Internal Cues Versus External Cues for Eating and Activity

NCT04025099 | Completed

• 1 other identifier: 1408101
• Study Type: interventional
• Target: 32
• Locations: 1 country
• Sites: 1

Brief Summary

The majority of female undergraduate students experience disordered eating and/or weight gain, increasing the risk for two serious public health problems, eating disorders and obesity. Traditional nutrition education about weight control delivered during college has not been effective and may even exacerbate these problems. Thus, the investigators propose that instead of focusing on external information as taught by nutrition education (e.g. 'calories in, calories out', quantification and cognitive processing of nutrition information), at-risk females be trained to become more attuned to their internal hunger and fullness signaling to set them on a trajectory for decreased chronic disease risk as they age.

Conditions

Eating Behavior; Body Image; Diet Habit; Dietary Habits

Keywords

intuitive eating; body positive yoga; weight management; cardiovascular fitness; interoceptive awareness; embodiment; internal cues; external cues

Outcome Measures

Primary Outcomes (20)

• Intuitive Eating

  Using the Intuitive Eating Scale-2 Measures tendency to follow physical hunger and fullness cues \*Total\*score range = 5-115 Higher scores indicate greater levels of intuitive eating or its dimensions

  Baseline - week 1

• Intuitive Eating

  Using the Intuitive Eating Scale-2 Measures tendency to follow physical hunger and fullness cues \*Total\*score range = 5-115 Higher scores indicate greater levels of intuitive eating or its dimensions

  Midpoint - week 5

• Intuitive Eating

  Using the Intuitive Eating Scale-2 Measures tendency to follow physical hunger and fullness cues \*Total\*score range = 5-115 Higher scores indicate greater levels of intuitive eating or its dimensions

  End of study - week 10

• Intuitive Eating

  Using the Intuitive Eating Scale-2 Measures tendency to follow physical hunger and fullness cues \*Total\*score range = 5-115 Higher scores indicate greater levels of intuitive eating or its dimensions

  Follow-up - 1 year post study completion

• Interoceptive Awareness

  Using the Multi-Dimensional Assessment of Interoceptive Awareness - 2 Measures the multiple levels of individual interoception \*Total\*score range = 0-185 Higher total scores and sub scale scores indicate higher levels of positive awareness

  Baseline - week 1

• Interoceptive Awareness

  Using the Multi-Dimensional Assessment of Interoceptive Awareness - 2 Measures the multiple levels of individual interoception \*Total\*score range = 0-185 Higher total scores and sub scale scores indicate higher levels of positive awareness

  Midpoint - week 5

• Interoceptive Awareness

  Using the Multi-Dimensional Assessment of Interoceptive Awareness - 2 Measures the multiple levels of individual interoception \*Total\*score range = 0-185 Higher total scores and sub scale scores indicate higher levels of positive awareness

  End of study - week 10

• Interoceptive Awareness

  Using the Multi-Dimensional Assessment of Interoceptive Awareness - 2 Measures the multiple levels of individual interoception \*Total\*score range = 0-185 Higher total scores and sub scale scores indicate higher levels of positive awareness

  Follow-up - 1 year post study completion

• Dietary Restraint

  Using the Three-Factor Eating Questionnaire-18 Measures dietary restraint Means are computed for three subscales and are transformed to a 0-100 scale score Higher scores indicate greater cognitive restraint, uncontrolled, emotional eating

  Baseline - week 1

• Dietary Restraint

  Using the Three-Factor Eating Questionnaire-18 Measures dietary restraint Means are computed for three subscales and are transformed to a 0-100 scale score Higher scores indicate greater cognitive restraint, uncontrolled, emotional eating

  Midpoint - week 5

• Dietary Restraint

  Using the Three-Factor Eating Questionnaire-18 Measures dietary restraint Means are computed for three subscales and are transformed to a 0-100 scale score Higher scores indicate greater cognitive restraint, uncontrolled, emotional eating

