships between several biomarkers crucially involved in obesity (ghrelin, insulin resistance, and leptin/adiponectin ratio) and eating styles in children and adolescents with obesity. Seventy participants aged between 8 and 16 (56.2% men) fulfilled the Spanish version of the Dutch Eating Behavior Questionnaire for Children to measure external, emotional, and restrained eating styles. In addition, concentrations of ghrelin, leptin, adiponectin, insulin, and glucose were obtained through a blood test. Hierarchical multiple regression analyses controlling for age and sex were computed for each eating style. Results indicated that individuals with higher ghrelin concentration levels showed lower scores in restrained eating (β = -0.61, p < 0.001). The total model explained 32% of the variance of the restrained pattern. No other relationships between obesity-related biomarkers and eating behaviors were found. This study highlights that one of the obesity-risk factors, namely lower plasma ghrelin levels, is substantially involved in a well-known maladaptive eating style, restraint eating, in childhood obesity.
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Affiliation(s)
- Lorena Desdentado
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5. Pabellón 11, Planta 0, 28029 Madrid, Spain; (L.D.); (F.P.); (G.M.); (A.J.-M.); (A.I.R.); (G.B.-L.); (A.C.-R.); (E.C.); (Z.A.); (R.M.B.)
- Polibienestar Research Institute, University of Valencia, Calle Serpis, 29, 46022 Valencia, Spain; (J.N.); (M.F.-A.); (J.N.-S.)
- Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Avda. Blasco Ibañez, 21, 46010 Valencia, Spain
| | - Jaime Navarrete
- Polibienestar Research Institute, University of Valencia, Calle Serpis, 29, 46022 Valencia, Spain; (J.N.); (M.F.-A.); (J.N.-S.)
| | - María Folgado-Alufre
- Polibienestar Research Institute, University of Valencia, Calle Serpis, 29, 46022 Valencia, Spain; (J.N.); (M.F.-A.); (J.N.-S.)
- Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Avda. Blasco Ibañez, 21, 46010 Valencia, Spain
| | - Ana de Blas
- Pediatric Department, Consorcio Hospital General Universitario de Valencia, Avda. Tres Cruces, 2, 46014 Valencia, Spain;
| | - Jéssica Navarro-Siurana
- Polibienestar Research Institute, University of Valencia, Calle Serpis, 29, 46022 Valencia, Spain; (J.N.); (M.F.-A.); (J.N.-S.)
| | - Francisco Ponce
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5. Pabellón 11, Planta 0, 28029 Madrid, Spain; (L.D.); (F.P.); (G.M.); (A.J.-M.); (A.I.R.); (G.B.-L.); (A.C.-R.); (E.C.); (Z.A.); (R.M.B.)
- Pediatric Department, Consorcio Hospital General Universitario de Valencia, Avda. Tres Cruces, 2, 46014 Valencia, Spain;
| | - Guadalupe Molinari
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5. Pabellón 11, Planta 0, 28029 Madrid, Spain; (L.D.); (F.P.); (G.M.); (A.J.-M.); (A.I.R.); (G.B.-L.); (A.C.-R.); (E.C.); (Z.A.); (R.M.B.)
| | - Andrea Jimeno-Martínez
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5. Pabellón 11, Planta 0, 28029 Madrid, Spain; (L.D.); (F.P.); (G.M.); (A.J.-M.); (A.I.R.); (G.B.-L.); (A.C.-R.); (E.C.); (Z.A.); (R.M.B.)
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Facultad de Ciencias de la Salud, Instituto Agroalimentario de Aragón, Universidad de Zaragoza, Calle Miguel Servet, 177, 50013 Zaragoza, Spain
| | - Azahara I. Rupérez
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5. Pabellón 11, Planta 0, 28029 Madrid, Spain; (L.D.); (F.P.); (G.M.); (A.J.-M.); (A.I.R.); (G.B.-L.); (A.C.-R.); (E.C.); (Z.A.); (R.M.B.)
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Facultad de Ciencias de la Salud, Instituto Agroalimentario de Aragón, Universidad de Zaragoza, Calle Miguel Servet, 177, 50013 Zaragoza, Spain
| | - Gloria Bueno-Lozano
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5. Pabellón 11, Planta 0, 28029 Madrid, Spain; (L.D.); (F.P.); (G.M.); (A.J.-M.); (A.I.R.); (G.B.-L.); (A.C.-R.); (E.C.); (Z.A.); (R.M.B.)
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Facultad de Ciencias de la Salud, Instituto Agroalimentario de Aragón, Universidad de Zaragoza, Calle Miguel Servet, 177, 50013 Zaragoza, Spain
- Paediatric Endocrinology Department, Clinical Hospital Lozano Blesa, Zaragoza, Avda. San Juan Bosco, 50009 Zaragoza, Spain
| | - Aida Cuenca-Royo
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5. Pabellón 11, Planta 0, 28029 Madrid, Spain; (L.D.); (F.P.); (G.M.); (A.J.-M.); (A.I.R.); (G.B.-L.); (A.C.-R.); (E.C.); (Z.A.); (R.M.B.)
