The Three-Factor Eating Questionnaire-R18 Is Able to Distinguish among Different Eating Patterns in a General Population. The Journal of Nutrition, (9), Stunkard, A. J., & Messick, S. (). The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. The Three-Factor Eating Questionnaire-R18 is able to distinguish among different eating patterns in a general population. The Journal of nutrition, (9), Cite. Is there a scoring system or norms for the Three Factor Eating Questionnaire (TFEQ-R18)? I am looking for scoring that will indicate severity (i.e., sub-clinical, mild, moderate, severe) of the.
Related videosBig Texas Bucks at Tajada Whitetails I Deer \u0026 Wildlife Stories
Mean height was BMI ranged between The majority, BMI of For the present study, we made one small change to one of the questionnaire items. In Finland, among adolescent and young adult females, steaks and meat are not considered the most desired or tempting foods. Rather, e. Thus, we modified item 1, "When I smell a sizzling steak or a juicy piece of meat , I find it very difficult to keep from eating, even if I have just finished a meal.
To keep the change as neutral as possible, the original, vivid description was replaced simply with a more general expression. As recommended by the designers of the TFEQ-R18, responses to all 18 items were coded on a four-point scale 1 — 4 , with higher values indicating more of the behaviour.
The four-point response alternatives measured, e. Brief questions on schooling of the respondent and her parents were included in the questionnaire. Body weight of each subject was measured in underwear to the nearest 0. In every study centre, identical, calibrated scales were used. Standing height was measured to the nearest 0. Beginning in September , they received invitation letters to our study on eating behaviour and health habits, and questionnaires. Letters were mailed about two weeks prior to a scheduled, six-monthly HPV study visit of each subject.
During the visit the subjects returned the filled questionnaires, and their weights and heights were measured by study nurses. Separate informed consent for both the vaccination trial and the health promotion study was obtained from all subjects. The SPSS programme, version In the formula, S stands for raw score, L stands for lowest possible raw score, and R s stands for possible raw score range. In one-way ANOVAs, populations are assumed to be normally distributed and homoscedastic with independent observations.
In this study the normality assumption was not required because of large sample sizes based on the central limit theorem. The assumption of homoscedasticity was examined with Levene's test of equal variances and ANOVAs were carried out accordingly. Correlations between study variables were analysed using Pearson Correlation Coefficients. According to the principal component analysis with a Varimax rotation, the original factor structure of the TFEQ-R18 was replicated in our sample.
The factor analysis produced item communalities ranging from 0. Communalities of 15 of the 18 items were above 0. The analysis proposed a three component model, which explained A rotated component matrix revealed that each of the 18 items strongly loaded positively to one of the three factors. Using different factor analyses and using different rotations Promax, Oblimin produced similar factor structures and high item loadings, thus corroborating the results.
The original statement was about smelling "a sizzling steak or a juicy piece of meat"; but these are not typically considered delicate or tempting among young, Finnish females. Thus, six of the 18 items measured cognitive restraint, nine items measured uncontrolled eating, and three items measured emotional eating, among adolescent and young adult, Finnish females.
Cronbach's alphas of these three scales were high: 0. The connection between emotional eating and classified BMI was straight-forward: mean score of emotional eating was lowest in the underweight category, and highest in the overweight category, and pair-wise differences between the four BMI categories were all statistically significant. Also the level of cognitive restraint increased with increasing BMI. Pair-wise comparisons of restraint scores between the BMI categories reached statistical significance, except for the comparison between overweight and obesity.
The mean scores of uncontrolled eating did not differ significantly between the BMI categories. Cognitive Restraint, Uncontrolled Eating and Emotional Eating each get scores from 0 to , with higher values indicating more of the behaviour. In the present study, factor structure and construct validity of a brief measure of eating behaviour, the Three Factor Eating Questionnaire Revised TFEQ-R18 [ 6 ], was examined in a population-based sample of Finnish adolescent and young adult females [ 16 ].
