Elise Carbonneau

Validation of a French-Canadian adaptation of the Intuitive Eating Scale-2 for the adult population

Intuitive eating is an adaptive eating style based on the reliance on physiological cues to determine when, what, and how much to eat. The Intuitive Eating Scale-2 (IES-2) is a validated four-subscale tool measuring the degree of adherence to intuitive eating principles. The present series of studies aimed at evaluating the psychometric properties of a French-Canadian adaptation of the IES-2 for the adult population. The factor structure, the reliability (internal consistency and test-retest), the construct validity, and the discriminant validity were evaluated in 334 women and 75 men from the Province of Québec, Canada, across two studies. A confirmatory factor analysis upheld that the four-factor structure of the original IES-2 was adequate for the present sample of French-Canadians. The scale demonstrated adequate internal consistency and test-retest reliability. Construct validity evidence was obtained with the significant associations between intuitive eating and psychological and eating-related variables. Intuitive eating was negatively associated with eating disorder symptomatology and with food- and weight-preoccupation, and positively associated with body-esteem and well-being. The French-Canadian IES-2 was also able to discriminate between genders and body mass index categories. The properties of this new version of the IES-2 are demonstrative of a reliable and valid tool to assess intuitive eating in the French-Canadian adult population of the Province of Québec.

Impact of nutritional labelling on 10-d energy intake, appetite perceptions and attitudes towards food

The purpose of this study was to investigate the impact of nutritional labelling on energy intake, appetite perceptions and attitudes towards food. During a 10-d period, seventy normal-weight (BMI<25 kg/m2) and seventy-one obese women (BMI≥30 kg/m2) were given three meals per d under ad libitum conditions. Participants were randomly assigned to one of three experimental labelling groups in which the only difference was the label posted on lunch meal entrée: (1) low-fat label, (2) energy label (energy content of the entrée and average daily needs) and (3) no label (control). Average energy intake was calculated by weighing all foods before v. after daily consumption. Hunger and fullness perceptions were rated on visual analogue scales immediately before and after each meal. Satiety efficiency was assessed through the calculation of the satiety quotient (SQ). The appreciation and perceived healthiness of the lunch entrées were rated on eight-point Likert scales. There was no difference in energy intake, SQ and attitudes towards food between the three labelling groups. Fasting hunger perception was higher in the low-fat label group compared with the two others groups (P=0·0037). No interactions between labelling groups and BMI categories were observed. In conclusion, although labelling does not seem to influence energy intake, a low-fat label may increase womens fasting hunger perceptions compared with an energy label or no label.

Development and validation of a nutrition knowledge questionnaire for a Canadian population.

OBJECTIVE The present study aimed to develop and validate a nutrition knowledge questionnaire in a sample of French Canadians from the province of Quebec, taking into account dietary guidelines. DESIGN A thirty-eight-item questionnaire was developed by the research team and evaluated for content validity by an expert panel, and then administered to respondents. Face validity and construct validity were measured in a pre-test. Exploratory factor analysis and covariance structure analysis were performed to verify the structure of the questionnaire and identify problematic items. Internal consistency and test-retest reliability were evaluated through a validation study. SETTING Online survey. SUBJECTS Six nutrition and psychology experts, fifteen registered dietitians (RD) and 180 lay people participated. RESULTS Content validity evaluation resulted in the removal of two items and reformulation of one item. Following face validity, one item was reformulated. Construct validity was found to be adequate, with higher scores for RD v. non-RD (21·5 (sd 2·1) v. 15·7 (sd 3·0) out of 24, P<0·001). Exploratory factor analysis revealed that the questionnaire contained only one factor. Covariance structure analysis led to removal of sixteen items. Internal consistency for the overall questionnaire was adequate (Cronbachs α=0·73). Assessment of test-retest reliability resulted in significant associations for the total knowledge score (r=0·59, P<0·001). CONCLUSIONS This nutrition knowledge questionnaire was found to be a suitable instrument which can be used to measure levels of nutrition knowledge in a Canadian population. It could also serve as a model for the development of similar instruments in other populations.

Examining women's perceptions of their mother's and romantic partner's interpersonal styles for a better understanding of their eating regulation and intuitive eating.

Intuitive eating is a positive approach to weight and eating management characterized by a strong reliance on internal physiological hunger and satiety cues rather than emotional and external cues (e.g., Tylka, 2006). Using a Self-Determination Theory framework (Deci & Ryan, 1985), the main purpose of this research was to examine the role played by both the mother and the romantic partner in predicting womens intuitive eating. Participants were 272 women (mean age: 29.9 years) currently involved in a heterosexual romantic relationship. Mothers and romantic partners were both found to have a role to play in predicting womens intuitive eating via their influence on womens motivation for regulating eating behaviors. Specifically, both the mothers and partners controlling styles were found to predict womens controlled eating regulation, which was negatively related to their intuitive eating. In addition, autonomy support from the partner (but not from the mother) was found to positively predict intuitive eating, and this relationship was mediated by womens more autonomous regulation toward eating. These results were uncovered while controlling for womens body mass index, which is likely to affect womens eating attitudes and behaviors. Overall, these results attest to the importance of considering womens social environment (i.e., mother and romantic partner) for a better understanding of their eating regulation and ability to eat intuitively.

