Abstract
Objective
To objective of the present study was to investigate the initial evidence for construct validity of the Brazilian Mindful Eating Scale (MES-B), developed to assess mindfulness in the context of eating behavior.
Method
A total of 236 overweight or obese Brazilian women, aged between 18 and 59 years, answered the Mindful Eating Scale (MES) and questionnaires related to eating behavior, mindfulness, anxiety, depression, self-compassion, and eating disorders. Data were analyzed using confirmatory factor analysis. Models were adjusted according to modification indices, if theoretically and semantically appropriate, respecting a > 10 threshold. McDonald’s ω coefficients were estimated as a reliability measure. Measurement invariance was tested by Multiple Indicators, Multiple Causes (MIMIC) models.
Results
The number of MES items had to be reduced from 28 to 24 for better scale reliability, due to low factor loadings and high cross-loadings on more than 1 item. In this reduced scale, McDonald’s omega coefficients (ω) ranged from 0.47 to 0.83, with only 2 factors (acceptance and awareness) showing an ω greater than 0.70. Unhealthy eating habits, measured by the Dutch Eating Behavior Questionnaire (DEBQ) and Binge Eating Scale (BES), were negatively associated with mindful eating.
Conclusion
The Brazilian Mindful Eating Scale (MES-B), consisting of 24 items and six domains, was initially and successfully validated. This proposed version may be promising but should be evaluated in all genders and not only in the overweight female population.
Preregistration
ClinicalTrials.gov Identifier: NCT02893150 – MindEat.
Similar content being viewed by others
Data Availability
Data can be obtained from the first author upon an email request.
References
Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., Toney, L., Baer, R. A., Smith, G. T., Hopkins, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45. https://doi.org/10.1177/1073191105283504
Benton, D., & Young, H. A. (2017). Reducing calorie intake may not help you lose body weight. Perspectives on Psychological Science, 12(5), 703–714. https://doi.org/10.1177/1745691617690878
Bighetti, F. (2003). Tradução e validação do Eating Attitudes Test (EAT-26) em adolescentes do sexo feminino na cidade de Ribeirão Preto - SP [Universidade de São Paulo]. In USP Ribeirão Preto. https://pesquisa.bvsalud.org/portal/resource/pt/lil-433521. Accessed 30 Nov 2021.
Brasil. Ministério da Saúde. (2020). Situação alimentar e nutricional no Brasil : excesso de peso e obesidade da população adulta na Atenção Primária à Saúde. https://aps.saude.gov.br/biblioteca/visualizar/MjAwNA. Accessed 30 Nov 2021.
Brown, T. A. (2015). Confirmatory factor analysis for applied research (2nd ed.). Guilford Press.
Cardaciotto, L., Herbert, J. D., Forman, E. M., Moitra, E., & Farrow, V. (2008). The assessment of present-moment awareness and acceptance: The Philadelphia Mindfulness Scale. Assessment, 15(2), 204–223. https://doi.org/10.1177/1073191107311467
Carrière, K., Khoury, B., Günak, M. M., & Knäuper, B. (2017). Mindfulness-based interventions for weight loss: A systematic review and meta-analysis. Obesity Reviews, 19(2), 164–177. https://doi.org/10.1111/obr.12623
Coffey, K. A., & Hartman, M. (2008). Mechanisms of action in the inverse relationship between mindfulness and psychological distress. Complementary Health Practice Review, 13(2), 79–91. https://doi.org/10.1177/1533210108316307
Czepczor-Bernat, K., Brytek-Matera, A., Gramaglia, C., & Zeppegno, P. (2020). The moderating effects of mindful eating on the relationship between emotional functioning and eating styles in overweight and obese women. Eating and Weight Disorders, 25(4), 841–849. https://doi.org/10.1007/s40519-019-00740-6