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Emili Corbella
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5. Pabellón 11, Planta 0, 28029 Madrid, Spain; (L.D.); (F.P.); (G.M.); (A.J.-M.); (A.I.R.); (G.B.-L.); (A.C.-R.); (E.C.); (Z.A.); (R.M.B.)
- Cardiovascular Risk Unit, Internal Medicine Department, Bellvitge University Hospital—IDIBELL, Feixa Llarga, s/n, 08907 Barcelona, Spain
| | - Zaida Agüera
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5. Pabellón 11, Planta 0, 28029 Madrid, Spain; (L.D.); (F.P.); (G.M.); (A.J.-M.); (A.I.R.); (G.B.-L.); (A.C.-R.); (E.C.); (Z.A.); (R.M.B.)
- Department of Public Health, Mental Health and Perinatal Nursing, Health Sciences Campus Bellvitge, School of Nursing, University of Barcelona, Feixa Llarga, s/n, 08907 Barcelona, Spain
| | - Rosa M. Baños
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5. Pabellón 11, Planta 0, 28029 Madrid, Spain; (L.D.); (F.P.); (G.M.); (A.J.-M.); (A.I.R.); (G.B.-L.); (A.C.-R.); (E.C.); (Z.A.); (R.M.B.)
- Polibienestar Research Institute, University of Valencia, Calle Serpis, 29, 46022 Valencia, Spain; (J.N.); (M.F.-A.); (J.N.-S.)
- Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Avda. Blasco Ibañez, 21, 46010 Valencia, Spain
| | - Julio Álvarez-Pitti
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5. Pabellón 11, Planta 0, 28029 Madrid, Spain; (L.D.); (F.P.); (G.M.); (A.J.-M.); (A.I.R.); (G.B.-L.); (A.C.-R.); (E.C.); (Z.A.); (R.M.B.)
- Pediatric Department, Consorcio Hospital General Universitario de Valencia, Avda. Tres Cruces, 2, 46014 Valencia, Spain;
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Chawner LR, Yu S, Cunningham PM, Rolls BJ, Hetherington MM. Construct validation of the Reasons Individuals Stop Eating Questionnaire (RISE-Q) and the development of the RISE-Q-15. Appetite 2021; 170:105898. [PMID: 34968562 DOI: 10.1016/j.appet.2021.105898] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/15/2021] [Accepted: 12/22/2021] [Indexed: 11/02/2022]
Abstract
Consumers vary in the explanations they give for meal termination. The Reasons Individuals Stop Eating Questionnaire (RISE-Q) was developed to measure these satiation processes. Individual differences in satiation may be associated with a general capacity to recognise and respond to contextual and interoceptive cues. The aims of the present study were to validate the factor structure of the RISE-Q and to explore its construct validity. In particular, we tested the prediction that a latent variable "Sensitivity to Internal Satiation Cues" is associated with high satiety responsiveness, high scores on the RISE-Q Physical Satisfaction (PS) and Decreased Food Appeal (DFA) scales and a healthy BMI. Participants (n = 216 adults) completed an online survey which included the RISE-Q, Mindful Eating Questionnaire, Multidimensional Assessment of Interoceptive Awareness, Adult Eating Behaviour Questionnaire (AEBQ) and self-reported height and weight. Confirmatory Factor Analysis supported the 5-factor structure of the RISE-Q, but model fit was improved by a new short form (RISE-Q-15) of the questionnaire. Construct validity replicated for most RISE-Q subscales, but not RISE-Q and BMI. Structural Equation Modelling demonstrated that Sensitivity to Internal Satiation Cues was associated with RISE-Q PS but not with the DFA, whereas AEBQ Satiety Responsiveness was associated with DFA, but not with PS. The RISE-Q-15 may be more sensitive to specific meal termination behaviours than pre-existing questionnaires, and due to its low participant burden, it provides a useful tool to explore further multiple processes of satiation in various contexts.
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Affiliation(s)
- Liam R Chawner
- School of Psychology, University of Leeds, LEEDS, LS2 9JT, UK
| | - Shihui Yu
- School of Psychology, University of Leeds, LEEDS, LS2 9JT, UK
| | - Paige M Cunningham
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Barbara J Rolls
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Marion M Hetherington
- School of Psychology, University of Leeds, LEEDS, LS2 9JT, UK; Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA.
