Psychometric properties and measurement invariance across gender of the Italian version of the tempest self-regulation questionnaire for eating adapted for young adults

Understanding the influencing factors of adolescents' (12-17) healthy and unhealthy food choices and experiences in Tamil Nadu, India: a socioecological perspective

Adolescents' food choices are critical for long-term health, yet increasing consumption of unhealthy foods driven by environmental and social factors contributes to rising obesity and non-communicable diseases. This study explored the perceptions of parents, teachers, and adolescents regarding the factors influencing adolescent food choices in urban, slum, and rural areas of Tamil Nadu. Adolescents illustrated their preferred foods through drawings used emojis to express emotions related to their food choices. Employing Bronfenbrenner's ecological theory, thematic analysis revealed that key factors influencing both healthy and unhealthy food choices across all regions included taste preferences, textural appeal, food cravings, peer and media influence, and family practices. In urban areas, economic status, food access, and working parents led to unhealthy eating, worsened by the COVID-19 pandemic, while in rural areas, COVID-19 reinforced traditional, healthy eating habits. However, "eye eating", emerged as a coping strategy to reduce unhealthy food cravings in urban settings. In rural areas, nearby neighbourhoods and extended families supported the provision of home-cooked meals in the absence of working parents. In slums, food bloggers and the accessibility of affordable street foods were prominent influencers. Emotional states influenced food choices across all settings: unhealthy foods were associated with immediate gratification, as evident in the drawings displayed by adolescents, followed by guilt, while home-cooked meals, particularly in rural areas, were linked to comfort. Leveraging "eye eating" by visually promoting healthy foods in urban areas, and strengthening nutrition education through families and schools in rural settings, can guide tailored interventions for healthier adolescent diets.

Relationships between nutritional intake, appetite regulation, and mental health with body composition among female college students with overweight and obesity

Introduction

The prevalence of overweight and obesity among college girls is a significant public health concern. This cross-sectional study investigated the relationships between nutritional intake, appetite regulation, and mental health with body composition among overweight and obese college girls.

Methods

This study involved 72 college girls. Standardized instruments measured the corresponding variables. The data analysis utilized Pearson and Spearman correlations.

Results

Results show that energy and carbohydrate intake were positively correlated with body fat percentage and waist circumference (both p ≤ 0.007). Fat intake was positively correlated with all body composition variables (all p < 0.001). Anxiety was negatively correlated with all body composition variables (all p ≤ 0.027). Hunger at 0 min was positively correlated with body fat percentage and waist circumference (both p ≤ 0.002). Hunger at 60 min was positively correlated with BMI and waist circumference (both p ≤ 0.012). Desire to eat at 0 and 60 min were positively correlated with all body composition variables (all p ≤ 0.003). Desire to eat at 30 min was positively correlated with BMI (p = 0.005). Desire to eat at 90 min was negatively correlated with body fat percentage (p = 0.047). Fullness at 0 min was positively correlated with waist circumference (p = 0.040). Fullness at 30 min was positively correlated with body fat percentage and waist circumference (both p ≤ 0.018). Fullness at 120 min was negatively correlated with all body composition variables (all p ≤ 0.023). Prospective food consumption at 0 min was positively correlated with all body composition variables (all p < 0.001). Prospective food consumption at 30, 60, and 120 min was positively correlated with BMI (all p ≤ 0.008).

Discussion

Overall, overweight and obese college girls should manage energy intake, fat intake, carbohydrate intake, anxiety, and appetite regulation to reduce fat levels. Further research suggests exploring counterintuitive correlations between body composition with anxiety, desire to eat at 90 min, and fullness at 0 and 30 min, along with limitations related to causal relationships, measurement accuracy, the relationship with physical activity, and population diversity.