Originally, based on psychometric analyses using data from Swedish obese men and women, Karlsson and colleagues shortened and revised the item-Three Factor Eating Questionnaire [ 3 ], into a version with 18 items [ 6 ]. Our analyses of TFEQ-R18 -data from the 2 young Finnish females with varying body weights produced a factor structure that corresponded to the one found by Karlsson et al [ 6 ]: six items loaded high on the factor "Cognitive Restraint", nine items loaded high on "Uncontrolled Eating", and three items loaded high on "Emotional eating".
Our findings corroborate earlier results suggesting that the TFEQ-R18 is a valid measure of eating behaviour not only in the obese but also in the general population. The French study reported very similar internal consistency reliability coefficients Cronbach's alphas for the three scales to the ones reported by the designers of the TFEQ-R18 [ 6 ]. Connections between eating behaviour and body weight have been extensively studied, especially in the field of obesity research.
However, to the best of our knowledge, there are but two earlier studies that explored this connection in samples with varying weights, and in which TFEQ-R18 was used as a measure of eating behaviour. De Lauzon-Guillain and colleagues analysed TFEQ-R18 responses and several measures of adiposity in a sample of French adults and adolescents, over a two-year period [ 18 ].
In the latter report, the main focus was on cognitive restraint. We found that of the three factors of the TFEQ-R18 questionnaire, cognitive restraint and emotional eating were connected with body weight in girls and young women. Higher scores of cognitive restraint and higher scores of emotional eating were associated with a higher BMI. In the latter analysis, the correlation probably reached significance due to the large sample size. In the Swedish adolescents, uncontrolled eating had no connection with BMI, whereas in the adult women, there was a positive correlation between BMI and uncontrolled eating [ 7 ].
Our sample was on average slightly older than the girls, but clearly younger than the women of the Swedish study. Perhaps the connection between higher body weight and higher level of uncontrolled eating in females starts to appear with increasing age. These cross-sectional findings raise the question of whether it is the eating behaviour that predicts body weight, or vice versa.
Do the tendencies of cognitive restraint and emotional eating make people gain weight. Or does a higher body weight make people eat differently? The two-year-follow-up by de Lauzon-Guillain and colleagues [ 18 ] suggest that the latter might be true, at least in case of cognitive restraint.
In the French sample, initial scores of cognitive restraint were not connected with subsequent adiposity changes, neither in adults, nor in adolescents. However, in all age groups studied, higher values of initial adiposity — BMI, waist circumference, sum of skinfold thicknesses, and percentage body fat — predicted a larger increase in cognitive restraint score over the two-year period [ 18 ].
Thus, differences in adiposity level seem to precede differences in cognitive restraint. Since the present study was carried out among participants of a phase III human papillomavirus HPV vaccination trial, which aims at following the efficacy of a vaccine against the HPV virus and the later development of cervical carcinoma, representativeness of our sample is limited even if the invitation was population-based.
The subjects had volunteered to participate in the vaccination trial as well as in our study on eating behaviour. Thus, these young females are a selected group, likely to be more health conscious than their peers among the general population. On the other hand, an ongoing questionnaire study with 4 respondents found that the young women who participated in the HPV vaccination trial did not differ significantly from young women who did not participate, regarding certain measures of living conditions and quality of life e.
Therefore, all in all, the phase III HPV vaccination trial provided a unique opportunity for us to attain a large and representative sample of young females from different parts of Finland. For example, well-organised weight and height measurements of the nearly three thousand subjects by professional nurses — instead of having to settle with self-reported weight data — would hardly have been possible without the organisation of the HPV vaccination trial.
The question "When I smell a sizzling steak or a juicy piece of meat , I find it very difficult to keep from eating, even if I have just finished a meal. In the Finnish culture, steaks and meat are not necessarily considered the most desired foods — definitely not among girls and young women. Steaks are thus a poor example of a tempting food in this population, and the original item needed to be changed in order for it to produce valid responses.