  End of study - week 10

• Dietary Restraint

  Using the Three-Factor Eating Questionnaire-18 Measures dietary restraint Means are computed for three subscales and are transformed to a 0-100 scale score Higher scores indicate greater cognitive restraint, uncontrolled, emotional eating

  Follow-up - 1 year post study completion

• Embodiment

  Using the Experience of Embodiment Scale - Body Connection and Comfort Subscale Measures one of the five dimensions of embodiment: body connection and comfort Subscale score range = 12-36 Higher sub scale scores indicate higher levels of embodiment in terms of connection and comfort to one's body

  Baseline - week 1

• Embodiment

  Using the Experience of Embodiment Scale - Body Connection and Comfort Subscale Measures one of the five dimensions of embodiment: body connection and comfort Subscale score range = 12-36 Higher sub scale scores indicate higher levels of embodiment in terms of connection and comfort to one's body

  Midpoint - week 5

• Embodiment

  Using the Experience of Embodiment Scale - Body Connection and Comfort Subscale Measures one of the five dimensions of embodiment: body connection and comfort Subscale score range = 12-36 Higher sub scale scores indicate higher levels of embodiment in terms of connection and comfort to one's body

  End of study - week 10

• Embodiment

  Using the Experience of Embodiment Scale - Body Connection and Comfort Subscale Measures one of the five dimensions of embodiment: body connection and comfort Subscale score range = 12-36 Higher sub scale scores indicate higher levels of embodiment in terms of connection and comfort to one's body

  Follow-up - 1 year post study completion

• Body Appreciation

  Using the Body Appreciation Scale - 2 Measures one's acceptance of, favorable opinions toward, and respect for their body Score answers are totaled and divided by 10 for an average score. \*total\* average scores can range from = 1-5 Higher scores indicate higher levels of body appreciation

  Baseline - week 1

• Body Appreciation

  Using the Body Appreciation Scale - 2 Measures one's acceptance of, favorable opinions toward, and respect for their body Score answers are totaled and divided by 10 for an average score. \*total\* average scores can range from = 1-5 Higher scores indicate higher levels of body appreciation

  Midpoint - week 5

• Body Appreciation

  Using the Body Appreciation Scale - 2 Measures one's acceptance of, favorable opinions toward, and respect for their body Score answers are totaled and divided by 10 for an average score. \*total\* average scores can range from = 1-5 Higher scores indicate higher levels of body appreciation

  End of study - week 10

• Body Appreciation

  Using the Body Appreciation Scale - 2 Measures one's acceptance of, favorable opinions toward, and respect for their body Score answers are totaled and divided by 10 for an average score. \*total\* average scores can range from = 1-5 Higher scores indicate higher levels of body appreciation

  Follow-up - 1 year post study completion

Secondary Outcomes (16)

• Fruit Consumption

  Baseline - week 1

• Fruit Consumption

  Midpoint - week 5

• Fruit Consumption

  End of study - week 10

• Fruit Consumption

  Follow-up - 1 year post study completion

• Vegetable Consumption

  Baseline - week 1

Study Arms (3)

Internal Cues

EXPERIMENTAL

Over 10 weeks, participants will be asked to participate in the following: 1. Classes (held in STAR Tower 419/420 IPE Space and Conference Room 413) * One \~60-minute Intuitive Eating class per week (total = 10 classes); * Two \~60-minute yoga classes per week (total = 20 classes); * Repeat one of the \~60-minute yoga classes each week on the participants' own, in a space participants feel comfortable, using a video recording (total = 10 classes). 2. Assessments (held in STAR tower) * Three \~60-minute assessments\* which will include: 1. Height \& weight measurements (taken privately) 2. A questionnaire that asks about participants' relationship with their body and eating and activity behaviors 3. Collection of participants' heart rate overnight (on their own) 4. Collection of participants' saliva three times in one day (on their own)

