Main Article Content
Intuitive eating, diet quality, body mass index, abnormal eating behaviour
Intuitive eating is an eating style that promotes a healthy attitude towards food and body image. Intuitive eaters would have more nutritious dietary intake and more positive eating patterns than non-intuitive eaters. The aim of the present study was to examine the association between intuitive eating, body mass index (BMI), abnormal eating behaviour and quality of dietary intake among young women in Turkey. A cross-sectional study was conducted in Istanbul on a total of 548 women aged 19 to 32 years who volunteered to participate in the study. Healthy Eating Index (HEI) score was 29.96±10.39, 58.77±6.83 and 84.59±3.89 points for healthy eating index category, respectively. In the “poor” eating category, body mass index values were significantly higher than the “needs improvement” and “good” categories (p<0.05). Also, total scores and subscale scoresof Intuitive Eating Scale-2 (IES-2) [except for Unconditional Permission to Eat (UPE)] were significantly higher than the “needs improvement” and “good” categories (p<0.05). The analyses showed significant correlation between the HEI score of participants and body mass index (r= -0.264;p<0.01), total score of IES-2 (r= 0.636;p<0.01), Eating Attitudes Test (EAT-26) (r= -0.186; p< 0.01). The total score of IES-2 was significantly inversely correlated with body mass index (r= -0.282;p < 0.01) and EAT-26 score (r= -0.297;p<0.01) in participants. In addition, the correlation analyses showed significant correlationbetween all the subscales of IES-2 and HEI scores (p<0.05). As a conclusion, our findings reveal that intuitive eating is positively related to diet quality, weight status and abnormal eating in young women; and that women who had more intuitive dietary choices respond to their physiological needs. Although our study is a cross-sectional analysis; the findings are in accordance with the idea that intuitive eating can offer a more holistic and long-term weight control approach compared to other traditional body weight management strategies.
2. de Castro J. M. Age related changes in natural spontaneous fluid ingestion and thirst in humans. J Gerontol 1992; 47: 321-330.
3. de Castro J. M. Age-related changes in spontaneous food intake and hunger in humans. Appetite 1993; 21: 255-272.
4. Canetti L., Bachar E., Berry E. M. Food andemotion. Behav Process 2002; 60(2): 157-164.
5. Van Dyke N., Drinkwater E. J. Relationships between intuitive eating and health indicators: literature review. Public Health Nutr 2014; 17(8): 1757-66.
6. Tribole E., Resch E. (1995a). Intuitive Eating: A Recovery Book for the Chronic Dieter: Rediscover the Pleasures of Eating and Rebuild Your Body Image. New York: St. Martin’s Press.
7. Tribole, E., Resch, E. (1995b). Intuitive Eating: A Revolutionary Program that Works. New York: St. Martin’s Press.
8. Tribole, E., Resch, E. (2003). Intuitive eating (2nd ed.). New York, N.Y.: St. Martin’s Press.
9. Tribole, E., Resch, E. (2012). Intuitive eating: A revoutionary program that works. 3rd edition. New York: St. Martin’s Press.
10. Tylka T. Development and psychometric evaluation of a measure of intuitive eating. J Couns Psychol 2006; 53: 226–240.
11. Tylka T. L., Kroon Van Diest A. M. The Intuitive Eating Scale-2: item refinement and psychometric evaluation with college women and men. J Couns Psychol 2013; 60: 137–153.
12. Gast J. A., Hawks S. R. Examining intuitive eating as a weight loss program. Healthy Weight Journal 2000; 14(3): 42-46.
13. Gast J., Hawks, S. R. Weight Loss Education: The Challenge of a New Paradigm. Health Educ Behav 1998; 25(4): 464-473.
14. Smith T., Hawks S. R. Intuitive eating, diet composition, and the meaning of food in healthy weight promotion. Am J Health Educ 2006; 37(3):130–136.
15. Bruce L. J., Ricciardelli L. A. A systematic review of the psychosocial correlates of intuitive eating among adult women. Appetite 2016; 96: 454-472.
16. Hawks S. R., Madanat H. N, Hawks J., Harris A. The relationship between intuitive eating and health indicators among college women. Am J Health Educ 2005; 36: 331-336.
17. Madden C. E., Leong S. L., Gray A., Horwath C. C. Eating in response to hunger and satiety signals is related to BMI in a nationwide sample of 1601 mid-age New Zealand women. Public Health Nutr 2012; 15: 2272–2279.
18. Hawley G., Horwath C., Gray A. et al. Sustainability of health and lifestyle improvements following a non-dieting randomised trial in overweight women. Prev Med 2008; 47: 593–599.
19. Cole R. E., Horacek T. Effectiveness of the ‘My Body Knows When’ intuitive-eating pilot program. Am J Health Behav 2010; 34: 286–297.
