Abstract
BACKGROUND: Having an instrument that allows for the precise assessment of eating behavior is a necessary requirement for developing research aimed at improving people's nutritional health. OBJECTIVE: This study aimed to examine the psychometric properties of the revised Three-Factor Eating Questionnaire (TFEQ-18) in a sample of Chilean adults. METHOD: Through an online survey, eating behavior, stress levels, anxiety and eating self-regulation were evaluated in 618 participants of both sexes. Analyzes of CFA, reliability, concurrent validity and analysis of invariance based on sex were carried out. RESULT: The three-dimensional structure of the scale was confirmed, composed of the Cognitive Restriction (CR), Eating Disinhibition (DA) and Emotional Eating (EE) factors. Invariance by sex was also confirmed. Satisfactory internal consistency coefficients were obtained for each of the scales. The DA and EE factors correlated positively with anxiety and stress levels, while RC was inversely associated with eating self-regulation. CONCLUSION: Our findings suggest that the TFEQ-18 is a psychometrically valid and reliable measure that can be used to assess eating behavior in the Chilean adult population.
References
Ahmad, F., Jhajj, A. K., Stewart, D. E., Burghardt, M. y Bierman, S. A. (2014). Single item measures of self-rated mental health: A scoping review. BMC Health Services Research, 14(1), 398. https://doi.org/10.1186/1472-6963-14-398
Ambresin, G., Chondros, P., Dowrick, C., Herrman, H. y Gunn, J. M. (2014). Self-rated health and long-term prognosis of depression. Annals of Family Medicine, 12(1), 57–65. https://doi.org/10.1370/afm.1562
Balani, R., Herrington, H., Bryant, E., Lucas, C. y Kim, S. C. (2019). Nutrition knowledge, attitudes, and self-regulation as predictors of overweight and obesity. Journal of the American Association of Nurse Practitioners, 31(9), 502–510. https://doi.org/10.1097/JXX.0000000000000169
Bedford, J. L. y Johnson, C. S. (2006). Societal influences on body image dissatisfaction in younger and older women. Journal of Women & Aging, 18(1), 41–55. https://doi.org/10.1300/J074v18n01_04
Brown, T. (2015). Confirmatory factor analysis for applied research (2a ed.). Guilford Press.
Bryant, E. J., King, N. A. y Blundell, J. E. (2008). Disinhibition: Its effects on appetite and weight regulation. Obesity Reviews, 9(5), 409–419. https://doi.org/10.1111/j.1467-789X.2007.00426.x
Brytek-Matera, A., Rogoza, R. y Czepczor-Bernat, K. (2017). The three-factor eating questionnaire-R18 polish version: Factor structure analysis among normal weight and obese adult women. Archives of Psychiatry and Psychotherapy, 3, 81–90. https://doi.org/10.22201/fpsi.20074719e.2021.1.376
Campos-Uscanga, Y., Lagunes, R., Morales-Romero, J. y Romo-González, T. (2015). Diseño y validación de una escala para valorar la autorregulación de hábitos alimentarios en estudiantes universitarios mexicanos. Archivos Latinoamericanos de Nutrición, 65(1), 44–50. https://tinyurl.com/4vum39s3
Cappelleri, J. C., Bushmakin, A. G., Gerber, R. A., Leidy N. K., Sextón, C. C., Lowe, S. y Karlsson, J. (2009). Psychometric analysis of the three-factor rating questionnaire-R21: Results from a large diverse sample of obese and non-obese participants. International Journal of Obesity, 33(5), 611–620. https://doi.org/10.1038/ijo.2009.74
Castañeda, F., Riestra, F. y Cerda, J. (2023). Barreras de acceso a tratamiento en trastornos de la conducta alimentaria: Una revisión de la literatura. Revista Médica de Chile, 151(12), 1613–1622. https://doi.org/10.4067/S0034-98872023001201613
Chen, F. F. (2007). Sensitivity of goodness of fit indexes to lack of measurement invariance. Structural Equation Modeling, 14(3), 464–504. https://doi.org/10.1080/10705510701301834
Cheung, G. W. y Rensvold, R. B. (2002). Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling, 9(2), 233–255. https://doi.org/10.1207/S15328007SEM0902_5
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2a ed.). Lawrence Erlbaum Associates.