Daubenmier, J., Kristeller, J., Hecht, F. M., Maninger, N., Kuwata, M., Jhaveri, K., Lustig, R. H., Kemeny, M., Karan, L., & Epel, E. (2011). Mindfulness intervention for stress eating to reduce cortisol and abdominal fat among overweight and obese women: An exploratory randomized controlled study. Journal of Obesity, 2011, 651936. https://doi.org/10.1155/2011/651936
de Barros, V. V., Kozasa, E. H., Cristina, I., Souza, W. D., & Ronzani, T. M. (2015). Validity evidence of the Brazilian version of the Mindful Attention Awareness Scale (MAAS). Psicologia Reflexão e Crítica, 28(1), 87–95. https://doi.org/10.1590/1678-7153.201528110
De Souza, L. K., & Hutz, C. S. (2016). Adaptation of the Self-Compassion Scale for use in Brazil: Evidences of construct validity. Temas Em Psicologia, 24(159687), 159–172. https://doi.org/10.9788/TP2016.1-11
de Souza, A. C., Alexandre, N. M. C., de Guirardello, E., & B. (2017). Propriedades psicométricas na avaliação de instrumentos: Avaliação da confiabilidade e da validade. Epidemiologia e Servicos De Saude : Revista Do Sistema Unico De Saude Do Brasil, 26(3), 649–659. https://doi.org/10.5123/S1679-49742017000300022
Dunn, C., Haubenreiser, M., Johnson, M., Nordby, K., Aggarwal, S., Myer, S., & Thomas, C. (2018). Mindfulness approaches and weight loss, weight maintenance, and weight regain. Current Obesity Reports, 7(1), 37–49. https://doi.org/10.1007/s13679-018-0299-6
Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191. https://doi.org/10.3758/BF03193146
Framson, K. A. R., Schenk, J., Littman, J. A., Zeliadt, S., & B. D. (2009). Development and validation of the Mindful Eating Questionnaire. Journal of the American Dietetic Association, 109(8), 1439–1444. https://doi.org/10.1016/j.jada.2009.05.006
Freitas, S., Lopes, C. S., Coutinho, W., & Appolinario, J. C. (2001). Tradução e adaptação para o português da Escala de Compulsão Alimentar Periódica Translation and adaptation into Portuguese of the Binge-Eating Scale. Revista Brasileira De Psiquiatria, 23(4), 215–220. https://doi.org/10.1590/S1516-44462001000400008
Fung, T. T., Long, M. W., Hung, P., & Cheung, L. W. Y. (2016). An expanded model for mindful eating for health promotion and sustainability: Issues and challenges for dietetics practice. Journal of the Academy of Nutrition and Dietetics, 116(7), 1081–1086. https://doi.org/10.1016/j.jand.2016.03.013
Gan, A., Loureiro, S. R., & Santos, J. (2001). Obesidade mórbida em mulheres - estilos alimentares e qualidade de vida. Archivos Latinoamericanos De Nutricion, 51(4), 359–365.
Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2014). Multivariate data analysis (7th ed.). Pearson Education.
Hong, P. Y., Lishner, D. A., Han, K. H., & Huss, E. A. (2011). The positive impact of mindful eating on expectations of food liking. Mindfulness, 2(2), 103–113. https://doi.org/10.1007/s12671-011-0048-3
Hulbert-Williams, L., Nicholls, W., Joy, J., & Hulbert-Williams, N. (2014). Initial validation of the mindful eating scale. Mindfulness, 5(6), 719–729. https://doi.org/10.1007/s12671-013-0227-5
Hunecke, M., & Richter, N. (2019). Mindfulness, construction of meaning, and sustainable food consumption. Mindfulness, 10(3), 446–458. https://doi.org/10.1007/s12671-018-0986-0
Jorgensen, T. D., Pornprasertmanit, S., Schoemann, A. M., Rosseel, Y., Miller, P., Quick, C., Garnier-Villarreal, M., Selig, J., Boulton, A., Preacher, K., Coffman, D., Rhemtulla, M., Robitzsch, A., Enders, C., Arslan, R., Clinton, B., Panko, P., Merkle, E., Chesnut, S., & Rönkkö, M. (2021). semTools: Useful tools for structural equation modeling (0.5-4) [Computer software]. https://CRAN.R-project.org/package=semTools
Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results [JOUR]. General Hospital Psychiatry, 4(1), 33–47.