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Robinson E, Foote G, Smith J, Higgs S, Jones A. Interoception and obesity: a systematic review and meta-analysis of the relationship between interoception and BMI. Int J Obes (Lond) 2021; 45:2515-2526. [PMID: 34480102 PMCID: PMC8606313 DOI: 10.1038/s41366-021-00950-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 07/27/2021] [Accepted: 08/17/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Interoception refers to the processes by which we sense, interpret and integrate signals originating from within the body. Deficits in interoception have been linked to higher BMI and may contribute to weight gain. However, there have been conflicting findings and it is not clear how higher BMI is associated with different facets of interoception, such as interoceptive accuracy (the ability to detect internal signals) and sensibility (the tendency to attend to internal signals). METHODS We conducted a systematic review and meta-analysis of studies that measured interoception and BMI. We examined relationships between interoception and BMI in children and adults separately and as a function of interoceptive facet and measure. In sensitivity analyses, we tested for evidence of publication bias and whether the results were consistent when studies with a high risk of bias were excluded. RESULTS A total of 87 articles were eligible for inclusion. In adults (121 effects, 10,425 participants), there was cross-sectional evidence of higher BMI being associated with overall deficits in interoception (r = -0.054, 95% CI: -0.084 to -0.025) and this was consistent across sensitivity analyses. There was no statistically significant evidence of moderation by interoceptive facet or measure, although there was some variability in effect size estimates based on interoceptive facet and measures. A smaller meta-analysis limited to studies that compared participants with normal weight vs. overweight/obesity indicated poorer interoception in participants with overweight/obesity (SMD = -0.39, 95% CI -0.60 to -0.18). CONCLUSIONS In cross-sectional studies, deficits in interoception are associated with higher BMI. However, it remains unclear whether deficits in interoception contribute to or are a consequence of weight gain and obesity.
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Affiliation(s)
- Eric Robinson
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK.
| | - Georgia Foote
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - Jemma Smith
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Andrew Jones
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
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Letranchant A, Montebello YKD, Bigre CDL, Wagner A, Curt F, Silva J, Nicolas I, Votadoro P, Kalindjian N, Korchonnoff A, Gutierre A, Novelli AB, Pham-Scottez A, Corcos M. The ACAMTO study-impact of add-on osteopathic treatment on adolescent patients with anorexia nervosa: study protocol for a randomized controlled trial. Trials 2021; 22:839. [PMID: 34819116 PMCID: PMC8611636 DOI: 10.1186/s13063-021-05810-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 11/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background Anorexia nervosa (AN) mainly affects women (sex ratio 1/10) and most often starts during adolescence. The prognosis of AN remains poor (10% of deaths and high risk of chronicity). Body dissatisfaction, disturbances in recognition and identification of body sensations are some of the key symptoms of AN. However, there is a contrast between this consensual observation of body image disorders in AN, and the relative deficit of specifically targeted body treatments. Our proposal for a body approach specifically dedicated to AN is based on the understanding that posture, breathing, muscle tension and body perception are closely linked to our psychological and emotional state and are therefore disturbed in patients with AN. The purpose of this monocentric randomized controlled trial is to evaluate if a targeted osteopathic protocol treatment for AN in addition to treatment as usual (TAU) is significantly more effective than TAU alone. Methods In total, 72 patients meeting the inclusion criteria will be randomly assigned to one of the two treatment groups: one receiving the specific osteopathic treatment targeted for AN in addition to the TAU (group A) and the other one, receiving TAU only (group B). The patients in group A will receive 5 30-min osteopathic treatment sessions. Soft specific palpatory techniques on the diaphragm, digestive system and cervical region will be performed. The TAU is defined by the multidisciplinary approach recommended by the French health high authority. The primary outcome is the evaluation of interoceptive sensibility and secondary outcomes include clinical and psychopathology-related symptoms with assessment of somatic dysfunctions’ evolution. A qualitative study will also be carried out, applying the Interpretative Phenomenological Analysis method. Patients will be included for a maximum of 14 weeks between the inclusion time and the last evaluation. Discussion If the results of the study are positive (statistically significant efficacy of this osteopathic treatment protocol), the study will provide arguments in favor of osteopathic sessions as a possible non-invasive additional treatment option in the multidisciplinary care approach for patients with AN. Trial registration ClinicalTrials.gov ID: NCT04666415, Release Date: December 11, 2020; N° ID-RCB: 2019-A02613-54. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05810-8.
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Affiliation(s)
- Aurélie Letranchant
- Adolescent and Young adult psychiatry Unit, Institut Mutualiste Montsouris, 42 boulevard Jourdan, 75014, Paris, France.