Food Neophobia in Brazilian Children: A Nationwide Cross-Sectional Study Comparing Neurodivergent and Neurotypical Children with and Without Dietary Restrictions

Objective: This study aims to compare food neophobia (FN) in groups of neurodivergent and neurotypical children with and without food restrictions. Methods: This cross-sectional study used a convenience sample of participants from all Brazilian Federative Units through the snowball method. Participants were separated into four groups for comparison: neurodivergent children without dietary restrictions; neurodivergent children with dietary restrictions; neurotypical children with dietary restrictions; and neurotypical children without dietary restrictions. The Brazilian Children's Food Neophobia Questionnaire (BCFNeo) was selected and administered to caregivers of Brazilian children between four and eleven years old. The categorization of FN scores followed a previously validated protocol. Results: The sample was composed of the caregivers of 2387 children. Considering the sample as a whole (neurodiversity), the prevalence of high FN was 44.2%. Boys are significantly more neophobic (p < 0.001) than girls. FN does not decrease with age. Older children (eight to eleven years) are equally neophobic as younger children (four to seven years). The prevalence of high FN was greater in neurodivergent children (without dietary restrictions-62.8% and with dietary restrictions-62.4%) than in neurotypical children (with dietary restrictions-29.4% and without dietary restrictions-33.4%). Conclusions: FN is more prevalent in boys and neurodivergent children, regardless of food restrictions and age. More longitudinal and experimental studies are necessary to evaluate the factors influencing FN in these groups and to develop intervention strategies.

Predictors and Moderators of Outcomes in a Trial of Cognitive Behavioural Therapy Integrated with Behavioural Weight Loss for High Weight Individuals with Disorders of Recurrent Binge Eating

Background/Objectives: To inform person-centred clinical practice, it is important to know what features may predict or moderate treatment outcomes. Thus, we investigated pre-treatment clinical features and mid-therapy reduction in loss of control over eating (MTLOCE), including impacts on treatment outcomes of a new manualised psychotherapy, a healthy approach to weight management and food in eating disorders (HAPIFED). HAPIFED was developed as an integrated psychological and behavioural treatment for individuals with bulimia nervosa or binge eating disorder, which are co-morbid with a high body mass index (BMI). Methods: In total, 50 participants were randomised to HAPIFED and 48 were randomised to the control cognitive behaviour therapy-enhanced group. Assessments included mental health-related quality of life (MHRQoL), eating disorder symptom severity, binge-eating frequency, BMI, and loss of control over eating (LOCE) at baseline, mid-treatment, end-treatment, and 6 and 12 months end of follow-up (EndFU). These were measured with the SF-12, the EDE-Q, and the LOCES, respectively. Linear and negative binomial mixed models were used. Missing data were imputed multiple times, assuming intention of treatment for the analysis. Results: Pre-treatment eating disorder symptom severity, MHRQoL, and BMI positively predicted eating disorder symptom severity, MHRQoL, and BMI up to 6 and 12 months end of follow-up. Mid-treatment LOCE MTLOCE predicted improved MHRQoL (coefficient = 0.387, 95% CI 0.0824-0.6921, p = 0.004), reduced binge-eating frequency (IRR = 0.5637, 95% CI 0.3539-0.8977, p = 0.0191), and eating disorder symptom severity (coefficient= -0.65, 95% CI -1.0792--0.2217, p = 0.0139). Neither purging nor illness duration were a significant predictor of any of the outcomes. The effect of HAPIFED was not moderated by baseline weight/BMI but was moderated negatively by MTLOCE for binge-eating frequency (coefficient = -0.636, SE = 0.28, p < 0.05, IRR = 0.529) and eating disorder symptom severity (coefficient = -0.268, SE = 0.13, p < 0.05, Cohen's d = -0.102). Conclusions: Greater control over eating improved MHRQoL and decreased the frequency of binge-eating episodes and eating disorder symptom severity. These positive effects were moderated by being in the HAPIFED group, supporting previous findings of benefits to people's mental health through participation in the HAPIFED trial.

