Gamze YURTDAŞ DEPBOYLU

Eating behavior styles and factors associated with disordered eating behaviors in early adolescents: cross-sectional study

Aims: Disordered eating attitudes and behaviors have become a global concern among adolescents. Given that eating behaviors developed during adolescence will determine lifelong adolescent health outcomes, it is important to understand the factors associated with disordered eating behaviors in early adolescents. This study aimed to assess the eating behaviors styles of early adolescents and to determine the relationship between eating behaviors and sociodemographic, lifestyle factors, and dietary patterns. Methods: This cross-sectional was conducted on 700 middle school students aged 10-14 years old. Sociodemographics, dietary, and lifestyle data were collected using a questionnaire. Anthropometric measurements were performed. The Dutch Eating Behavior Questionnaire Children (DEBQ-C) was used to evaluate adolescents’ restrained, emotional, and external eating styles. Mediterranean Diet Quality Index (KIDMED) was used to assess adherence to the Mediterranean diet (AMD). Results: Girls had higher scores in all three eating styles compared to boys. Students with overweight/obese scored higher in restrained, but lower in external and emotional eating style compared to students with normal weight. Students with excessive energy, carbohydrate, and protein intake had higher external eating but lower restrained eating scores than those with low or normal intake. Being female, higher KIDMED score, less screen time, higher BMI z score, higher waist/hip ratio, and body dissatisfaction were positively associated with restrained eating behavior. Being female (β =0.085, p=0.024), screen time < 2 hours (β =-0.086, p =0.027), and BMI z score (β =-0.211, p =<0.001) were found to be significant predictors of external eating behaviors, while being female and older age were associated with emotional eating behaviors among early adolescents. Conclusion: There are differences in early adolescents eating behavior styles based on gender, nutritional status, body dissatisfaction, perceived health, screen time, physical activity status, AMD, and dietary intake.

Keywords:

