Abstract
Background
Latinos are at high risk for cardiovascular disease (CVD). Identifying behavioral
factors associated with CVD risk in this population may provide novel targets for
further research to reduce chronic disease disparities. Dysfunctional eating patterns
(emotional eating [EE], uncontrolled eating [UE], and cognitive restraint of eating
[CR]) may be associated with CVD risk but little is known about this relationship
in Latinos.
Objective
The aim of this study was to examine associations between dysfunctional eating patterns
and metabolic risk factors for CVD in Latinos.
Design
The study used a cross-sectional design.
Participants/setting
Latino individuals (n=602), aged 21 to 84 years, were enrolled in the study from September
2011 to May 2013 from a community health center that serves 80% to 85% of the Latino
population in Lawrence, MA. Individuals with complete data were included in this analysis
(n=578).
Measures
Dysfunctional eating patterns were measured with the Three Factor Eating Questionnaire-R18V2.
CVD risk factors examined included obesity assessed by body mass index and waist circumference
and diagnoses of type 2 diabetes, hypertension, and hyperlipidemia abstracted from
electronic health records.
Statistical analysis
Multivariable logistic and Poisson regressions adjusting for age, sex, perceived income,
employment, education, physical activity, and perceived stress were performed. The
no dysfunctional eating category (ie, no EE, no UE, or no CR) was used as the reference
category in all analyses.
Results
High EE was associated with greater odds of obesity (odds ratio [OR] 2.19, 95% CI
1.38 to 3.45) and central obesity (OR 2.97, 95% CI 1.81 to 4.87), and diagnosis of
type 2 diabetes (OR 1.99, 95% CI 1.13 to 3.48) and hypertension (OR 2.01, 95% CI 1.16
to 3.48). High UE was associated with obesity (OR 1.96, 95% CI 1.20 to 3.21) and central
obesity (OR 2.33, 95% CI 1.38 to 3.94). Low and high CR were associated with obesity
(OR 2.26, 95% CI 1.43 to 3.56 and OR 2.77, 95% CI 1.75 to 4.37, respectively) and
central obesity (OR 2.04, 95% CI 1.25 to 3.32 and 2.51, 95% CI 1.54 to 4.08, respectively)
and diagnosis of type 2 diabetes (OR 1.83, 95% CI 1.05 to 3.16 and OR 2.73, 95% CI
1.58 to 4.70, respectively) and hyperlipidemia (OR 1.94, 95% CI 1.16 to 3.24 and OR
2.14, 95% CI 1.28 to 3.55, respectively). Lastly, high EE and low and high CR were
associated with increased odds of having a greater number of metabolic CVD risk factors
(incidence-rate ratio [IRR] 1.33, 95% CI 1.13 to 1.58; IRR 1.34, 95% CI 1.13 to 1.58;
and IRR 1.44, 95% CI 1.22 to 1.71, respectively).
Conclusions
Dysfunctional eating patterns were positively associated with metabolic CVD risk factors
in this Latino sample, with dose–response relationships for some associations. Future
studies are needed to determine whether dysfunctional eating patterns influence CVD
risk factors among Latinos.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Academy of Nutrition and DieteticsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Heart Disease and Stroke Statistics—2016 Update: A report from the American Heart Association.Circulation. 2016; 133: e38-e360
- Prevalence of major cardiovascular risk factors and cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the United States.JAMA. 2012; 398: 1775-1784
- Prediction of coronary heart disease using risk factor categories.Circulation. 1998; 97: 1837-1847
D’Vera C. Future immigration will change the face of America by 2065. Pew Research Center. http://www.pewresearch.org/fact-tank/2015/10/05/future-immigration-will-change-the-face-of-america-by-2065/. Published 2015. Accessed February 15, 2017.