Kabat-Zinn, J. (2013). Full catastrophe living, revised edition: How to cope with stress, pain and illness using mindfulness meditation. Hachette UK.
Kawasaki, Y., Akamatsu, R., Omori, M., Sugawara, M., Yamazaki, Y., Matsumoto, S., Fujiwara, Y., Iwakabe, S., & Kobayashi, T. (2020). Development and validation of the Expanded Mindful Eating Scale. International Journal of Health Care Quality Assurance, 33(4–5), 309–321. https://doi.org/10.1108/IJHCQA-01-2020-0009
Keyte, R., Egan, H., & Mantzios, M. (2020). How does mindful eating without non-judgement, mindfulness and self-compassion relate to motivations to eat palatable foods in a student population? Nutrition and Health, 26(1), 27–34. https://doi.org/10.1177/0260106019888367
Kreitchmann, R. S., Abad, F. J., Ponsoda, V., Nieto, M. D., Morillo, D., & Kyllonen, P. C. (2019). Controlling for response biases in self-report scales: Forced-choice vs. psychometric modeling of Likert items. Frontier in Psychology, 10, 2309. https://doi.org/10.3389/fpsyg.2019.02309
Kristeller, J. L., & Hallett, C. B. (1999). An exploratory study of a meditation-based intervention for binge eating disorder. Journal of Health Psychology, 4(3), 357–363. https://doi.org/10.1177/135910539900400305
Kristeller, J. L., & Wolever, R. Q. (2011). Mindfulness-based eating awareness training for treating binge eating disorder: The conceptual foundation. Eating Disorders, 19, 49–61. https://doi.org/10.1080/10640266.2011.533605
Lindsay, E. K., Young, S., Brown, K. W., Smyth, J. M., & David Creswell, J. (2019). Mindfulness training reduces loneliness and increases social contact in a randomized controlled trial. Proceedings of the National Academy of Sciences of the United States of America, 116(9), 3488–3493. https://doi.org/10.1073/pnas.1813588116
Ludwig, D. S., & Kabat-zinn, J. (2018). Mindfulness in medicine. JAMA, 300(11), 1350–1352. https://doi.org/10.1001/jama.300.11.1350
Malik, V. S., Willet, W. C., & Hu, F. B. (2020). Nearly a decade on — trends, risk factors and policy implications in global obesity. Nature Reviews Endocrinology, 16(11), 615–616. https://doi.org/10.1038/s41574-020-00411-y
Mantzios, M. (2020). (Re)defining mindful eating into mindful eating behaviour to advance scientific enquiry. Nutrition and Health, 27(4), 367–371. https://doi.org/10.1177/0260106020984091
Mantzios, M., & Egan, H. (2018). An exploratory examination of mindfulness, self-compassion, and mindful eating in relation to motivations to eat palatable foods and BMI. Health Psychology Report, 6(3), 207–215. https://doi.org/10.5114/hpr.2018.73052
Moher, D., Hopewell, S., Schulz, K. F., Montori, V., Gøtzsche, P. C., Devereaux, P. J., Elbourne, D., Egger, M., & Altman, D. G. (2012). CONSORT 2010 explanation and elaboration: Updated guidelines for reporting parallel group randomised trials. International Journal of Surgery, 10(1), 28–55. https://doi.org/10.1016/j.ijsu.2011.10.001
Moor, K. R., Scott, A. J., & McIntosh, W. D. (2013). Mindful eating and its relationship to body mass index and physical activity among university students. Mindfulness, 4(3), 269–274. https://doi.org/10.1007/s12671-012-0124-3
O’Reilly, G., Cook, L., Spruijt-Metz, D., & Black, D. S. (2014). Mindfulness-based interventions for obesity-related eating behaviours: A literature review. Obesity Reviews, 15(6), 453–461. https://doi.org/10.1111/obr.12156
