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[Nutrition Research Review] Longitudinal associations between intuitive eating and weight-related behaviours in a population-based sample of young adults.

It is known that traditional weight loss interventions, other than bariatric surgery, have poor long-term success in terms of maintaining weight loss (National Health and Medical Research Council 2013). Weight loss diets can also be a risk factor for the development of disordered eating (Patton, Selzer et al. 1999) and lower psychosocial wellbeing (Berge, Christoph et al. 2019).

Attention has turned towards exploring whether non-dieting alternatives such as intuitive eating can attenuate weight gain and positively influence healthy eating behaviours.

Intuitive eating refers to the practice of eating in response to internal hunger and satiety cues (Tylka and Kroon Van Diest 2013) and is one strategy that can be used to support improved nutritional outcomes without focussing on weight reduction or energy restriction. There is some emerging evidence that this approach may improve physical health indicators (Dugmore, Winten et al. 2019) and improve psychological health markers (Linardon and Mitchell 2017).

This research explores how intuitive eating in young adulthood is related to weight, dieting, weight control behaviours and binge eating (with loss of control) five years later in a population-based survey of men and women (Christoph, Järvelä-Reijonen et al. 2021). Project EAT (Eating and Activity in Teens and Young Adults) is a US-based longitudinal study of young people’s intake, activity levels, weight control behaviours (healthy and unhealthy), weight status, and associated factors. The initial data collection took place in 1998-99 (EAT I) and in five-year intervals thereafter. The current data was drawn from the EAT III (2008-09) and EAT IV (2015-16) waves and 1660 participants, mean age 31.1 +/- 1.5 years (at EAT-IV), were included.

In the EAT-III survey, over half of the population surveyed reported eating intuitively (58% of women and 63% of men). At five year follow up (EAT-IV), intuitive eating was significantly related to lower prevalence of being in the higher weight status (as measured by BMI), engaging in fewer dieting behaviours, less engagement in unhealthy weight control behaviours and less binging with loss of control.

Taking a closer look at the negative relationship between intuitive eating and weight status found in the EAT-IV results, the authors found that the relationship was not independent of weight status in EAT-III. They suggest that this could be because intuitive eating patterns and weight trajectories may have inverse associations that have already been established by young adulthood.

It was found that intuitive eating predicted a lower engagement in unhealthy weight control behaviours for both males and females. When the data was adjusted for previous engagement in these behaviours, significance remained only for males, which could suggest that such behavioural patterns may already have been established amongst young female adults. It is noted that as females in this study already had a high baseline engagement in unhealthy weight control behaviours, that this potentially made it more difficult to detect increases in these behaviours.

Importantly, when exploring binge eating, it was identified that intuitive eaters were half as likely to be binge eating at five year follow up. For men, but not women, this finding was independent of binge eating in the previous study wave (EAT-III).

This study has many strengths including longitudinal design drawing on a large population-based cohort sample with adjustments made for a range of socioeconomic variables and outcomes of the previous study wave. It delivers insight into a population that has not been studied extensively in this research area, as many previous studies have drawn heavily on college students. Limitations include the inability to generalise results outside of the Western (US) sample from which results were derived and the brief assessment items that were used to assess intuitive eating in the EAT-III cohort. In addition, it is relevant to note that some of the loss to follow up across waves of this project was not random, however sample weights were used to address this issue.

Where to from here? There is still a lot to learn about intuitive eating and how it is developed and maintained in individuals, and how it interacts with an individual’s eating behaviours and health outcomes at different life stages. It is a promising area in nutrition intervention given its focus on improving health outcomes, regardless of body weight.

See the full article here.

Anna Millichamp, APD, Bond University

Learn more in the online Professional Diploma of Medical Nutrition Management.

References

Berge, J., et al. (2019). “Cumulative Encouragement to Diet From Adolescence to Adulthood: Longitudinal Associations With Health, Psychosocial Well-Being, and Romantic Relationships,.” Journal of Adolescent Health 65(5): 690-697.

Christoph, M., et al. (2021). “Longitudinal associations between intuitive eating and weight-related behaviors in a population-based sample of young adults.” Appetite 105093.

Dugmore, J. A., et al. (2019). “Effects of weight-neutral approaches compared with traditional weight-loss approaches on behavioral, physical, and psychological health outcomes: a systematic review and meta-analysis.” Nutrition Reviews 78(1): 39-55.

Linardon, J. and S. Mitchell (2017). “Rigid dietary control, flexible dietary control, and intuitive eating: Evidence for their differential relationship to disordered eating and body image concerns,.” Eating Behaviors 26: 16-22.

National Health and Medical Research Council (2013). Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. Melbourne, National Health and Medical Research Council.

Patton, G. C., et al. (1999). “Onset of adolescent eating disorders: population based cohort study over 3 years.” BMJ 318(7186): 765-768.

Tylka, T. L. and A. M. Kroon Van Diest (2013). “The Intuitive Eating Scale–2: Item refinement and psychometric evaluation with college women and men.” Journal of Counseling Psychology 60(1): 137-153.

Citation

Mary Christoph, Elina Järvelä-Reijonen, Laura Hooper, Nicole Larson, Susan M. Mason, Dianne Neumark-Sztainer. Longitudinal associations between intuitive eating and weight-related behaviors in a population-based sample of young adults. Appetite. Volume 160, 2021, 105093, ISSN 0195-6663, https://doi.org/10.1016/j.appet.2021.105093. (https://www.sciencedirect.com/science/article/pii/S0195666321000015)

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