To examine changes in eating competence (EC) in 12-month weight loss intervention.
Design:
Randomized, parallel-arm with weight loss phase (baseline to month 4) and weight-maintenance phase (months 4-12).
Setting:
Face-to-face in University classrooms, supervised and self-directed fitness sessions at University fitness center, and home.
Participants:
Premenopausal, mostly college-educated Pennsylvania women, body mass index >25 (n = 101).
Intervention:
Twenty-eight, 1-hour classes tailored for extremes of the Dietary Guidelines’ fat recommendations, based on social cognitive theory, problem-based learning delivery over 12 months. Exercise component included supervised and self-directed stretching, aerobics, and strength training.
General linear model repeated measures analysis of variance for outcome variables.
Results:
A total of 40% (n = 40) completed the ecSI. Overall, education and supervised exercise session attendance were 77% and 88%, respectively. Similar weight loss for lower and moderate fat groups (6.7 kg and 5.4 kg). The EC was unchanged baseline to month 4 but increased significantly from months 4 to 12, baseline to month 12 for both groups. The EC change baseline to month 12 was inversely associated with weight change from baseline to months 4 and 12.
Conclusion:
Weight management interventions, likely to introduce concerns with eating attitudes, behaviors, and foods, can reduce EC. Short-term measurement of EC change captures these consequent adjustments without opportunity to regain self-efficacy. Extending the measurement interval better reflects intervention impact on EC.
LohseBArnoldKWamboldtP. Evaluation of About Being Active, an online lesson about physical activity shows that perception of being physically active is higher in eating competent low-income women. BMC Womens Health. 2013;13:12. doi:10.1186/1472-6874-13-12.
2.
SatterE. Eating competence. Definition and evidence for the Satter eating competence model. J Nutr Educ Behav. 2007;39(suppl 5):S142–S153.
3.
LohseBSatterEHoracekTGebreselassieTOaklandMJ. Measuring eating competence: psychometric properties and validity of the ecSatter inventory. J Nutr Educ Behav. 2007;39(5):S154–S166.
4.
LohseBBaileyRKrallJWallDMitchellDC. Diet quality is related to eating competence in cross-sectional sample of low-income females surveyed in Pennsylvania. Appetite. 2012;58(2):645–650.
5.
Tilles-TirkkonenTNuutinenOSuominenSLiukkonenJPoutanenKKarhunenL. Preliminary Finnish measures of eating competence suggest association with health-promoting eating patterns and related psychobehavioral factors in 10-17 year old adolescents. Nutrients. 2015;7(5):3828–3846.
6.
LohseBPsotaTEstruchR; PREDIMED Study Investigators. Eating competence of elderly Spanish adults is associated with a healthy diet and a favorable cardiovascular disease risk profile. J Nutr. 2010;140(7):1322–1327.
7.
PsotaTLLohseBWestSG. Associations between eating competence and cardiovascular disease biomarkers. J Nutr Educ Behav. 2007;39(suppl 5):S171–S178.
8.
KrallJSLohseB. Validation of a measure of the Satter eating competence model with low-income females. Int J Behav Nutr Phys Act. 2011;8:26.
9.
BrownLBLarsenKJNylandNKEggettDL. Eating competence of college students in an introductory nutrition course. J Nutr Educ Behav. 2013;45(3):269–73.
10.
GreeneGWSchembreSMWhiteAA. Identifying clusters of college students at elevated health risk based on eating and exercise behaviors and psychosocial determinants of body weight. J Amer Diet Assoc. 2011;111(3):394–400.
11.
CliffordDKeelerLAGrayKSteingrubeAMorrisMN. Weight attitudes predict eating competence among college students. Fam Con Sciences Res J. 2010;39(2):184–193.
12.
QuickVByrd-BredbennerCWhiteAA. Eat, sleep, work, play: associations of weight status and health-related behaviors among young adult college students. Am J Health Promot. 2014;29(2):e64–e72.
13.
QuickVShoffSLohseBWhiteAHoracekTGreeneG. Relationships of eating competence, sleep behaviors and quality, and overweight status among college students. Eat Behav. 2015;19:15–19.
14.
LohseBCunningham-SaboL. Eating competence of Hispanic parents is associated with attitudes and behaviors that may mediate fruit and vegetable-related behaviors of 4th grade youth. J Nutr. 2012;142(10):1904–1909. doi:10.3945/jn.112.164269.
15.
TylkaTLEneliIUVanDiestALumengJC. Which adaptive maternal eating behaviors predict child feeding practices? An examination with mothers of 2- to 5-year-old children. Eat Behav. 2013;14(1):57–63.
16.
SatterE. Eating competence. Nutrition education with the Satter eating competence model. J Nutr Educ Behav. 2007;39(5):S189–S194.
17.
StottsJLLohseB. Reliability of the ecSatter inventory as a tool to measure eating competence. J Nutr Educ Behav. 2007;39(5):S167–S170.
18.
LohseB. The Satter eating competence inventory for low-income persons is a valid measure of eating competence for persons of higher socioeconomic position. Appetite. 2015;87:223–228.
AndreouEPhilippouCPapandreouD. Effects of an intervention and maintenance weight loss diet with and without exercise on anthropometric indices in overweight and obese healthy women. Ann Nutr Metab. 2011;59(2-4):187–192.
21.
U.S. Department of Health and Human Services and U.S. Department of Agriculture. Dietary Guidelines for Americans, 2005. 6th ed. Washington, DC: Government Printing Office; 2005.
22.