Crescioni, A. W., Ehrlinger, J., Alquist, J. L., Conlon, K. E., Baumeister, R. F., Schatschneider, C. y Dutton, G. R. (2011). High trait self-control predicts positive health behaviors and success in weight loss. Journal of Health Psychology, 16(5), 750–759. https://doi.org/10.1177/1359105310390247
De Medeiros, A. C. Q., Yamamoto, M. E., Pedrosa, L. F. C. y Hutz, C. S. (2017). The brazilian version of the three-factor eating questionnaire-R21: Psychometric evaluation and scoring pattern. Eating and Weight Disorders, 22(1), 169–175. https://doi.org/10.1007/s40519-016-0256-x
DiStefano, C. y Morgan, G. B. (2014). A comparison of diagonal weighted least squares robust estimation techniques for ordinal data. Structural Equation Modeling, 21(3), 425–438. https://doi.org/10.1080/10705511.2014.915373
Ekström, S., Kull, I., Nilsson, S. y Bergström, A. (2015). Web-based self-reported height, weight, and body mass index among swedish adolescents: A validation study. Journal of Medical Internet Research, 17(3), e3947. https://doi.org/10.2196/jmir.3947
Elosua, P. O. (2003). Sobre la validez de los tests. Psicothema, 15(2), 315–3321. https://www.psicothema.com/pdf/1063.pdf
Ernst, B., Wilms, B., Thurnheer, M. y Schultes, B. (2015). Eating behaviour in treatment-seeking obese subjects – Influence of sex and BMI classes. Appetite, 95, 96–100. https://doi.org/10.1016/j.appet.2015.06.019
Field, A. (2018). Discovering statistics using IBM SPSS statistics (5a ed.). SAGE Publications.
Fornell, C. y Larcker, D. F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18(1), 39–50. https://doi.org/10.1177/002224378101800104
Galán, I., Gandarillas, A., Febrel, C. y Meseguer, C. M. (2001). Validación del peso y la talla autodeclarados en población adolescente. Gaceta Sanitaria, 15(6), 490–497. https://doi.org/10.1016/S0213-9111(01)71611-1
Gaete P., V. y López C., C. (2020). Trastornos de la conducta alimentaria en adolescentes. Una mirada integral. Revista Chilena de Pediatría, 91(5), 784–793. https://doi.org/10.32641/rchped.vi91i5.1534
Gibson-Smith, D., Bot, M., Brouwer, I. A., Visser, M., Giltay, E. J. y Penninx B. W. J. H. (2019). Association of food groups with depression and anxiety disorders. European Journal of Nutrition, 59(2), 767–778. https://doi.org/10.1007/s00394-019-01943-4
Haukoos, J. S. y Lewis, R. J. (2005). Advanced statistics: Bootstrapping confidence intervals for statistics with “difficult” distributions. Academic Emergency Medicine, 12(4), 360–365. https://doi.org/10.1197/j.aem.2004.11.018
Herman, C. P. y Mack, D. (1975). Restrained and unrestrained eating. Journal of Personality, 43(4), 647–660. https://doi.org/10.1111/j.1467-6494.1975.tb00727.x
Hernández, A., Hidalgo, M. D., Hambleton, R. K. y Gómez-Benito, J. (2020). International test commission guidelines for test adaptation: A criterion checklist. Psicothema, 32(3), 390–398. https://doi.org/10.7334/psicothema2019.306
Hu, L. y Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55. https://doi.org/10.1080/10705519909540118
Järvelä-Reijonen, E., Karhunen, L., Sairanen, E., Rantala, S., Laitinen, J., Puttonen, S., Peuhkuri, K., Hallikainen, M., Juvonen, K., Myllymäki, T., Föhr, T., Pihlajamäki, J., Korpela, R., Ermes, M., Lappalainen, R. y Kolehmainen, M. (2016). High perceived stress is associated with unfavorable eating behavior in overweight and obese finns of working age. Appetite, 103, 249–258. https://doi.org/10.1016/j.appet.2016.04.023
Jáuregui-Lobera, I., García-Cruz, P., Carbonero-Carreño, R., Magallares, A. y Ruiz-Prieto, I. (2014). Psychometric properties of spanish version of the three-factor eating questionnaire-R18 (Tfeq-Sp) and its relationship with some eating- and body image-related variables. Nutrients, 6(12), 5619–5635. https://doi.org/10.3390/nu6125619
Karlsson, J., Persson, L. O., Sjöström, L. y Sullivan, M. (2000). 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. International Journal of Obesity, 24(12), 1715–1725. https://doi.org/10.1038/sj.ijo.0801442
Kliemann, N., Vickerstaff, V., Croker, H., Johnson, F., Nazareth, I. y Beeken, R. J. (2017). The role of self-regulatory skills and automaticity on the effectiveness of a brief weight loss habit-based intervention: Secondary analysis of the 10 top tips randomised trial. International Journal of Behavioral Nutrition and Physical Activity, 14(1), 119. https://doi.org/10.1186/s12966-017-0578-8
Kliemann, N., Croker, H., Johnson, F. y Beeken, R. J. (2018). Starting university with high eating self-regulatory skills protects students against unhealthy dietary intake and substantial weight gain over 6 months. Eating Behaviors, 31, 105–112. https://doi.org/10.1016/j.eatbeh.2018.09.003
Kline, R. B. (2023). Principles and practice of structural equation modeling (5a ed.). Guilford Press.