Emotional and cognitive responses to romantic breakups in adolescents and young adults: the role of rumination and coping mechanisms in life impact

Background

Romantic breakups can significantly impact the psychological well-being of young adults, affecting emotional, physical, and social domains. This study examines the roles of rumination and coping strategies in shaping adjustment to breakup-related distress, specifically focusing on Italian adolescents and young adults.

Methods

A sample of 560 participants aged 17 to 22 who had recently experienced a romantic breakup completed questionnaires assessing rumination, coping strategies, and perceived impacts on life domains such as academic performance, family relationships, physical health, and emotional well-being. Correlation, regression, and mediation analyses were conducted to explore the relationships between rumination, coping strategies, and adjustment outcomes.

Results

Rumination emerged as a significant predictor of negative outcomes in academic performance and physical health. Avoidance coping mediated the relationship between rumination and emotional well-being, suggesting that individuals who ruminate are more likely to adopt avoidance strategies, leading to greater emotional distress. Conversely, adaptive strategies like Positive Attitude and Problem Solving were associated with better adjustment, predicting improved academic performance and healthier family relationships.

Conclusions

The findings underscore the importance of addressing rumination and avoidance coping in interventions aimed at supporting young adults post-breakup. Encouraging adaptive coping strategies, such as Positive Attitude and Problem Solving, could enhance resilience and mitigate the negative effects of relationship dissolution. This study contributes to a better understanding of coping processes in a culturally specific context, highlighting potential avenues for fostering resilience in youth facing emotional challenges.

Immunonutrition in ERAS Protocol for Patients with Gynecologic Cancer: A Narrative Review of the Literature

In-hospital patients who are in the gynecologic oncology setting often suffer from malnutrition, which is one of the primary problems, the rate of which reportedly ranges from 28% to 70%. Malnutrition is a significant risk factor for immunosuppression, negatively impacting immune response and postoperative recovery capacity. At the time of the surgeries, due to their wide scope and aggressive treatments such as chemotherapy and radiotherapy, the situation becomes more serious. Those micronutrients taking part in immunonutrition, namely, arginine, omega-3 fatty acids, nucleotides, and antioxidants, have the potential to prevent inflammation, protect against infections, and promote healing after the surgery. Research has shown that immunonutrition can lower the risk of postoperative infection, promote the normal healing of wounds, and reduce the hospital stays of patients, as well as support malnutrition status during chemotherapy. This review is based on a literature search conducted in Medline, Scopus, Clinicaltrials.gov, Cochrane CENTRAL, and Google Scholar, with the last search date being November 2024. Some studies. found that perioperative immunonutrition decreases wound infections and affects some immune indexes in gynecologic oncology patients positively. However, factors such as non-compliant patients, high costs, and non-standard formulations can deter its wider use. Patient adherence drops postoperatively mainly due to nausea and decreased appetite, whereas the cost of enriched formulations acts as an economic barrier. Postoperative compliance drops from ~78% prior to surgery to ~28% due to nausea, anorexia, and chemotherapy. Additionally, cost remains a constraining factor since special formulas are 2-4 times that of normal nutrition. While immunonutrition reduces hospital stay (by ~2-3 days) and infection rate (by 25-40%), access is hindered by prohibitive initial costs and lack of insurance coverage. Approaches such as subsidized schemes, enhanced palatability, and cost-benefit analyses are required to increase adoption. In addition, the lack of standardized protocols makes the clinical community hesitant to adopt this approach. Immunonutrition is, despite these problems, still hoped to be the new adjunct to gynecologic oncology patients. In future studies, it is imperative to pay attention to the best formulations that produce the best outcomes and evaluate and implement guidelines that are based on evidence. Together, with these improvements, immunonutrition could very well be an integral part of perioperative care thus completing the process by which patients in intense treatments are benefited not only via treatment but also via quality of life.