Eating behaviors, body image dissatisfaction, dietary intake lifestyles,

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Chang YJ, Lin W, Wong Y. Survey on eating disorder-related thoughts, behaviors, and their relationship with food intake and nutritional status in female high school students in Taiwan. J Am Coll Nutr. 2011;30(1):39-48.
Demirdöğen EŞ, Algedik P, Demirpence D. Hollanda yeme davranışı anketinin Türkçe formunun 12-18 yaş arasındaki ergenlerde psikometrik özelliklerinin ve yeme davranışlarının yaş ve cinsiyete göre incelen-mesi. Klinik Psikiyatri Derg. 2021;24(4):547-557.
Yirga B, Assefa Gelaw Y, Derso T, Wassie MM. Disordered eating attitude and associated factors among high school adolescents aged 12-19 years in Addis Ababa, Ethiopia: a cross-sectional study. BMC Res Notes. 2016;9:1-7.
Feng T, Abebe DS. Eating behaviour disorders among adolescents in a middle school in Dongfanghong, China. J Eat Disord. 2017;5(1):1-9.
Daly AN, O’Sullivan EJ, Walton J, McNulty BA, Kearney JM. Eating behaviour styles in Irish teens: a cross-sectional study. Public Health Nutr. 2021;24(8):2144-2152.
Van Strien T, Frijters JE, Bergers GP, Defares PB. The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. Int J Eat Disord. 1986;5(2):295-315.
Thomas R, Siliquini R, Hillegers MH, Jansen PW. The association of adverse life events with children's emotional overeating and restrained eating in a population‐based cohort. Int J Eat Disord. 2020;53(10):1709-1718.
American Academy of Pediatrics. Council on communications and media. children, adolescents, and the media. Pediatrics. 2013;132:958-61.
Kaya ÇA, Temiz G. The Turkish version of the Mediterranean diet quality index (KIDMED). TJFMPC. 2021;15(2):341-347.
Saglam D, Aydemir M, Colak GA, Bas M. Validation of the dutch eating behaviour questionnaire children (DEBQ-C) version in Turkish preadolescence children. Nutr Res Pract. 2022;16(6):765-774.
Pekcan G. Beslenme durumunun saptanmasi. Diyet El Kitabi. 2008:67-141.
World Helath Organization. WHO AnthroPlus for personal computers Manual: Software for assessing growth of the world's children and adolescents. Erişim Adresi: [https://www.who.int/growthref/tools/en/]. Accessced: 6/07/2023.
Baysal A, Aksoy M, Besler H, et al. Diyet el kitabı. Ankara: Hatipoğlu Baskı. 2002:225-253.
Wrottesley SV, Bosire EN, Mukoma G. et al. Age and gender influence healthy eating and physical activity behaviours in South African adolescents and their caregivers: Transforming Adolescent Lives through Nutrition Initiative (TALENT). Public Health Nutr. 2021;24(16):5187-5206.
Ersöz Alan B, Akdemir D, Cetin FC, Karahan S. Mindful eating, body weight, and psychological well-being in adolescence. Child Obes. 2022;18(4):246-253.
Gümüş D, Sevim S, Kızıl M. Social media addiction and adolescents: relationship between social media and eating behaviors during pandemic. Addicta. 2023;10:59-66.
Snoek HM, Van Strien T, Janssens JM, Engels RC. Emotional, external, restrained eating and overweight in Dutch adolescents. Scand J Psychol. 2007;48(1):23-32.
Yang F, Qi L, Liu S, et al. Body dissatisfaction and disordered eating behaviors: the mediation role of smartphone addiction and depression. Nutrients. 2022; 14(6):1281.
Yong C, Liu H, Yang Q, et al. The relationship between restrained eating, body image, and dietary intake among university students in china: a cross-sectional study. Nutrients. 2021;13(3):990.
Yurtdaş-Depboylu G, Kaner G, Özçakal S. The association between social media addiction and orthorexia nervosa, eating attitudes, and body image among adolescents. Eat Weight Disord. 2022;27(8):3725-3735.
Sze KY, Lee EK, Chan RH, Kim JH. Prevalence of negative emotional eating and its associated psychosocial factors among urban Chinese undergraduates in Hong Kong: a cross-sectional study. BMC Public Health. 2021;21(1):1-10.
Saat NZM, Hanawi SA, Chew NHH, et al. The association of eating behaviour with physical activity and screen time among adolescents in the Klang Valley, Malaysia: a cross-sectional study. Healthcare. 2023;11(9):1260.
Bawaked RA, Gomez SF, Homs C, et al. Association of eating behaviors, lifestyle, and maternal education with adherence to the Mediterranean diet in Spanish children. Appetite. 2018;130:279-285.
Kendirkiran G, Batur B. The Relationship between eating behavior and job satisfaction of academic staff. Int J Car Sci. 2022;15(2):825-836.
Mougharbel F, Valois DD, Lamb M, et al. Mediating role of disordered eating in the relationship between screen time and BMI in adolescents: longitudinal findings from the Research on Eating and Adolescent Lifestyles (REAL) study. Public Health Nutr. 2020;23(18):3336-3345.
Van Strien T, Oosterveld P. The children's DEBQ for assessment of restrained, emotional, and external eating in 7‐to 12‐year‐old children. Int J Eat Disord. 2008;41(1):72-81.
Lowe MR, Kral TV. Stress-induced eating in restrained eaters may not be caused by stress or restraint. Appetite. 2006;46(1):16-21.
Ferreira-Pêgo C, Rodrigues J, Costa A, Sousa B. Eating behavior: The influence of age, nutrition knowledge, and Mediterranean diet. Nutr Health. 2020;26(4):303-309.
Benbaibeche H, Saidi H, Bounihi A, Koceir EA. Emotional and external eating styles associated with obesity. J Eat Disord. 2023;11(1):1-7.
Marb A, Libuda L, Standl M, et al. Obesogenic eating behaviour and dietary intake in German children and adolescents: results from the GINIplus and LISA birth cohort studies. Eur J Clin Nutr. 2022;76(10):1478-1485.
Mahmood L, Flores-Barrantes P, Moreno LA, Manios Y, Gonzalez-Gil EM. The influence of parental dietary behaviors and practices on children's eating habits. Nutrients. 2021 13(4):1138. d
Tiggemann M, Lowes J. Predictors of maternal control over children's eating behaviour. Appetite. 2002;39(1):1-7.
Bui C, Lin L-Y, Wu C-Y, Chiu Y-W, Chiou H-Y. Association between emotional eating and frequency of unhealthy food consumption among Taiwanese adolescents. Nutrients. 2021;13(8):2739.
Zahrah NI, Fanani M, Ardyanto TD. The relationship between emotional eating, meal skipping and unhealthy food consumption pattern in adolescent girls. The Indonesian Journal of Public Health. 2023;18(1):47-58.