- Avoiding the looming Latino/Hispanic cardiovascular health crisis: A call to action.J Cardiometab Syndr. 2007; 2: 238-243
- Reporting and representation of race/ethnicity in published randomized trials.Am Hear J. 2009; 185: 742-747
- Eating behaviour in the general population: An analysis of the factor structure of the German version of the Three Factor Eating Questionnaire and its association with bofy mass index.PLoS ONE. 2015; 10: e0133977
- Relationship of physical activity and eating behaviour with obesity and type 2 diabetes mellitus: Sofia Lifestyle (SLS) Study.Folia Med (Plovdiv). 2001; 53: 11-18
- Three factor eating questionnaire-R18 as a measure of cognitive restraint, uncontrolled eating and emotional eating in a sample of young Finnish females.Int J Behav Nutr Phys Act. 2009; 6: 41
- Psychometric properties of Spanish version of the Three Factor Eating Quationnaire-R18 (TFEQ-Sp) and its relationship with some eating- and body image-related variables.Nutrients. 2014; 6: 5619-5635
- Eating behavior and BMI in adolescent survivors of brain tumor and acute lymphoblastic leukemia.J Pediatr Oncol Nurs. 2014; 31: 41-50
- Psychometric analysis of the Three-Factor Eating Questionnaire-R21: Results from a large diverse sample of obese and non-obese participants.Int J Obes. 2009; 33: 611-620
- 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: 1715-1725
- A global measure of perceived stress.J Heal Soc Behav. 1983; 24 (385-296)
- Validation of the WHI brief physical activity questionnaire among women diagnosed with breast cancer.Am J Heal Behav. 2007; 31: 193-202
- The Three-Factor Eating Questionnaire-R18 is able to distinguish among different eating patterns in a general population.J Nutr. 2004; 134: 2372-2380
- The associations between emotional eating and consumption of energy-dense snack foods are modified by sex and depressive symptomatology.J Nutr. 2014; 144: 1264-1273
Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: The evidence report. 1998. https://www.ncbi.nlm.nih.gov/books/NBK2003/. Accesed May 24, 2017.
ICD-9. http://www.icd9data.com/. Accessed July 22, 2017.
- Identification of obesity and cardiovascular risk in ethnically and racially diverse populations: A scientific statement From the American Heart Association.Circulation. 2015; 132: 457-472
SPSS [computer program]. Version 20. Armonk, NY: IBM-SPSS Inc; 2011.
- Eating behaviors, mental health, and food intake are associated with obesity in older congregate meal participants.J Nutr Gerontol Geriatr. 2014; 33: 340-356
- Implication of corrticotropic hormone axis in eating behaviour pattern in obese and type 2 diabetic participants.Br J Nutr. 2015; 113: 1237-1243
- The eating inventory, body adiposity and prevalence of diseases in a quota sample of Czech adults.Int J Obes. 2006; 30: 830-836
- Dietary patterns, meat intake, and the risk of type 2 diabetes in women.Arch Intern Med. 2004; 164: 2235-2240
- Dietary patterns and risk for type 2 diabetes mellitus in U.S. men.Ann Intern Med. 2002; 136: 201-209
- Reducing population salt intake worldwide: From evidence to implementation.Prog Cardiovasc Dis. 2010; 52: 363-382
- Perceived stress, unhealthy eating behaviors, and severe obesity in low-income women.Nutr J. 2015; 14: 122
- Cognitive restraint can be offset by distraction, leading to increased intake in women.Am J Clin Nutr. 2001; 74: 197-200
- Situational obstacles to dietary adherence for adults with diabetes.J Am Diet Assoc. 1994; 94: 874-879
- The self-regulation of eating: Theoretical and practical problems.in: Vohs K. Maumeister R. Handbook of Self-Regulation: Research, Theory and Applications. 2nd ed. Guilford Press, New York, NY2011: 522
- Mindfulness-based interventions for obesity-related eating behaviors: A literature review.Obes Rev. 2014; 15: 453-461
- Prevalence of major cardiovascular risk factors and cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the United States.JAMA. 2012; 308: 1775-1784
- The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger.J Psychosom Res. 1985; 29: 71-83
- Investigating the structure of the eating inventory (three-factor eating questionnaire): A confirmatory approach.Int J Eat Disord. 2003; 2: 255-264
- Psychometric analysis of the Stunkard-Messick Eating Questionnaire (SMEQ) and comparison with the Dutch Eating Behaviour Questionnaire (DEBQ).Curr Psychol. 1989; 8: 228-233
- Genetic and environmental influences on eating behavior: The Swedish Young Male Twins Study.Am J Clin Nutr. 2005; 81: 564-569
- Cardiovascular disease risk factors in the Hispanic/Latino Population: Lessons From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).Prog Cardiovasc Dis. 2014; 57: 230-236
Biography
A. Lopez-Cepero is a research assistant, Clinical and Population Health Research Program, Department of Quantitative Health Sciences, and Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester.
Biography
C. F. Frisard is a biostatistician, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester.
Biography
S. C. Lemon is a professor of medicine, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester.
Biography
M. C. Rosal is a professor of medicine, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester.
Article info
Publication history
Published online: August 01, 2017
Accepted:
June 6,
2017
Received:
August 9,
2016
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This work was funded by grants from the National Institute of Mental Health (R01 MH085653), National Institute of Minority Health and Health Disparities (5 P60 MD006912), and Centers for Disease Control and Prevention (1 U48 DP005031).
Identification
Copyright
© 2018 by the Academy of Nutrition and Dietetics.