20. Leblanc V., Provencher V., Bégin C., Corneau L., Tremblay A., Lemieux S. Impact of a Health-At-Every-Size intervention on changes in dietary intakes and eating patterns in premenopausal overweight women: results of a randomized trial. Clin Nutr 2012; 31: 481–488.
21. Banks A. W. (2008). Nutritional analyses of intuitive eaters as compared to dieters. MA Thesis, Utah State University.
22. Hawks S. R., Madanat H. N., Smith T., De La Cruz N. A classroom approach for managing dietary restraint, negative eating styles and body image concerns among college women. J Am Coll Health 2008; 56(4): 359-66.
23. Bacon L., Stern J. S., Van Loan M. D., Keim N. L. Size acceptance and intuitive eating improve health for obese, female chronic dieters. J Am Diet Assoc 2005; 105: 929–936.
24. Willig A. L., Richardson B. S., Agne A., Cherrington A. Intuitive eating practices among African-American women living with type 2 diabetes: A qualitative study. J Acad Nutr Diet 2014; 114: 889–896.
25. Bas M., Karaca K. E., Saglam D. et al. Turkish version of the Intuitive Eating Scale-2: Validity and reliability among university students. Appetite 2017; 114: 391-397.
26. Tylka T. L., Wilcox J. A. Are intuitive eating and eatingdisorder symptomatology opposite poles of the same construct? J Couns Psychol 2006; 53: 474–485.
27. Augustus-Horvath C. L., Tylka T. L. The acceptance model of intuitive eating: a comparison of women in emerging adulthood, early adulthood, and middle adulthood. J Couns Psychol 2011; 58: 110–125.
28. Avalos L. C., Tylka T. L. Exploring a model of intuitive eating with college women. J Couns Psychol 2006; 53: 486–497.
29. Oh K. H., Wiseman M. C., Hendrickson J., Phillips J. C., Hayden E. W. Testing the acceptance model of intuitive eating with college women athletes. Psychology of Women Quarterly 2012; 36: 88–98.
30. Garner D. M., Garfinkel P. E. The EAT. An index of the symptoms of anorexia. Psychol Med 1979; 9:273-279.
31. Garner D. M., Olmsted M. P., Bohr Y., Garfinkel P. E. The eating attitudes test: Psychometric features and clinical correlates. Pscyhol Med 1982; 12: 871-878.
32. Pope Z., Gao Y., Bolter N., Pritchard M. Validity and reliability of eating disorder assessments used with athletes: A review. Journal of Sport and Health Science 2015; 4(3): 211-221.
33. Savaşır I., Erol N. Yeme Tutum Testi. Anoreksiya nevroza belirtileri indeksi. Psikoloji Dergisi 1989; 7: 19-25.
34. Bas M., Asci H., Karabudak E., Kiziltan G. Eating attitudes and their psychological correlates among Turkish adolescents. Adolescence 2004; 39(155): 593-599.
35. Salvador Castell G., Serra-Majem L., Ribas-Barba L. What and how much do we eat? 24-hour dietary recall method. Nutr Hosp 2015; 31(3): 46-48.
36. Guenther P. M., Casavale K. O., Reedy J. et al. Update of the Healthy Eating Index: HEI-2010. J Acad Nutr Diet 2013; 113: 569-580.
37. Guenther P. M., Kirkpatrick S. I., Reedy J. et al. The Healthy Eating Index-2010 is a valid and reliable measure of diet quality according to the 2010 Dietary Guidelines for Americans. J Nutr 2014; 144: 399-407.
38. Acar Tek N., Yildiran H., Akbulut G. et al. Evaluation of dietary quality of adolescents using Healthy Eating Index. Nutr Res Pract 2011; 5(4): 322–328.
39. World Health Organization (2000). Obesity: Preventing and managing the global endemic. WHO technical report, 894 Geneva.
40. Kadıoğlu M., Ergün A. Üniversite öğrencilerinin yeme tutumu, öz-etkililik ve etkileyen faktörler. Marmara Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 2015; 5(2): 96-104.
41. Şengül A. M., Hekimoğlu Ş. Vücut kitle indeksi ile yeme tutumu test puanları arasındaki ilişki. Göztepe Tıp Dergisi 2005; 20: 21-23.
42. Keskin Y., Lüleci N.E., Çelik Ş., Erşan N., Dikyol M., Durucu B. Maltepe Üniversitesi Tıp Fakültesi Öğrencilerinde Olası Yeme Bozukluğu Sıklığı. Maltepe Tıp Dergisi 2010; 2(2): 18-25.
43. Oğur S., Aksoy A., Selen H. Üniversite Öğrencilerinin Yeme Davranışı Bozukluğuna Yatkınlıkları: Bitlis Eren Üniversitesi Örneği. Bitlis Eren Üniversitesi Fen Bilimleri Dergisi 2016; 5(1): 14-26.