The data we gathered using the TFEQ-R18 behaved in the analyses in a very similar manner when compared to earlier analyses of TFEQ-R18 data [ 6 , 8 , 18 ], suggesting that the instrument was valid despite the slight modification of one of the eighteen items. As the construct validity of the TFEQ-R18 appeared to be good in this sample of young Finnish females with a varying range of body weights, usability of the instrument as a measure of eating behaviour was corroborated.
Connections of the three factors of the questionnaire with body weight were in accordance with previous findings: higher levels of cognitive restraint and emotional eating were associated with higher BMI.
Our results suggest that the TFEQ-R18 is a psychometrically sound and valid measure of the tendencies of cognitive restraint, uncontrolled eating and emotional eating also in Finland, at least among adolescent and young adult females. All authors approved the submission of this paper. SA wrote the first draft of the manuscript and it was revised by all eight authors.
JE designed and conducted the statistical analyses. TE, as the coordinator of the human papillomavirus vaccination trial HPV , organized the recruitment of study participants and data collection of this study. ML, the principal investigator of the HPV trial, contributed to the design of the study, and critical drafting of the manuscript.
All authors have read and approved the final manuscript. National Center for Biotechnology Information , U. Published online Jul Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received Feb 24; Accepted Jul This article has been cited by other articles in PMC. Abstract Background The aim of the study was to examine the construct validity of the Three-Factor Eating Questionnaire -R18 TFEQ-R18 , a measure of eating behaviour, and to evaluate cognitive restraint, uncontrolled eating and emotional eating in a sample of adolescent and young adult females of different weights.
Methods Subjects were 2 females, aged 17 to 20 years, who participated in a phase III human papillomavirus vaccination trial in Finland in — Results The original factor structure of the TFEQ-R18 was replicated: six of the eighteen items measured cognitive restraint, nine measured uncontrolled eating, and three measured emotional eating. Background The psychology of eating behaviour — e. The strong associations among the variables indicated the functions of the elements, but the underlying genetic factors remain to be identified by gene-mapping experiments and the environmental factors by more detailed epidemiologic studies.
Close consideration of the relations among BMI, dieting behaviors, and the use and liking ratings of fatty foods showed that the relation between diet and obesity is partly modified by dieting behaviors—ie, dietary restraint and disinhibition of the control over eating. The results provide insight into the background mechanisms of obesity and suggest that, in dietary counseling, attention should be paid to the dieting behaviors as well as to strict control over food intake.
None of the authors had a personal or financial conflict of interest. Tuschl RJ. From dietary restraint to binge eating: some theoretical considerations. Appetite ; 14 : — 9.
Google Scholar. Allison DB , Heshka S. Emotion and eating in obesity? A critical analysis. Int J Eat Disord ; 13 : — Is restrained eating a risk factor for weight gain in a general population? Am J Clin Nutr ; 83 : — 8. Int J Eat Disord ; 5 : — Herman CP , Polivy J. Anxiety, restraint, and eating behavior.
J Abnorm Psychol ; 84 : 66 — Stunkard AJ , Messick S. The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res ; 29 : 71 — Three-factor eating questionnaire and the use and liking of sweet and fat among dieters. Physiol Behav ; 57 : 81 — Int J Obes ; 24 : — The Three-Factor Eating Questionnaire-R18 is able to distinguish among different eating patterns in a general population.
J Nutr ; : — Influence of heredity on dietary restraint, Disinhibition, and perceived hunger in humans. Nutrition ; 21 : — Are dietary restraint scales valid measures of acute dietary restriction?
Unobtrusive data suggest not. Psychol Assess ; 16 : 51 — 9. Dietary energy density and body weight: is there a relationship? Nutr Rev ; 62 : — Sugar and body weight regulation. Sex differences in heritability of BMI: a comparative study of results from twin studies in eight countries. Twin Res ; 6 : — Genetic and environmental contributions to food use patterns of young adult twins.