Kooiman, T. J. M., Dijkstra, A., Kooy, A., Dotinga, A., van der Schans, C. P. y de Groot, M. (2020). The role of self-regulation in the effect of self-tracking of physical activity and weight on BMI. Journal of Technology in Behavioral Science, 5(2), 206–214. https://doi.org/10.1007/s41347-020-00127-w
Kolar, D. R. y Mebarak, M. (2022). An update on the epidemiology of eating disorders in Latin America: Current findings and future challenges. Current Opinion in Psychiatry, 35(6), 385–389. https://doi.org/10.1097/YCO.0000000000000813
Kyriazos, T. A. (2018). Applied psychometrics: Sample size and sample power considerations in factor analysis (EFA, CFA) and SEM in general. Psychology, 9(8), 2207–2230. https://doi.org/10.4236/psych.2018.98126
Leiva, M. J., Fuentealba, C., Boggiano, C., Gattás, V., Barrera, G., Leiva, L., Bunout, D., Hirsch, S. y de la Maza, M. P. (2009). Calidad de vida en pacientes operadas de bypass gástrico hace más de un año: Influencia del nivel socioeconómico. Revista Médica de Chile, 137(5), 625–633. https://doi.org/10.4067/S0034-98872009000500005
Levinson, D. y Kaplan, G. (2014). What does self rated mental health represent?. Journal of Public Health Research, 3(3), 122–127. https://doi.org/10.4081/jphr.2014.287
Lovibond, P. F. y Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343. https://doi.org/10.1016/0005-7967(94)00075-u
Martínez-Rodríguez, T. Y., Bernal-Gómez, S. J., Mora, A., Hun, N., Reyes-Castillo, Z., Valdés-Miramontes, E. H. y Espinoza-Gallardo, A. C. (2021). Patrones disfuncionales de la ingesta alimentaria por ansiedad durante el aislamiento por COVID-19 en Chile, Colombia y México. International Journal of Psychological Research, 14(1), 48–54. http://doi.org/10.21500/20112084.4721
Martins, B. G., da Silva, W. R., Maroco, J. y Campos, J. A. D. B. (2021). Psychometric characteristics of the three-factor eating questionnaire-18 and eating behavior in undergraduate students. Eating and Weight Disorders, 26(2), 525–536. https://doi.org/10.1007/s40519-020-00885-9
Natacci, L. y Ferreira, J. M. (2011). The three factor eating questionnaire - R21: Translation and administration to Brazilian women. Revista de Nutrição, 24(3), 383–394. https://doi.org/10.1590/S1415-52732011000300002
O’Connor, L., Brage, S., Griffin, S. J., Wareham, N. J. y Forouhi, N. G. (2015). The cross-sectional association between snacking behaviour and measures of adiposity: The Fenland Study, UK. British Journal of Nutrition, 114(8), 1286–1293. https://doi.org/10.1017/S000711451500269X
Oliver, N., Barber, X., Roomp, K. y Roomp, K. (2020). Assessing the impact of the COVID-19 pandemic in Spain: Large-scale, online, self-reported population survey. Journal of Medical Internet Research, 22(9), e21319. https://doi.org/10.2196/21319
Palomino-Pérez, A. M. (2020). Rol de la emoción en la conducta alimentaria. Revista Chilena de Nutrición, 47(2), 286–291. https://doi.org/10.4067/S0717-75182020000200286
Pérez-Fuentes, M. C., Molero Jurado, M. M., Gázquez Linares, J. J. y Oropesa Ruiz, N. F. (2019). Propiedades psicométricas del Three Factor Eating Questionnaire en personal sanitario. Nutrición Hospitalaria, 36(2), 434–440. https://doi.org/10.20960/nh.2189