| | | | - Corinne Dugré-Le Bigre
- Adolescent and Young adult psychiatry Unit, Institut Mutualiste Montsouris, 42 boulevard Jourdan, 75014, Paris, France
| | - Agathe Wagner
- Department of Research, CEESO, 175 Boulevard Anatole France, 93200, Saint-Denis, France
| | - Florence Curt
- Adolescent and Young adult psychiatry Unit, Institut Mutualiste Montsouris, 42 boulevard Jourdan, 75014, Paris, France
| | - Jérôme Silva
- Adolescent and Young adult psychiatry Unit, Institut Mutualiste Montsouris, 42 boulevard Jourdan, 75014, Paris, France
| | - Isabelle Nicolas
- Adolescent and Young adult psychiatry Unit, Institut Mutualiste Montsouris, 42 boulevard Jourdan, 75014, Paris, France
| | - Pablo Votadoro
- Adolescent and Young adult psychiatry Unit, Institut Mutualiste Montsouris, 42 boulevard Jourdan, 75014, Paris, France
| | - Nina Kalindjian
- Adolescent and Young adult psychiatry Unit, Institut Mutualiste Montsouris, 42 boulevard Jourdan, 75014, Paris, France
| | - Anna Korchonnoff
- Adolescent and Young adult psychiatry Unit, Institut Mutualiste Montsouris, 42 boulevard Jourdan, 75014, Paris, France
| | - Andréa Gutierre
- Adolescent and Young adult psychiatry Unit, Institut Mutualiste Montsouris, 42 boulevard Jourdan, 75014, Paris, France
| | - Ana Beatriz Novelli
- Adolescent and Young adult psychiatry Unit, Institut Mutualiste Montsouris, 42 boulevard Jourdan, 75014, Paris, France.,Doctoral school « Recherches en psychanalyse et psychopathologie (ED 450) », Paris University, Paris, France
| | | | - Maurice Corcos
- Adolescent and Young adult psychiatry Unit, Institut Mutualiste Montsouris, 42 boulevard Jourdan, 75014, Paris, France
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Brewer R, Murphy J, Bird G. Atypical interoception as a common risk factor for psychopathology: A review. Neurosci Biobehav Rev 2021; 130:470-508. [PMID: 34358578 PMCID: PMC8522807 DOI: 10.1016/j.neubiorev.2021.07.036] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/09/2021] [Accepted: 07/31/2021] [Indexed: 02/06/2023]
Abstract
The inadequacy of a categorial approach to mental health diagnosis is now well-recognised, with many authors, diagnostic manuals and funding bodies advocating a dimensional, trans-diagnostic approach to mental health research. Variance in interoception, the ability to perceive one's internal bodily state, is reported across diagnostic boundaries, and is associated with atypical functioning across symptom categories. Drawing on behavioural and neuroscientific evidence, we outline current research on the contribution of interoception to numerous cognitive and affective abilities (in both typical and clinical populations), and describe the interoceptive atypicalities seen in a range of psychiatric conditions. We discuss the role that interoception may play in the development and maintenance of psychopathology, as well as the ways in which interoception may differ across clinical presentations. A number of important areas for further research on the role of interoception in psychopathology are highlighted.
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Affiliation(s)
- Rebecca Brewer
- Department of Psychology, Royal Holloway, University of London, United Kingdom
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom.
| | - Geoffrey Bird
- Department of Experimental Psychology, University of Oxford, United Kingdom; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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Iceta S, Panahi S, García-García I, Michaud A. The Impact of Restrictive and Non-restrictive Dietary Weight Loss Interventions on Neurobehavioral Factors Related to Body Weight Control: the Gaps and Challenges. Curr Obes Rep 2021; 10:385-395. [PMID: 34318394 DOI: 10.1007/s13679-021-00452-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/03/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Restrictive diets, such as low-calorie diets, are difficult to maintain in the long term. For this reason, their popularity has decreased compared to non-restrictive approaches, which instead promote healthy eating strategies. Since both strategies may entail different neurobiological mechanisms, this review will examine the current evidence on the effects of restrictive and non-restrictive interventions on neurobehavioral factors. RECENT FINDINGS Restrictive diets appear to improve eating behaviors, and the evidence reviewed argues against the notion that they may worsen the severity of binge eating. Moreover, they may lead to short-term changes in brain structure and improvements in cerebrovascular markers which, in turn, could impact eating behaviors. Non-restrictive interventions may have a positive effect on weight management and eating behaviors. However, evidence of their neural effects is scarce. Small sample sizes, short follow-ups, and the absence of control groups are limitations of the studies targeting both interventions. Rigorous long-term randomized studies are needed to examine the neurobehavioral effects of restrictive and non-restrictive approaches.
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Affiliation(s)
- Sylvain Iceta
- Quebec Heart and Lung Institute Research Center, Québec, QC, G1V 4G5, Canada
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Québec, QC, G1V OA6, Canada
- School of Nutrition, Université Laval, Québec, QC, G1V OA6, Canada
| | - Shirin Panahi
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Québec, QC, G1V OA6, Canada
- Faculty of Educational Sciences, Department of Physical Education, Université Laval, Québec, QC, G1V OA6, Canada
- Faculty of Medicine, Department of Kinesiology, Université Laval, Québec, QC, G1V OA6, Canada
| | - Isabel García-García
- Department of Clinical Psychology and Psychobiology, University of Barcelona, 08035, Barcelona, Spain
| | - Andréanne Michaud
- Quebec Heart and Lung Institute Research Center, Québec, QC, G1V 4G5, Canada.
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Québec, QC, G1V OA6, Canada.
- School of Nutrition, Université Laval, Québec, QC, G1V OA6, Canada.