Meta-analytic prospective associations between self-esteem and eating disorders appear to be spurious: a reanalysis and comment on Krauss et al. (2023)

In a recent meta-analysis, Krauss et al. found support for a reciprocal model of low self-esteem and eating disorders where, in a vicious circle, low self-esteem makes people more vulnerable to developing eating disorders and eating disorders, in turn, scars individuals' self-esteem. However, in the present reanalyses of the same meta-analytic data, we found that the prospective effects between self-esteem and eating disorders are likely spurious, meaning they do not reflect a true causal effect, but rather correlations with residuals and regression to the mean. Consequently, the claims by Krauss et al. can be challenged. To avoid statistical artifacts, we recommend researchers to fit, as we did in the present study, complementary models to their data in order to evaluate if prospective effects may be genuinely increasing or decreasing or if they appear to be spurious.

The Impact of Social Media on Eating Disorder Risk and Self-Esteem Among Adolescents and Young Adults: A Psychosocial Analysis in Individuals Aged 16-25

BACKGROUND/OBJECTIVES

Eating disorders (EDs) result from complex interactions of biological, psychological, social, and cultural factors, disproportionately affecting adolescents and young adults. Social media, peer pressure, and self-esteem issues contribute to ED prevalence. This study examines ED risk, eating behaviors, and self-esteem among individuals aged 16-25, exploring differences by gender, age, and social media usage.

METHODS

A total of 261 participants (113 high school students, 115 college students, 33 working individuals) completed the Computer-Assisted Web Interview (CAWI) between April and June 2024. This study utilized the Eating Attitudes Test-26 (EAT-26), Rosenberg Self-Esteem Scale (SES), and My Eating Habits (MEH) questionnaires. Statistical analyses, including chi-square tests and linear regression, assessed associations between ED risk, self-esteem, and social media activity.

RESULTS

ED risk was identified in 47% (n = 123) of participants, with the highest prevalence in high school students (56.6%, n = 64). Significant gender differences were observed (p < 0.001), with males in the high school group showing elevated ED risk (64%, n = 32). Body dissatisfaction and frequent social media comparisons increased ED risk (p < 0.001); 45.7% (n = 102) of participants who often compared their bodies online reported heightened risk. Photo manipulation correlated with higher ED risk (p = 0.005). Regression analysis revealed a significant relationship between ED risk and restrictive dieting (estimate = 0.9239; p < 0.001), while self-esteem had no significant effect (estimate = 0.00503, p = 0.977).

CONCLUSIONS

This study highlights high ED risk driven by social media and body dissatisfaction. Interventions should focus on body image issues, self-acceptance, and media literacy. This study focused on a specific age group (16-25) in Poland, which may limit the ability to generalize the results to other demographic or cultural groups. Future research should include more diverse populations and objective measurements.

Dietary Habits of Pregnant Women in Spain: The Role of Nutrition Education in Midwife Consultations

Background & Objectives: Correct nutrition during pregnancy is key to guaranteeing success at this stage of a woman's life, and nutritional education is the fundamental tool for achieving this. Studies carried out in different countries indicate that pregnant women do not comply with dietary and nutritional recommendations. Given the lack of evidence available in Spain and the importance of this knowledge to be able to assess the need for nutritional intervention in this group, the aim of this study focused on the current status of the issue in Spain: the quality of the diet of Spanish pregnant women and its conditioning factors. Methods: Two representative regions of the country were selected, one located in the north of Spain (Burgos) and the other in the south (Granada), and a descriptive, cross-sectional observational study (sample size: 771) was carried out using a questionnaire administered at the University Hospital of Burgos and the Hospital Clínico San Cecilio in Granada, which had previously been subjected to a process of evaluation by expert judgement. Results: Pregnant women presented an adequate diet quality (8.0 ± 2.0), according to the questionnaire used, despite their poor knowledge of food and nutrition (4.9 ± 1.6 out of 10). However, deficiencies were detected in the consumption of very interesting food groups from a nutritional point of view, such as legumes, nuts and fish (just 29.4%, 37.6% and 24.8% of the pregnant women met the recommendations, respectively) and insufficient physical exercise. The eating habits of pregnant women depend on their age, their country of origin, their level of education, their pre-pregnancy BMI, the knowledge acquired during pregnancy and the degree to which they put into practice the advice received from their midwife. Most pregnant women do not change their habits during pregnancy, although there are positive trends in this respect. Conclusion: The quality of the diet of the Spanish pregnant women surveyed, and their level of physical activity, could be improved by enhancing the nutritional education they receive during this stage of life. The role of the dietician in this respect, as part of multidisciplinary teams, should be the basis for future research.

