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The ORTO-15 is a commonly used screening instrument for symptoms of Orthorexia Nervosa (ON), an obsessive overconcern with healthy eating. However, its limitations have been evidenced in several published factorial models. We analyzed the psychometric properties of seven different ORTO-15 factorial models using data from Brazilian adult participants (n = 1455; 71.4% women; M age = 29.5, SD = 8.9 years) from the country's five macro-regions who answered online questions for sample characterization and completed the Portuguese version of the ORTO-15 containing 15 items. We tested the fit of each model separately, analyzing data for men and women with separate confirmatory factor analysis, and using the Weighted Least Squares Mean and Variance Adjusted estimation method and goodness-of-fit indices. We also calculated the average variance extracted and the alpha ordinal and omega coefficients to analyze the convergent validity and reliability of the factors. None of the models tested presented adequate properties of validity and reliability. Although we found some acceptable reliability coefficients, they do not guarantee the validity of the data. Future investigators should be cautious when choosing the ORTO-15 for ON screening.

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Measures of beliefs and attitudes toward food have generally been limited to the measurement of more pathological eating attitudes (e.g., disordered eating). The Food Life Questionnaire (FLQ) and its short form (FLQ-SF) were developed to examine attitudes toward a broader range of foods; however, the factor structure of the FLQ-SF was not confirmed in any study with young women. In the present study, we performed a psychometric evaluation of the Brazilian Portuguese translation of the FLQ-SF in a sample of 604 women. We evaluated the factor structure using a two-step, split-sample exploratory and confirmatory factor analytic approach. Results supported a four-factor structure (i.e., weight concern, diet-health orientation, belief in a diet-health linkage, and food and pleasure) with 18 items (χ2/df = 2.09; CFI = 0.95; TLI = 0.94; RMSEA = 0.05 (90% CI = 0.04; 0.06; p > 0.05); and SRMR = 0.08). Additionally, we found good internal consistency for all FLQ-SF subscales (McDonald's ω = 0.79-0.89) and convergent validity with measures of feelings, beliefs, and behaviors involved in food attitudes. Collectively, these results support the use of the FLQ-SF in Brazilian women and provide a foundation to expand the literature on beliefs and attitudes toward food in this population.

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Prior studies on perceived healthiness of foods have often compared nutrient and hedonic claims, neglecting comparisons to a control condition. The effect of food claims focusing on the food processing level has received considerably less research attention, although food processing has been included in dietary guidelines in Brazil. Thus, the present study aimed to explore the effect of a control and processing claim, additionally to the effects of a nutrient. and hedonic claim, on perceptions related to a food item typically considered "less healthy" (chocolate cake). We further compared these effects between Brazil and Germany, a country where food processing is currently not included in dietary guidelines. A total of 634 lay adults were recruited in a cross-sectional online study and randomised to see the photo of a piece of cake with one of the four different claim conditions and to report their health-related perceptions of the cake. The main analyses included two-way ANCOVAs (4 claims x 2 countries) for each dependent variable controlled for gender, age and level of hunger; followed by post hoc tests. Overall, results revealed that in both countries, the claims highlighting nutrients or processing aspects rendered the perceptions of the cake healthier compared to the control claim. These effects were more pronounced among Brazilian than among German participants. Food-related perceptions mostly did not differ between the hedonic and control claim and did not differ at all between the nutrient and processing claims. In conclusion, it is noteworthy that, even for an inherently considered "less healthy food item" (chocolate cake) nutrient and processing claims increase healthiness perceptions. While our findings may imply that in both countries lay people are highly susceptible to nutrient claims, food processing aspects seem to be similarly relevant.

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This study investigated which foods are most saliently judged as healthy and unhealthy in Brazil and Germany and the reasons for these judgements. Dietary guidelines in the two countries differ in that those in Brazil are based on a food processing classification rather than nutrient profiling, whereas dietary guidelines in Germany do not include the processing level of food. In an online study with 355 lay adults (Brazil n = 205, Germany n = 150), we explored which foods are listed as healthy and unhealthy using a free-listing method. The main reasons for these healthiness judgements were then identified with a one or two-word phrase and compared between countries. Saliency analysis was conducted to identify the 15 most salient healthy and unhealthy foods in each country. Principles of content analysis were used to assess the reasons why these 15 items were listed as most salient by the participants. Results showed that both Brazilians and Germans listed mostly natural or minimally processed food (e.g. fruits, vegetables, grains, fish and milk) as healthy, whereas types of convenience and fast food, sweets and other ultra-processed foods (e.g. chocolate, soda, French fries, pizza and hamburger) were the most salient unhealthy items listed in both countries. Differences in culturally relevant items listed in each country are discussed. Further, in both countries, despite differences in their dietary guidelines, food healthiness judgements for the most salient items listed relied heavily on the nutritional content of food, reinforced the 'good/healthy' and 'bad/unhealthy' dichotomy, and were centred on benefits or harms to the body (e.g. prevention or cause of diseases and weight control). The similarity of food healthiness judgements between the two countries, together with their agreement with conventional health claims and dietary guidelines, suggest that lay Brazilian and German adults are knowledgeable about the general concepts of 'healthy' and 'unhealthy' food. Finally, these findings suggest that rather than just providing more nutritional information, policymakers and health professionals need to take into account the multiple psychosocial and environmental determinants of eating in these countries.