Peitz, D., Schulze, J., & Warschburger, P. (2020). Getting a deeper understanding of mindfulness in the context of eating behavior: Development and validation of the Mindful Eating Inventory. Appetite, 159, 105039. https://doi.org/10.1016/j.appet.2020.105039
Rosseel, Y. (2012). lavaan: An R package for structural equation modeling. Journal of Statistical Software, 48(2), 1–36. https://doi.org/10.18637/jss.v048.i02
Sauer, S., Walach, H., Schmidt, S., Hinterberger, T., Lynch, S., Büssing, A., & Kohls, N. (2013). Assessment of mindfulness: Review on state of the art. Mindfulness, 4(1), 3–17. https://doi.org/10.1007/s12671-012-0122-5
Snaith, R. P., & Zigmond, A. S. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinivica, 67(6), 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
Sperber, A. D. (2004). Translation and validation of study instruments for cross-cultural research. Gastroenterology, 126(1), 124–128. https://doi.org/10.1053/j.gastro.2003.10.016
The Center for Mindful Eating. (2021). https://www.thecenterformindfuleating.org/. Accessed 30 Nov 2021.
Warren, J. M., Smith, N., & Ashwell, M. (2017). A structured literature review on the role of mindfulness, mindful eating and intuitive eating in changing eating behaviours: Effectiveness and associated potential mechanisms. Nutrition Research Reviews, 30(2), 272–283. https://doi.org/10.1017/S0954422417000154
Williams, L. H., Nicholls, W., Flynn, S., & Williams, N. H. (2015). Further development and validation of a novel measure of trait mindful eating - poster (p. 727). https://www.chester.ac.cuk/psychology/cruph/resources. Accessed 30 Nov 2021.
Winkens, L. H. H., Van Strien, T., Barrada, J. R., Brouwer, I. A., Penninx, B. W. J. H., & Visser, M. (2018a). The Mindful Eating Behavior Scale. Journal of the Academy of Nutrition and Dietetics, 118(7), 1277-1290.e4. https://doi.org/10.1016/j.jand.2018.01.015
Winkens, L. H. H., van Strien, T., Brouwer, I. A., Penninx, B. W. J. H., Visser, M., & Lähteenmäki, L. (2018b). Associations of mindful eating domains with depressive symptoms and depression in three European countries. Journal of Affective Disorders, 228, 26–32. https://doi.org/10.1016/j.jad.2017.11.069
Funding
This research was funded by a CAPES grant awarded to the first author.
Author information
Authors and Affiliations
Contributions
Vera Salvo: conceptualization, implementation, analyzing, writing, editing; Daniela Fernandez Curado and Adriana Sanudo: statistical analysis and wrote part of the results; Fabiane Aparecida Canaan Rezende: reviewed the introduction and discussion of the results; Marcelo Demarzo: conceptualization, supervision, reviewed the final version. All authors approved the final version for submission.
Corresponding author
Ethics declarations
Ethical Approval
All procedures performed in this study involving human participants followed the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The project was submitted and approved by the Research Ethics Committee of UNIFESP (CEP/UNIFESP) under protocol number CAE: 43093115.8.0000.5505.
Informed Consent
Informed consent was obtained from all study participants.
Conflict of Interest
The authors declare no competing interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Salvo, V., Curado, D.F., Sanudo, A. et al. Initial Validation of the Brazilian Mindful Eating Scale Among Overweight and Low-Income Women. Mindfulness 14, 1162–1170 (2023). https://doi.org/10.1007/s12671-023-02122-7
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12671-023-02122-7