Meal Timing and Sleep Health Among Midlife Mexican Women During the Early Stages of the COVID-19 Pandemic

BACKGROUND/OBJECTIVES

This study aimed to examine associations between meal timing habits and sleep health in midlife Mexican women.

METHODS

Data comprised 379 midlife Mexican women who participated in a phone survey conducted within the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) project during the early stages of the COVID-19 pandemic. Women answered questions related to meal habits and sleep duration, latency, and quality. We used linear regression to investigate the associations between meal timing, frequency of meals/snacks, eating window (duration between first and last eating occasion of the day), duration between last meal, bedtime, sleep duration, and logistic regression to examine the associations between meal timing, sleep latency, and sleep quality, adjusting for confounders.

RESULTS

Later timing of meals throughout the day, and a shorter interval between the last meal of the day and bedtime, were associated with prolonged sleep latency and worse sleep quality. Associations with sleep duration were mixed: a longer eating window and a later largest and last meal were each associated with shorter sleep duration, while a later first meal and a shorter interval between the last meal of the day and bedtime were associated with longer sleep duration.

CONCLUSIONS

Meal timing habits are associated with sleep duration, latency, and quality in midlife women.

Fitness and Dietary Supplements: A Cross-Sectional Study on Food Practices and Nutrivigilance

Background/Objectives: The use of dietary supplements (DSs) has become common among fitness enthusiasts, aiming to enhance performance, recovery, and overall well-being. Methods: A cross-sectional study was conducted in the city of Beni Mellal from April to July 2024, assessed dietary practices, motivations for supplement use, and associated adverse effects among 420 survey participants. Results: The majority of dietary supplement users were aged 25-64 and had higher education levels. Colopathy (67.38%) was the most common eating disorder, followed by digestive (59.46%), inflammatory, and rheumatic diseases (53.50%). Dietary supplementation prevalence was 88.1%, with proteins (60.81%), medicinal plants (45.13%), and vitamins (42.70%) being the most consumed. Key motivations included supporting muscle, bone, and joint strength (musculoskeletal) (83.78%) and enhancing heart and lung function for cardiorespiratory health (82.43%). However, 28% of protein users experienced adverse effects, such as myalgia, gastralgia, palpitations, and insomnia. Multivariate linear regression indicated a significant negative association of creatine with effectiveness (β = -0.485, p = 0.001). Conclusions: Overall, while the benefits of dietary and sports practices are evident, the adverse effects associated with protein supplements highlight the necessity for enhanced nutrivigilance and nutritional education to ensure safe supplements.

Enhancing nutritional knowledge and self-regulation among adolescents: efficacy of a multifaceted food literacy intervention