HarrisJABenedictFG. A Biometric Study of Basal Metabolism in Man. Washington, DC: Carnegie Institute of Washington; 1919.
23.
BanduraA. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall; 1986.
24.
BarrowsHS. A taxonomy of problem-based learning methods. Med Educ. 1986;20(6):481–486.
25.
LohseBShaferKJ. Learner perception and performance in a problem-based clinical nutrition course. Topics Clin Nutr. 2007;22(2):94–107.
26.
BeckATSteerRABallRRanieriW. Comparison of Beck depression inventories-IA and -II in psychiatric outpatients. J Pers Assess. 1996;67(3):588–597.
27.
GarnerDMGarfinkelPE. The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychol Med. 1979;9(2):273–279.
28.
GormollyJBlackSDastonSRardinD. The assessment of binge eating severity among obese persons. Addict Behav. 1982;7(1):47–55.
29.
ThomasSReadingJShephardRJ. Revision of the Physical Activity Readiness Questionnaire (PAR-Q). Can J Sport Sci. 1992;17(4):338–345.
30.
U.S. Department of Health & Human Services. NHANES III Anthropometric Procedures Video. Stock Number 017-022-01335-5. Washington, DC: U.S. Government Printing Office; 1996.
31.
U.S. Department of Health and Human Services and National Institutes of Health and National Heart, Lung, and Blood Institute. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, Treatment of High Blood Pressure. Bethesda, MD: National Institutes of Health; 2004.
32.
WarnickGRAlbersJJ. A comprehensive evaluation of the heparin-manganese precipitation procedure for estimating high density lipoprotein cholesterol. J Lipid Res. 1978;19(1):65–76.
33.
FriedewaldWTLevyRIFredricksonDS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18(6):499–502.
34.
JonnalagaddaSSMitchellDCSmiciklas-WrightH. Accuracy of energy intake data estimated by a multiple-pass, 24-hour dietary recall technique. J Am Diet Assoc. 2000;100(3):303–308.
35.
SacksFMBrayGACareyVJ. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med. 2009;360(9):859–873.
36.
WaddenTABerkowitzRISarwerDBPrus-WisniewskiRSteinbergC. Benefits of lifestyle modification in the pharmacologic treatment of obesity: a randomized trial. Arch Intern Med. 2001;161(2):218–227.
37.
GuentherPMReedyJKrebs-SmithSMReeveBBBasiotisPP. Development and Evaluation of the Health Eating Index-2005. Technical Report. Washington, DC: Center for Nutrition Policy and Promotion, U.S. Department of Agriculture; 2007.
38.
KarlssonJPerssonLOSjostromLSullivanM. Psychometric properties and factor structure of the Three-Factor Eating Questionnaire (TFEQ) in obese men and women. Results from the Swedish Obese Subjects (SOS) study. Int J Obes Relat Metab Disord. 2000;24(12):1715–1725.
39.
PatrickDLDanisMSoutherlandLIHongG. Quality of life following intensive care. J Gen Intern Med. 1988;3(3):218–223.
40.
NorburnJPatrickDLBeresfordSASteinJ. Functional status and perceived quality of life among older persons. In: Proceedings of the 21st Public Health Conference on Records and Statistics. Washington, DC: National Center for Health Statistics; July 13–15, 1987.
41.
PatrickDLKinneSEngelbergRAPearlmanRA. Functional status and perceived quality of life in adults with and without chronic conditions. J Clin Epidemiol. 2000;53(8):779–785.
42.
CliffordDOzierABundrosJMooreJKreiserAMorrisMN. Impact of non-diet approaches on attitudes, behaviors, and health outcomes: a systematic review. J Nutr Educ Behav. 2015;47(2):143–155.
43.
GreeneGWWhiteAAHoerrSL. Impact of an on-line healthful eating and physical activity program for college students. Am J Health Promot. 2012;27(2):e47–58.
44.
Lohse KnousBShafferKMcCabeA. Examining eating competence change in a general nutrition course reveals gender and food preparation issues. Soc Nutr Educ Ann Conf Proc. 2003;36(1):43.
45.
LohseBBelueRSmithSWamboldtPMCunningham-SaboL. About Eating: An online program with evidence of increased food resource management skills for low-income women. J Nutr Educ Behav. 2015;47(3):265–272.
46.
US Department of Agriculture, Food and Nutrition Services, Office of Research and Analysis. SNAP Education and Evaluation. Case Study Report: Pennsylvania State University’s About Eating Program Volume 1. 2012. Alexandria, VA: USDA, FNS, ORA. www.fns.usda.gov/sites/default/files/SNAP-EdWave1AboutEating_VolI_0.pdf. Accessed January 30, 2017.
47.
WangJYeLZhengYBurkeLE. Impact of perceived barriers to healthy eating on diet and weight in a 24-month behavioral weight loss trial. J Nutr Educ Behav. 2015;47(5):432–436.
48.
WingoBCDesmondRABrantleyP. Self-efficacy as a predictor of weight change and behavior change in the PREMIER trial. J Nutr Educ Behav. 2013;45(4):314–321.
49.
DiBonaventuraMDChapmanGB. The effect of barrier underestimation on weight management and exercise change. Psychol Health Med. 2008;13(1):111–122.
50.
MoyersTBRollnickS. A motivational interviewing perspective on resistance in psychotherapy. J Clin Psychol/In Session. 2002;58(2):185–193.
51.
GriffithsFBorkanJByrneD. Developing evidence for how to tailor medical interventions for the individual patient. Qual Health Res. 2010;20(12):1629–1641.