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Sanlier N, Kocabas Ş, Ulusoy HG, Celik B. The Relationship between Adults' Perceptions, Attitudes of COVID-19, Intuitive Eating, and Mindful Eating Behaviors. Ecol Food Nutr 2021; 61:90-109. [PMID: 34435919 DOI: 10.1080/03670244.2021.1968849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In total, 1224 Turkish adults (27.5 ± 9.6 years; 80.6% female) answered sociodemographic questions, and three instruments: Mindful Eating Questionnaire (MEQ), Intuitive Eating Scale-2 (IES-2), and COVID-19 Perception and Attitude Scale. Women's perceptions and attitudes toward COVID-19 indicated higher concerns than men (p < .001). It was found that IES-2 scores of all subjects increased as body mass index (BMI) decreased and education level increased (p < .001; p = .033, respectively). During the social isolation of COVID-19, the MEQ scores of married couples and those who did not eat take-out foods were higher (p = .027; p = .006, respectively). Interestingly, it was found that as the BMI of the subjects increased, their MEQ scores increased (p < .001). The COVID-19 pandemic, which has social and economic consequences, has a great impact on human health and causes sudden lifestyle changes through social distance and isolation at home. Although social isolation during the epidemic is a necessary precaution to protect public health, the results of this study support that it causes changes in intuitive eating, and mindful eating behaviors.
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Affiliation(s)
- Nevin Sanlier
- Department of Nutrition and Dietetics, School of Health Sciences, Ankara Medipol University, Ankara, Turkey
| | - Şule Kocabas
- Department of Nutrition and Dietetics, School of Health Sciences, Ankara Medipol University, Ankara, Turkey
| | - Hande Gül Ulusoy
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Bulent Celik
- Department of Statistics, Faculty of Science, Gazi University, Ankara, Turkey
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Linardon J, Tylka TL, Fuller-Tyszkiewicz M. Intuitive eating and its psychological correlates: A meta-analysis. Int J Eat Disord 2021; 54:1073-1098. [PMID: 33786858 DOI: 10.1002/eat.23509] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Intuitive eating is an adaptive style of eating that has generated significant research attention. Theoretically, intuitive eating is a core construct that features prominently in the Acceptance Model of Intuitive Eating, a framework that explains how positive environmental influences can foster intuitive eating practices via body appreciation. Empirically, intuitive eating has been connected to a broad range of adaptive mental health indices. At present, a quantitative synthesis of intuitive eating and its correlates has yet to be conducted. This was the objective of the current meta-analysis. METHOD Ninety-seven studies (89% cross-sectional) were included. Random effects meta-analyses were conducted on 23 psychological correlates, divided into three clusters: eating behavior and body image disturbances, positive body image and other adaptive factors, and general psychopathology. Meta-analytic path analyses were also computed to test the validity of the Acceptance Model. RESULTS Intuitive eating was inversely associated with multiple indices of eating pathology, body image disturbances, and psychopathology (rs = -.23 to -.58). Intuitive eating was positively associated with numerous positive psychological constructs, such as positive body image, self-esteem, and wellbeing (rs = .20 to .58). Men reported higher levels of intuitive eating than women (d = 0.39), with differences being largest in Caucasian samples. Meta-analytic path analyses strongly supported the hypothesized pathways specified in the Acceptance Model of Intuitive Eating. CONCLUSIONS There is a strong evidence base for intuitive eating's connection to numerous adaptive psychological constructs. Attention should now shift toward prospective and experimental designs so that the temporal nature of these relationships can be identified.
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Affiliation(s)
- Jake Linardon
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Tracy L Tylka
- Department of Psychology, The Ohio State University, Columbus, Ohio, USA
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Geelong, Victoria, Australia.,Center for Social and Early Emotional Development, Deakin University, Burwood, Victoria, Australia
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Flasbeck V, Bamberg C, Brüne M. Short-Term Fasting and Ingestion of Caloric Drinks Affect Heartbeat-Evoked Potentials and Autonomic Nervous System Activity in Males. Front Neurosci 2021; 15:622428. [PMID: 34267619 PMCID: PMC8276132 DOI: 10.3389/fnins.2021.622428] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 05/20/2021] [Indexed: 11/24/2022] Open
Abstract
Central nervous systems receive and process information from the internal and external environment to maintain homeostasis. This includes interoceptive awareness of the organism’s nutritional state. Whenever food supply is required, feelings of hunger initiate the search for and the consumption of appropriate amounts of nutrients. How this is physiologically regulated in humans has been subjected to research into interoceptive awareness of body states during fasting and food consumption. However, there is no research on the distinct effects of carbohydrate or protein intake on interoception. Therefore, we aimed to investigate the impact of fasting and consumption of standardized carbohydrate and protein shakes on interoception in a repeated-measures cross-over design in a sample of 37 healthy, normal weight males. As a physiological correlate of interoception, we measured heartbeat-evoked potentials (HEPs), which are suggested to reflect the cortical representation of cardiac signals, during eight-minutes resting state EEG-recordings. After a 16-hour fasting period, the HEP amplitudes were lower over right central and parietal electrodes and increased after ingestion of the nutritional shake. Exploratory analyses indicated that the difference between fasting and satiety was more prominent at carbohydrate compared protein testing days. Correlation analyses with heart rate variability (HRV) suggested that high cardiac sympathetic activity is related to lower HEP amplitudes. Furthermore, cardiac sympathetic activity and stress indices decreased from before to after the intervention, whereas HRV increased. Together, this study shows for the first time that fasting and the intake of a nutritional shake affects cardiac measures of autonomic nervous system functioning and the neural correlates of cardiac interoception. These findings could be relevant for diets and psychosomatic disorders, including eating disorders.