Pino, A. C., Roco, V. A. y Valladares, V, M. (2021). Potencial efecto conjunto de los alelos SNP rs3749474T y SNP rs4864548A del gen Clock sobre el estado nutricional y cronotipo en jóvenes universitarios. Revista Salud Uninorte, 37(1), 11–20. https://doi.org/10.14482/sun.37.1.613.2
Provencher, V., Drapeau, V., Tremblay, A., Després, J. P. y Lemieux, S. (2003). Eating behaviors and indexes of body composition in men and women from the Québec family study. Obesity Research, 11(6), 783–792. https://doi.org/10.1038/oby.2003.109
Pruis, T. A. y Janowsky, J. S. (2010). Assessment of body image in younger and older women. The Journal of General Psychology, 137(3), 225–238. https://doi.org/10.1080/00221309.2010.484446
Rodriguez, A., Reise, S. P. y Haviland, M. G. (2016). Evaluating bifactor models: Calculating and interpreting statistical indices. Psychological Methods, 21(2), 137–150. https://doi.org/10.1037/met0000045
Román, M. F., Vinet, E. V. y Alarcón, M. A. M. (2014). Escalas de depresión, ansiedad y estrés (DASS-21): Adaptación y propiedades psicométricas en estudiantes secundarios de Temuco. Revista Argentina de Clínica Psicológica, 23(2), 179–190. https://www.redalyc.org/articulo.oa?id=281943265009
Skeie, G., Mode, N., Henningsen, M. y Borch, K. B. (2015). Validity of self-reported body mass index among middle-aged participants in the norwegian women and cancer study. Clinical Epidemiology, 7, 313–322. https://doi.org/10.2147/CLEP.S83839
Spangler, D. L. (2002). Testing the cognitive model of eating disorders: The role of dysfunctional beliefs about appearance. Behavior Therapy, 33(1), 87–105. https://doi.org/10.1016/S0005-7894(02)80007-7
Stunkard, A. J. y Messick, S. (1985). The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. Journal of Psychosomatic Research, 29(1), 71–83. https://doi.org/10.1016/0022-3999(85)90010-8
Tabachnick, B. G. y Fidell, L. S. (2018). Using multivariate statistics (7a ed.). Pearson Education.
Torres, S. J. y Nowson, C. A. (2007). Relationship between stress, eating behavior, and obesity. Nutrition, 23(11-12), 887–894. https://doi.org/10.1016/j.nut.2007.08.008
Valentini, F. y Damásio, B. F. (2016). Variância média extraída e confiabilidade composta: Indicadores de precisão. Psicologia: Teoria e Pesquisa, 32(2), 1–7. https://doi.org/10.1590/0102-3772e322225
Valladares, M. O., Weisstaub, A. M. G., Patiño, R., Ho-Urriola, A. J. y Santos, J. L. (2015). Asociación entre la conducta alimentaria y polimorfismos genéticos de la leptina y su receptor en niños obesos chilenos. Nutrición Hospitalaria, 31(3), 1044–1051. https://doi.org/10.3305/nh.2015.31.3.8049
Vega, J. A., Salazar, G., Hodgson, M. I., Cataldo, L. R., Valladares, M., Obregón, A. M. y Santos, J. L. (2016). Melanocortin-4 receptor gene variation is associated with eating behavior in chilean adults. Annals of Nutrition and Metabolism, 68(1), 35–41. https://doi.org/10.1159/000439092
West, S. G., Taylor, A. B. y Wu, W. (2012). Model fit and model selection in structural equation modeling. In R. H. Hoyle (Ed.), Handbook of structural equation modeling (pp. 209–231). Guilford Press.
Wrzecionkowska, D. y Rivera, A. S. (2021). Three-factor eating questionnaire-R18 (TFEQ-R18) spanish version: Factor structure analysis among normal weight and overweight adults. Acta de Investigación Psicológica, 11(1), 84–94. https://doi.org/10.22201/fpsi.20074719e.2021.1.376