Physiol Behav ; 93 : — Am J Clin Nutr ; 70 : — A twin study of dietary restraint, disinhibition and hunger: an examination of the eating inventory three-factor eating questionnaire. Twin Res ; 6 : — 8. Am J Clin Nutr ; 81 : — 9. Taste preferences in human obesity: environmental and familial factors. Am J Clin Nutr ; 54 : — Twin Res Hum Genet ; 9 : — Genetic and environmental factors in health-related behaviors: studies on Finnish twins and twin families.
Twin Res ; 5 : — Validation of a telephone questionnaire in twins of known zygosity. Behav Genet ; 28 : — The inheritance of scholastic abilities in a sample of twins. Ascertainments of the sample and diagnosis of zygosity. Ann Hum Genet ; 39 : — 8. Diagnosis of twin zygosity by mailed questionnaire. Hum Hered ; 28 : — Mx: statistical modeling. Google Preview. Methodology for genetic studies of twins and families.
Sweet taste preferences are partly genetically determined: identification of a trait locus on chromosome Am J Clin Nutr ; 86 : 55 — Food and emotion. Behav Process ; 60 : — The psychosocial and behavioral characteristics related to energy misreporting.
Nutr Rev ; 64 : 53 — Sugars: hedonic aspects, neuroregulation, and energy balance. Comparison of affective rating scales and their relationship to variables reflecting food consumption. Food Qual Pref ; 19 : 51 — Same genetic components underlie different measures of sweet taste preference. Am J Clin Nutr ; 86 : — 9.
Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Sign In. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume The Three-Factor Eating Questionnaire, body mass index, and responses to sweet and salty fatty foods: a twin study of genetic and environmental associations Kaisu Keskitalo , Kaisu Keskitalo.
E-mail: kaisu. Oxford Academic. Hely Tuorila. Tim D Spector. Lynn F Cherkas. Antti Knaapila. Jaakko Kaprio. Karri Silventoinen. Markus Perola. Select Format Select format. Permissions Icon Permissions. Theoretical range.
Open in new tab. United Kingdom. Open in new tab Download slide. Sweet-and-fatty foods. Salty-and-fatty foods. Cognitive restraint. Uncontrolled eating. Emotional Eating. Correlated traits. Additive genetic correlation. Specific environmental correlation. Proportion of trait correlation explained. Google Scholar Crossref. Search ADS. Google Scholar PubMed. Issue Section:. Download all figures.
Supplementary data. Comments 0. Add comment Close comment form modal. I agree to the terms and conditions. You must accept the terms and conditions. Add comment Cancel. Submit a comment. Comment title. You have entered an invalid code. Submit Cancel. Thank you for submitting a comment on this article.
Your comment will be reviewed and published at the journal's discretion. Please check for further notifications by email. View Metrics. Email alerts Article activity alert. Advance article alerts. New issue alert. Receive exclusive offers and updates from Oxford Academic. More on this topic Associations between growth from birth to 18 years, intelligence, and schooling in a Brazilian cohort. Could vitamin D reduce obesity-associated inflammation?
Observational and Mendelian randomization study. Weight gain during pregnancy and the risk of severe maternal morbidity by prepregnancy BMI. Associations between human milk oligosaccharides and growth in infancy and early childhood.
Related articles in Google Scholar. Related articles in PubMed Type of menopause, age of menopause and variations in the risk of incident cardiovascular disease: pooled analysis of individual data from 10 international studies.
Spatio-temporal partitioning facilitates mesocarnivore sympatry in the Stara Planina Mountains, Bulgaria. Usefulness of bee bread and capped brood for the assessment of monocyclic aromatic hydrocarbon levels in the environment. Citing articles via Google Scholar. Contrasting effects of viscous and particulate fibers on colonic fermentation in vitro and in vivo, and their impact on intestinal water studied by MRI in a randomized trial.
Glycemic index, glycemic load, and risk of coronary heart disease: a pan-European cohort study. Cognitive restraint 2 — 4. Uncontrolled eating 2. Emotional eating 2 , 3. Liking 2 , 4. Use-frequency 4. Use-frequency 2 , 4. BMI 1.