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Affiliation(s)
- Vera Flasbeck
- Division of Social Neuropsychiatry and Evolutionary Medicine, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Christoph Bamberg
- Division of Social Neuropsychiatry and Evolutionary Medicine, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Martin Brüne
- Division of Social Neuropsychiatry and Evolutionary Medicine, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
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Iatridi V, Quadt L, Hayes JE, Garfinkel SN, Yeomans MR. Female sweet-likers have enhanced cross-modal interoceptive abilities. Appetite 2021; 165:105290. [PMID: 33965436 DOI: 10.1016/j.appet.2021.105290] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 04/19/2021] [Accepted: 04/27/2021] [Indexed: 10/21/2022]
Abstract
There are well known phenotypic differences in sweet-liking across individuals, but it remains unknown whether these are related to broader underlying differences in interoceptive abilities (abilities to sense the internal state of the body). Here, healthy women (N = 64) classified as sweet likers (SLs) or sweet dislikers (SDs) completed a bimodal interoception protocol. A heartbeat tracking and a heartbeat discrimination task determined cardiac interoception; both were accompanied by confidence ratings. A water load task, where participants consumed water to satiation and then to maximum fullness was used to assess gastric interoceptive abilities. Motivational state, psychometric characteristics and eating behaviour were also assessed. SLs performed significantly better than SDs on both heartbeat tasks, independently of impulsivity, anxiety, depression, and alexithymia. No differences in metacognitive awareness and subjective interoceptive measures were found. With gastric interoception, SLs were more sensitive to stomach distention, and they ingested less water than SDs to reach satiety when accounting for stomach capacity. SLs also scored higher on mindful and intuitive eating scales and on emotional eating particularly in response to negative stimuli; emotional overeating was fully mediated via interoceptive performance. Overall, our data suggest the SL phenotype may reflect enhanced responsiveness to internal cues more broadly.
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Affiliation(s)
- Vasiliki Iatridi
- Department of Sport, Health Sciences and Social Work, Faculty of Health and Life Sciences, Oxford Brookes University, UK.
| | - Lisa Quadt
- Department of Neuroscience, Brighton and Sussex Medical School, UK; Sackler Centre for Consciousness Science, University of Sussex, UK; Sussex Partnership NHS Foundation Trust, UK.
| | - John E Hayes
- Sensory Evaluation Center, College of Agricultural Sciences, The Pennsylvania State University, PA, United States; Department of Food Science, College of Agricultural Sciences, The Pennsylvania State University, PA, United States.
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Palazzo CC, Leghi BE, Pereira-Júnior A, Diez-Garcia RW. Educational intervention for food consciousness: A randomized study protocol. Nutr Health 2021; 28:123-129. [PMID: 33913348 DOI: 10.1177/02601060211011801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Contemporary living conditions present opportunities that promote obesity. In addition, traditional nutritional intervention have been considered inefficient, and there is a demand for the development and evaluation of strategies not based on the traditional paradigm of diets. AIM The aim of this study is to describe the Food and Nutrition Education Program with Sensory and Cognitive Exercises (PESC), which seeks to promote consciousness of eating experience and body signals appreciation to adult women and thus to make them less vulnerable to food consumption stimuli. METHOD This protocol outlines a randomized study that will include 60 adult women. PESC is based on the sensory influence for eating behavior and on the Triple-Aspect Monism theory of consciousness. It is composed of exercises that explore sensory, cognitive and emotional aspects of food experience in order to promote it into a conscious process. The program consists of four weekly workshops that explore themes related to the current obesogenic environment problematic. The intervention group (n=30) will be evaluated at the beginning of the first workshop and after the last one. The control group (n=30) will not participate on the workshops and will be evaluated twice, with a one-month interval. CONCLUSIONS This study will contribute substantially to the development of nutritional interventions based on sensory aspects and consciousness of food experience. Therefore, PESC is considered an innovative approach with regard to improving individuals' eating behavior. TRIAL REGISTRY This clinical trial was registered with the Brazilian Registry of Clinical Trials (ReBEC), http://www.ensaiosclinicos.gov.br/rg/RBR-4qgpg5/,numberRBR-4qgpg5.