This health literacy intervention study, conducted on adolescent students, aimed to evaluate the impact of a comprehensive educational program on promoting healthy eating habits. The intervention sought to enhance adolescents' knowledge about nutrition, foster self-regulation skills, and ultimately improve their overall health, including their body mass index (BMI). Through a multi-component approach that combined theoretical learning with practical activities and the integration of digital tools such as the MyFitnessPal app, the study targeted improvements in food literacy, which encompasses nutrition knowledge, food label interpretation skills, and cooking abilities. These elements are critical in influencing adolescents' food choices and eating behaviors, with a focus on increasing the consumption of fruits and vegetables while reducing the intake of fast food and processed snacks. The intervention was structured around a series of educational workshops and interactive sessions, facilitated by professionals experienced in nutrition. These sessions covered topics such as food composition, the importance of a balanced diet, and strategies for avoiding excessive consumption of processed and high-energy-density foods. A distinctive feature of the program was its use of digital tools to enhance engagement and allow for the practical application of learned concepts through food tracking and activity monitoring. Preliminary results indicate positive outcomes in terms of increased food knowledge and improved dietary habits among participants. Notably, there was a significant improvement in adolescents' BMI, highlighting the potential of food literacy interventions to contribute to better physical health outcomes. The study underscores the importance of adopting multidisciplinary and technology-enhanced approaches in educational programs aimed at promoting healthy eating among adolescents. The study's findings suggest that well-structured food education programs, tailored to address the specific needs of adolescents, can facilitate positive changes in eating behavior. This highlights the critical role of food literacy in adolescents' health and wellbeing and points to the need for continued investment in research and development to optimize intervention strategies. The integration of digital technologies and a focus on self-regulation strategies are identified as promising avenues for future research and educational practice, reinforcing the call for innovative investments in food education and health promotion among the youth.

Psychometric Properties of the Dutch Version of the Eating Competence Satter Inventory (ecSI 2.0TM) in Community Adolescents

Eating competence can help adolescents navigate their food choices and attitudes toward eating in a healthy and balanced way. In the present study, we investigated the psychometric properties of the Dutch translation of the Eating Competence Satter Inventory 2.0TM (ecSI 2.0TM), which was developed to assess eating attitudes and behaviors. A sample of 900 Flemish adolescents completed the ecSI 2.0TM DUTCH and two self-report measures on eating disorder symptoms and identity functioning (i.e., confusion and synthesis). Confirmatory factor analysis confirmed the four-factor structure of the ecSI 2.0TM DUTCH, and the resulting four subscales (i.e., Eating Attitudes, Food Acceptance, Internal Regulation, and Contextual Skills) showed acceptable-to-excellent reliability (αs ranging from 0.69 to 0.91). The ecSI 2.0TM DUTCH also demonstrated scalar invariance across sex and age (<17 years, ≥17 years). Males reported significantly higher ecSI 2.0TM DUTCH scores than females on the four subscales and the total scale. The two age groups did not significantly differ on the ecSI 2.0TM DUTCH scales. Finally, scores on the ecSI 2.0TM DUTCH subscales showed non-significant or small negative correlations with adolescents' Body Mass Index (BMI), large negative correlations with eating disorder symptoms and identity confusion, and large positive associations with identity synthesis. The Dutch translation of the ecSI 2.0TM is a valid and reliable instrument to assess eating competence skills in male and female adolescents.

Internet addiction in young adults: The role of impulsivity and codependency

Excessive Internet use has demonstrated comorbidity with other psychological symptoms and psychiatric disorders, as well as impairments in the management of daily life, relationships and emotional stability. Recent findings in the literature have consistently supported the relationship between impulsivity and Internet addiction. The present study hypothesized that, in addition to impulsivity, a further predictor of Internet addiction might be relational co-dependency, which is also associated in the literature with addiction phenomena, but mainly substance addiction. This paper investigates the role and predictive weight of impulsivity and codependency on Internet addiction on a sample of young adult university students (n = 481) by using a hierarchical regression analysis. The participants were administered the UADI-2, the BIS-11 and the SFCDS. In terms of percentage distribution, 38 % of the participants were in the dependency range, while 37.7 % demonstrated Internet abuse behavior. The results confirmed the role of impulsiveness (β = 0.312) and added to the literature by showing the significant role of relational codependency (β = 0.275), gender (β = 0.174) and age (β = 0.196). Thus, male participants were more dependent, more impulsive and more co-dependent, with increasing age in the given range (18-30). The present study shed light to the presence of this issue among young adults and that, as a preventive and restraining measure, there is a need not only for targeted awareness-raising programmes but also for interventions to promote greater emotional control and a more balanced management of personal relationships.