Other: Internal Cues

External Cues

ACTIVE COMPARATOR

Over the next 10 weeks, participants will be asked to participate in the following: 1. Classes (held in STAR Tower 419/420 IPE Space) * One \~60-minute Healthy Eating class per week (total = 10 classes); * Participants will be provided with a UD group fitness membership. Using this membership, participants will be asked to attend at least 2 cardio fitness classes per week and do an additional 30 minutes of heart-raising activity on participants' own (total = 3 exercise sessions/week). 2. Assessments (held in STAR tower) * Three \~60-minute assessments\* which will include: 1. Height \& weight measurements (taken privately) 2. A questionnaire that asks about participants' relationship with their body and eating and activity behaviors 3. Collection of participants' heart rate overnight (on their own) 4. Collection of participants' saliva three times in one day (on their own)

Other: External Cues

Assessment Only

NO INTERVENTION

Over the next 10 weeks, participants will be asked to participate in the following: a. Assessments (held in STAR tower) •Three \~60-minute assessments\* which will include: 1. Height \& weight measurements (taken privately) 2. A questionnaire that asks about participants' relationship with their body and eating and activity behaviors 3. Collection of participants' heart rate overnight (on their own) 4. Collection of participants' saliva three times in one day (on their own)

Interventions

Internal Cues OTHER

The intuitive eating curriculum that was pilot tested and adapted has been modified for use for the Internal Cues group with college-aged females for delivery over a 10-week time period. The classes will be delivered by two Registered Dietitians and Certified Intuitive Eating Counselors from the University of Delaware, Julia Katcher and Maryann Eastep. During the Internal Cues group's intuitive eating classes, participants will, as a group, eat dinner that is prepared by ServSafe certified undergraduate dietetics students in the test kitchen in the STAR Tower. This dinner will allow the participants to experientially learn the intuitive eating principles taught in class. The yoga classes will be adapted to all levels of experience, mobility, and body size. Specific breathing techniques and body positive language will be incorporated into a body-positive yoga training done by Ms. Lisa Jones, RYT.

Internal Cues

External Cues OTHER

The 10-week traditional healthy weight program for the External Cues group was created by a Graduate Assistant based on MyPlate principles. The External Cues classes will be delivered by two Registered Dietitians from the University of Delaware, Julia Katcher and Maryann Eastep. During the External Cues group's healthy eating classes, participants will, as a group, eat dinner that is prepared by ServSafe certified undergraduate dietetics students in the test kitchen in the STAR Tower. This dinner will allow the participants to experientially learn how to properly portion their meals to meet their caloric needs, in line with traditional education about weight control. Students randomized to the External Cues group will receive a UD fitness pass and will be able to choose from select cardio-based fitness classes in order to meet public health recommendations for physical activity.

External Cues

Eligibility Criteria

• Age: 18 Years - 26 Years
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Female
• Between the ages of 18 and 26
• Freshman, Sophomore, or Junior University of Delaware student
• Willing and able to commit to the 10-week study at the specified times and a follow up visit 1-year after the completion of the study
• Have concerns about body shape, weight, and/or eating
• Are not currently being treated for an eating disorder

You may not qualify if:

• They have a severe medical food allergy.
• They are pregnant - this program is not geared towards someone who is pregnant.

Sponsors & Collaborators

• University of Delaware: lead

Study Sites (1)

University of Delaware

Newark, Delaware, 19711, United States

Location

MeSH Terms

Conditions

Feeding Behavior

Condition Hierarchy (Ancestors)

Behavior, Animal; Behavior

Study Officials

• Carly Pacanowski, PhD

  University of Delaware

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: This three-armed randomized, controlled trial will assess the effects of a novel internal cues intervention (treatment group; intuitive eating and body positive yoga) compared to an active control group consisting of traditional healthy weight sessions, following standardized government recommendations for eating and activity, and a no-treatment control group completing assessments only.

Study Record Dates

• First Submitted: July 12, 2019
• First Posted: July 18, 2019
• Study Start: September 8, 2019
• Primary Completion: April 15, 2020
• Study Completion: April 15, 2020
• Last Updated: April 27, 2021

Record last verified: 2021-04

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)