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Affiliation(s)
- Carina C Palazzo
- Internal Medicine Department, Ribeirão Preto Medical School, 28133University of São Paulo (USP), Brazil.,Laboratory of Food Practices and Behavior - PrátiCA, 28133University of São Paulo (USP), Brazil
| | - Barbara E Leghi
- Internal Medicine Department, Ribeirão Preto Medical School, 28133University of São Paulo (USP), Brazil.,Laboratory of Food Practices and Behavior - PrátiCA, 28133University of São Paulo (USP), Brazil
| | - Alfredo Pereira-Júnior
- Department of Education, Biosciences Institute, São Paulo State University (UNESP), Brazil
| | - Rosa Wanda Diez-Garcia
- Laboratory of Food Practices and Behavior - PrátiCA, 28133University of São Paulo (USP), Brazil.,Nutrition and Metabolism, Health Sciences Department, Ribeirão Preto Medical School, 28133University of São Paulo (USP), Brazil
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45
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Interoception, eating behaviour and body weight. Physiol Behav 2021; 237:113434. [PMID: 33901529 DOI: 10.1016/j.physbeh.2021.113434] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/21/2021] [Accepted: 04/22/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Interoception refers to the process of identifying and listening to internal bodily signals, which may be a modifiable determinant of appetite regulation and weight gain. The objective was to examine whether the extent to which self-reported interoception is associated with higher BMI is explained by eating behavior traits. METHODS UK adults (N = 1181, 49% female, 53% with overweight/obesity) completed validated self-report measures of interoception, habitual tendencies to eat in response to satiety signals (intuitive eating), emotional over-eating and other eating traits. RESULTS Poorer self-reported ability to detect interoceptive signals (deficits in interoceptive accuracy) was predictive of higher BMI (r = - 0.07 (95% CI -0.13; -0.01), p < .05). In parallel mediation analyses, participants with poorer interoceptive accuracy were significantly less likely to report considering satiety signals when eating and this explained the cross-sectional association between interoceptive accuracy and higher BMI. There was also some evidence that participants with poorer interoceptive accuracy were more likely to report emotional overeating and this also in part explained why interoceptive accuracy was predictive of higher BMI. CONCLUSIONS Deficits in interoception may decrease the likelihood that satiety signals are integrated into eating behaviour related decision making and in doing so contribute to higher BMI.
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DeVille DC, Erchull MJ, Mailloux JR. Intuitive eating mediates the relationship between interoceptive accuracy and eating disorder risk. Eat Behav 2021; 41:101495. [PMID: 33713922 DOI: 10.1016/j.eatbeh.2021.101495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 02/20/2021] [Accepted: 02/25/2021] [Indexed: 10/22/2022]
Abstract
Research supports an association between altered interoceptive accuracy, or the ability to accurately monitor sensations from the body, and disordered eating. However, the behavioral mechanism through which interoceptive accuracy may influence eating behaviors is unclear. Intuitive eating, the ability to regulate food intake according to visceral cues of hunger and satiety, is positively related to interoceptive accuracy and negatively related to disordered eating. Therefore, we hypothesized that interoceptive accuracy would be negatively associated with intuitive eating which would, in turn, influence eating disorder risk. A mediation analysis was performed to test this hypothesis in a sample of 41 undergraduate women who completed a heartbeat counting task to assess interoceptive accuracy, followed by self-report measures of intuitive eating ability and eating disorder risk. We found that eating for physical rather than emotional reasons and reliance on hunger and satiety cues, two aspects of intuitive eating, mediated the relationship between interoceptive accuracy and eating disorder risk. Although further research is necessary, it is possible that findings regarding the association between interoceptive accuracy and intuitive eating may inform the development of eating disorder prevention efforts.
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Affiliation(s)
- Danielle C DeVille
- University of Mary Washington, Department of Psychological Science, 1301 College Avenue, Fredericksburg, VA 22401, United States; University of Tulsa, Department of Psychology, 800 S. Tucker Drive, Tulsa, OK 74104, United States
| | - Mindy J Erchull
- University of Mary Washington, Department of Psychological Science, 1301 College Avenue, Fredericksburg, VA 22401, United States.
| | - Jennifer R Mailloux
- University of Mary Washington, Department of Psychological Science, 1301 College Avenue, Fredericksburg, VA 22401, United States.