44. Kaya A.Y., Demirhan A., Demirhan B.İ. Obez Hastalarda Yeme Tutumu ile Vücut Kitle Endeksi Arasındaki İlişkinin Değerlendirilmesi. Avrasya Aile Hekimliği Dergisi 2016; 5(3): 117-120.
45. Coşkun B.A., Bilici S. (2017). Üniversite öğrencilerinde beslenme bilgi düzeylerinin beslenme durumu ile yeme tutum ve davranışlarına etkisinin değerlendirilmesi. Gazi Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara (unpublished master of science dissertation).
46. Yıldırım İ., Yıldırım Y., Ersöz Y., Işık Ö., Saraçlı S., Karagöz Ş. Egzersiz bağımlılığı, yeme tutum ve davranışları ilişkisi. CBÜ Beden Eğitimi ve Spor Bilimleri Dergisi 2017; 12(1): 43-54.
47. Yayan G., Karaca K. E. (2019). Sezgisel yeme davranışının vücut kompozisyonu ve bazı biyokimyasal parametreler üzerine etkisi. Acıbadem Mehmet Ali Aydınlar Üniversitesi, Sağlık Bilimleri Enstitüsü. 2019, İstanbul (unpublished master of science dissertation).
48. Camilleri G. M., Méjean C., Bellisle F. et al. Intuitive eating is inversely associated with body weight status in the general population-based NutriNet-Santé study. Obesity 2016; 24: 1154–1161.
49. Horwath C., Hagmann D., Hartmann C. Intuitive eating and food intake in men and women: Results from the Swiss food panel study. Appetite 2019; 135: 61–71.
50. Carbonneau E., Bégin C., Lemieux S. et al. A Health at Every Size intervention improves intuitive eating and diet quality in Canadian women. Clin Nutr 2017; 36(3): 747–754.
51. Plante A. S., Savard C., Lemieux S. et al. Trimester-Specific Intuitive Eating in Association With Gestational Weight Gain and Diet Quality. J Nutr Educ Behav 2019; 51(6): 677-683.
52. Camilleri G. M., Méjean C., Bellisle F. et al. Intuitive eating dimensions were differently associated with food intake in the general population-based Nutri- Net-Sante study. J Nutr 2017; 147: 61-69.
53. Dockendorff S. A., Petrie T. A., Greenleaf C. A., Martin S. Intuitive Eating Scale: An examination among early adolescents. J Couns Psychol 2012; 59: 604–611.
54. Denny K. N., Loth K., Eisenberg M. E., Neumark-Sztainer D. Intuitive eating in young adults. Who is doing it, and how is it related to disordered eating behaviors? Appetite 2013; 60: 13–19.
55. Warren J. M., Smith N., Ashwell M. A structured literature review on the role of mindfulness, mindful eating and intuitive eating in changing eating behaviours: effectiveness and associated potential mechanisms. Nutr Res Rev 2017; 30: 272-283.
56. Provencher V., Begin C., Tremblay A. et al. Health‐at‐every‐size and eating behaviors: 1‐year follow‐up results of a size acceptance intervention. J Am Diet Assoc 2009; 109: 1854‐1861.
57. Ciampolini M., Lovell‐Smith D., Sifone M. Sustained self‐regulation of energy intake. Loss of weight in overweight subjects. Maintenance of weight in normal‐weight subjects. Nutr Metab (Lond) 2010; 7:4.
58. van Dyck Z., Herbert B. M., Happ C., Kleveman G. V., Vögele C. German version of the intuitive eating scale: Psychometric evaluation and application to an eating disordered population. Appetite 2016; 105: 798–807.
59. Herbert B. M., Pollatos O. Attenuated interoceptive sensitivity in overweight and obese individuals. Eat Behav 2014; 15(3): 445-448.
60. Ruzanska U. A., Warschburger P. (2019). Intuitive eating mediates the relationship between self-regulation and BMI - results from a cross-sectional study in a community sample. Eat Behav 2019; 33: 23-29.
61. Reel J. J., Lee J. J., Bellows A. Integrating exercise and mindfulness for an emerging conceptual framework: The intuitive approach to prevention and health promotion (IAPHP). Eat Disord 2016; 24: 90–97.
62. Richards P. S., Crowton S., Berrett M. E., Smith M. H., Passmore K. Can patients with eating disorders learn to eat intuitively? A 2-year pilot study. Eat Disord 2017; 25: 99–113.
63. Mensinger J. L., Calogero R. M., Stranges S., Tylka T. L. A weight-neutral versus weight-loss approach for health promotion in women with high BMI: A randomized-controlled trial. Appetite 2016; 105: 364–374.
64. Linardon J., Mitchell S. Rigid dietary control, flexible dietary control, and intuitive eating: Evidence for their differential relationship to disordered eating and body image concerns. Eat Behav 2017; 26: 16-22.