Effects of the Mediterranean Diet before and after Weight Loss on Eating Behavioral Traits in Men with Metabolic Syndrome

The objective of this study was to investigate the impact of the Mediterranean diet (MedDiet) consumed before and after weight loss on eating behavioral traits as measured by the Three-Factor Eating Questionnaire (TFEQ) in men with metabolic syndrome (MetS). In this fixed sequence study, 19 men with MetS (National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) criteria), aged between 24 and 62 years, first consumed a five-week standardized North American control diet followed by a five-week MedDiet, both under weight-maintaining controlled-feeding conditions. This was followed by a 20-week caloric restriction weight loss period in free-living conditions, without specific recommendations towards adhering to the principles of the MedDiet. Participants were finally subjected to a final five-week MedDiet phase under isoenergetic controlled-feeding conditions. The MedDiet before weight loss had no impact on eating behavioral traits. Body weight reduction by caloric restriction (−10.2% of initial weight) was associated with increased cognitive restraint (p < 0.0001) and with reduced disinhibition (p = 0.02) and susceptibility to hunger (p = 0.01). Feeding the MedDiet for five weeks under isoenergetic conditions after the weight loss phase had no further impact on eating behavioral traits. Results of this controlled-feeding study suggest that consumption of the MedDiet per se has no effect on eating behavioral traits as measured by TFEQ, unless it is combined with significant weight loss.

Development and validation of the perceived food environment questionnaire in a french-canadian population

OBJECTIVE The present study aimed to develop and validate a questionnaire assessing perceived food environment in a French-Canadian population. DESIGN A questionnaire, the Perceived Food Environment Questionnaire, was developed assessing perceived accessibility to healthy (nine items) and unhealthy foods (three items). A pre-test sample was recruited for a pilot testing of the questionnaire. For the validation study, another sample was recruited and completed the questionnaire twice. Exploratory factor analysis was performed on the items to assess the number of factors (subscales). Cronbachs α was used to measure internal consistency reliability. Test-retest reliability was assessed with Pearson correlations. SETTING Online survey. SUBJECTS Men and women from the Québec City area (n 31 in the pre-test sample; n 150 in the validation study sample). RESULTS The pilot testing did not lead to any change in the questionnaire. The exploratory factor analysis revealed a two-subscale structure. The first subscale is composed of six items assessing accessibility to healthy foods and the second includes three items related to accessibility to unhealthy foods. Three items were removed from the questionnaire due to low loading on the two subscales. The subscales demonstrated adequate internal consistency (Cronbachs α=0·77 for healthy foods and 0·62 for unhealthy foods) and test-retest reliability (r=0·59 and 0·60, respectively; both P<0·0001). CONCLUSIONS The Perceived Food Environment Questionnaire was developed for a French-Canadian population and demonstrated good psychometric properties. Further validation is recommended if the questionnaire is to be used in other populations.

Eating-Related and Psychological Outcomes of Health at Every Size Intervention in Health and Social Services Centers Across the Province of Québec

Purpose: To report the outcomes of a Health at Every Size (HAES) intervention in a real-world setting. Design: Quasi-experimental design evaluating eating behaviors and psychological factors. Setting: The HAES intervention is offered in Health and Social Services Centers in Québec (Canada). Participants: For this study, 216 women (body mass index [BMI]: 35.76 [6.80] kg/m2) who participated to the HAES intervention were compared to 110 women (BMI: 34.56 [7.30] kg/m2) from a comparison group. Intervention: The HAES intervention is composed of 14 weekly meetings provided by health professionals. It focuses on healthy lifestyle, self-acceptance, and intuitive eating. Measures: Eating behaviors (ie, flexible restraint, rigid restraint, disinhibition, susceptibility to hunger, intuitive eating, and obsessive-compulsive eating) and psychological correlates (ie, body esteem, self-esteem, and depression) were assessed using validated questionnaires at baseline, postintervention, and 1-year follow-up. Analysis: Group, time, and interaction effects analyzed with mixed models. Results: Significant group by time interactions were found for flexible restraint (P = .0400), disinhibition (P < .0001), susceptibility to hunger (P < .0001), intuitive eating (P < .0001), obsessive–compulsive eating (P < .0001), body-esteem (P < .0001), depression (P = .0057), and self-esteem (P < .0001), where women in the HAES group showed greater improvements than women in the comparison group at short and/or long term. Conclusion: The evaluation of this HAES intervention in a real-life context showed its effectiveness in improving eating-, weight-, and psychological-related variables among women struggling with weight and body image.

Development and Validation of the Food Liking Questionnaire in a French-Canadian Population

The purpose of this study was to develop and validate a questionnaire assessing food liking in a French-Canadian population. A questionnaire was developed, in which participants were asked to rate their degree of liking of 50 food items. An expert panel evaluated the content validity. For the validation study, 150 men and women completed the questionnaire twice. An Exploratory Factor Analysis (EFA) was performed to assess the number of subscales of the questionnaire. Internal consistency and test-retest reliability of the subscales were evaluated. Concurrent validity was assessed through correlations between liking scores and self-reported frequencies of consumption. Comments from the experts led to changes in the list of foods included in the questionnaire. The EFA revealed a two-factor structure for the questionnaire (i.e., savory and sweet foods) and led to the removal of nine items, resulting in a 32-item questionnaire. The two subscales revealed good internal consistency (Cronbach alphas: 0.85 and 0.89) and test-retest reliability (p = 0.84 and 0.86). The questionnaire demonstrated adequate concurrent validity, with moderate correlations between food liking and self-reported frequency of consumption (r = 0.19–0.39, ps < 0.05). This new Food Liking Questionnaire assessing liking of a variety of savory and sweet foods demonstrated good psychometric properties in every validation step. This questionnaire will be useful to explore the role of food liking and its interactions with other factors in predicting eating behaviors and energy intake.