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Armitage RM, Iatridi V, Yeomans MR. Understanding sweet-liking phenotypes and their implications for obesity: Narrative review and future directions. Physiol Behav 2021; 235:113398. [PMID: 33771526 DOI: 10.1016/j.physbeh.2021.113398] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/02/2021] [Accepted: 03/19/2021] [Indexed: 01/21/2023]
Abstract
Building on a series of recent studies that challenge the universality of sweet liking, here we review the evidence for multiple sweet-liking phenotypes which strongly suggest, humans fall into three hedonic response patterns: extreme sweet likers (ESL), where liking increases with sweetness, moderate sweet likers (MSL), who like moderate but not intense sweetness, and sweet dislikers (SD), who show increasing aversion as sweetness increases. This review contrasts how these phenotypes differ in body size and composition, dietary intake and behavioural measures to test the widely held view that sweet liking may be a key driver of obesity. Apart from increased consumption of sugar-sweetened beverages in ESL, we found no clear evidence that sweet liking was associated with obesity and actually found some evidence that SD, rather than ESL, may have slightly higher body fat. We conclude that ESL may have heightened awareness of internal appetite cues that could protect against overconsumption and increased sensitivity to wider reward. We note many gaps in knowledge and the need for future studies to contrast these phenotypes in terms of genetics, neural processing of reward and broader measures of behaviour. There is also the need for more extensive longitudinal studies to determine the extent to which these phenotypes are modified by exposure to sweet stimuli in the context of the obesogenic environment.
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Affiliation(s)
| | - Vasiliki Iatridi
- Department of Sport, Health Sciences and Social Work, Oxford Brookes University, UK
| | - Martin R Yeomans
- School of Psychology, University of Sussex, Brighton, BN1 9QH, UK.
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The Relationship Between Body Awareness and Self-care in Patients With Heart Failure: Moderating Effect of Age. J Cardiovasc Nurs 2021; 37:266-273. [PMID: 33764942 DOI: 10.1097/jcn.0000000000000801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Recognizing changing symptoms is challenging for patients with heart failure (HF), especially older patients. Body awareness involves an attentional focus on and awareness of internal bodily changes. Patients with poor body awareness are unlikely to recognize subtle bodily changes, which may result in improper self-care. Despite the potential benefits of body awareness, its contribution to HF management has not been examined. AIMS The aims of this study were to examine the relationship between body awareness and self-care in patients with HF and explore whether this relationship varies by age. METHODS Patients (N = 136) completed the Body Awareness Questionnaire and 2 scales of the Self-care of HF Index (maintenance and management). Linear regression models were constructed to explore the relationship between body awareness and self-care after controlling for covariates. The moderation effect of age on the relationship between body awareness and self-care was examined using the PROCESS macro. RESULTS Body awareness was associated with self-care maintenance (unstandardized coefficient = 0.19; 95% confidence interval, 0.05-0.34) but not management. When the interaction effect of body awareness and age was entered in the regression model, neither self-care maintenance nor management was related to this interaction term. CONCLUSION We found that body awareness is conducive to self-care maintenance but not self-care management in patients with HF, and the relationship between body awareness and self-care did not vary by age. Our findings suggest that relying on internal body sensations may be insufficient to facilitate self-care management. Thus, other strategies along with the strategies to enhance body awareness are necessary to improve the full process of self-care in HF patients.
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Cardoso A, Oliveira S, Ferreira C. Negative and positive affect and disordered eating: The adaptive role of intuitive eating and body image flexibility. CLIN PSYCHOL-UK 2021. [DOI: 10.1111/cp.12224] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Ana Cardoso
- CINEICC – Center for Research in Neuropsychology and Cognitive and Behavioral Intervention Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal,
| | - Sara Oliveira
- CINEICC – Center for Research in Neuropsychology and Cognitive and Behavioral Intervention Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal,
| | - Cláudia Ferreira
- CINEICC – Center for Research in Neuropsychology and Cognitive and Behavioral Intervention Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal,
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50
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Internal states and interoception along a spectrum of eating disorder symptomology. Physiol Behav 2021; 230:113307. [PMID: 33373691 DOI: 10.1016/j.physbeh.2020.113307] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Recent studies on atypical interoceptive capabilities have focused on clinical populations, including anorexia nervosa[1,2]. The present exploratory study aims to characterize the influence of disordered eating symptomology on interoceptive capabilities in college students, a population for which dangerous dieting behaviors may emerge. METHOD Ninety-nine participants were randomized to consume a blinded high calorie or low calorie midday shake. Participants reported frequency of eating disorder cognitions and behaviors; indicated changes in satiety, happiness, and energy pre- and post-consumption; and guessed the calories in their shake. Outcomes (perceived satiety, changes in mood, and caloric guess) were regressed on eating disorder symptoms scores, the high/low calorie shake condition, and the interaction between these predictors. RESULTS Those randomized to receive the high calorie shake reported feeling fuller, but only when endorsing lower levels of eating concern. Those randomized to the high calorie shake reported greater post-meal happiness, but only at greater levels of eating concerns. Lastly, those with lower levels of eating restraint reported an expected positive association between level of fullness and calorie guess, but those with higher levels of eating restraint did not exhibit any relationship between perceived fullness and calorie guess. DISCUSSION Results of this exploratory suggest that irregular eating habits (e.g., not eating a sufficient amount for lunch) may have direct consequences on interoceptive capabilities. Further, these capacities may be impacted by individual differences in eating concern and restraint. Preliminary findings suggest that impairment in deciphering visceral signals may be associated with the degree of eating disorder symptomology; such impairment may occur at lower levels of symptomatology than normative data would indicate.
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