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Instruments to evaluate psychosocial determinants of fruit and vegetable (F&V) consumption among adolescents are scarce, and there appears to be only one instrument - unnamed and unvalidated - that investigates determinants derived from theories of social psychology targeting the frequency of F&V consumption among adolescents. The scope of this paper was to present the process of cultural adaptation and factor validation of this instrument al-lowing its use in studies with Brazilian adolescents. The cross-cultural adaptation process was accomplished and the final version - named Psychosocial Influence Scale for Fruit and Vegetable Consumption among Adolescents (PSI-FAVES) - was tested with 429 students (58% female) using McDonald's omega (ω) reliability and Confirmatory Factor Analysis (CFA) as analytical methods. The final version required refinement and the instrument showed adequate overall reliability (ω=0.86) and good fit of the data to the previously elaborated model (CFI=0.955; TLI=0.951 and RMSEA (90%CI) =0.043 (0.038-0.049)), being the first systematically validated instrument to investigate psychosocial determinants of F&V consumption among adolescents.

Instrumentos para avaliar determinantes psicossociais da ingestão de frutas, verduras e legumes (FLV) de adolescentes são escassos, e há um instrumento - sem nome e validação - que investiga estes determinantes oriundos de teorias da psicologia social e direcionado à frequência de ingestão semanal de FLV de adolescentes. O objetivo foi apresentar o processo de adaptação e validação fatorial deste instrumento para ser aplicado em estudos na população brasileira. Realizou-se equivalência conceitual e de itens; equivalência semântica por tradutores e especialistas e semântica e operacional por entrevistas dirigidas com público-alvo. A versão final - denominada Escala de Influências Psicossociais da ingestão de Frutas, Verduras e Legumes de Adolescentes (PSI-FAVES) - foi testada com 429 estudantes (58% mulheres) utilizando confiabilidade por ômega de McDonald (ω) e Análise Fatorial Confirmatória (AFC) como métodos analíticos. A versão final demandou refinamento e o instrumento apresentou confiabilidade total adequada (ω=0,86) e bom ajuste dos dados ao modelo previamente conjecturado (CFI=0,955; TLI=0,951 e RMSEA (90%IC)=0,043 (0,038-0,049), sendo o primeiro instrumento sistematicamente validado para investigar determinantes psicossociais da ingestão de FLV de adolescentes.

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Resumo Instrumentos para avaliar determinantes psicossociais da ingestão de frutas, verduras e legumes (FLV) de adolescentes são escassos, e há um instrumento - sem nome e validação - que investiga estes determinantes oriundos de teorias da psicologia social e direcionado à frequência de ingestão semanal de FLV de adolescentes. O objetivo foi apresentar o processo de adaptação e validação fatorial deste instrumento para ser aplicado em estudos na população brasileira. Realizou-se equivalência conceitual e de itens; equivalência semântica por tradutores e especialistas e semântica e operacional por entrevistas dirigidas com público-alvo. A versão final - denominada Escala de Influências Psicossociais da ingestão de Frutas, Verduras e Legumes de Adolescentes (PSI-FAVES) - foi testada com 429 estudantes (58% mulheres) utilizando confiabilidade por ômega de McDonald (ω) e Análise Fatorial Confirmatória (AFC) como métodos analíticos. A versão final demandou refinamento e o instrumento apresentou confiabilidade total adequada (ω=0,86) e bom ajuste dos dados ao modelo previamente conjecturado (CFI=0,955; TLI=0,951 e RMSEA (90%IC)=0,043 (0,038-0,049), sendo o primeiro instrumento sistematicamente validado para investigar determinantes psicossociais da ingestão de FLV de adolescentes.

Abstract Instruments to evaluate psychosocial determinants of fruit and vegetable (F&V) consumption among adolescents are scarce, and there appears to be only one instrument - unnamed and unvalidated - that investigates determinants derived from theories of social psychology targeting the frequency of F&V consumption among adolescents. The scope of this paper was to present the process of cultural adaptation and factor validation of this instrument al-lowing its use in studies with Brazilian adolescents. The cross-cultural adaptation process was accomplished and the final version - named Psychosocial Influence Scale for Fruit and Vegetable Consumption among Adolescents (PSI-FAVES) - was tested with 429 students (58% female) using McDonald's omega (ω) reliability and Confirmatory Factor Analysis (CFA) as analytical methods. The final version required refinement and the instrument showed adequate overall reliability (ω=0.86) and good fit of the data to the previously elaborated model (CFI=0.955; TLI=0.951 and RMSEA (90%CI) =0.043 (0.038-0.049)), being the first systematically validated instrument to investigate psychosocial determinants of F&V consumption among adolescents.

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OBJECTIVE: The aim of this study was the cross-cultural adaptation of the Eating Belief Questionnaire (EBQ)-an instrument that assesses positive, negative, and permissive eating beliefs in relation to binge eating episodes-in its shorted version of 18 questions, into Brazilian Portuguese, for female teenagers. METHODS: Conceptual, semantic, cultural and operational equivalence of the items were evaluated. The semantic and cultural equivalence involved 12 bilingual people and 12 experts in eating behavior. Operational equivalence consisted of applying the transcultural adapted version of the EBQ-18 to 20 girls with a mean age of 17.55 (SD=1.00) years. Item's clarity and understanding were assessed by the Content Validity Coefficient. RESULTS: Questions 5, 6, 11, 14, 15, 16, 17 and 18, with adequate classification percentage for all equivalences, were not altered. The other items were adapted according to the committee's suggestions and by consensus among researchers. The adapted version of the EBQ-18 in Brazilian Portuguese displayed good content validity coefficient for clarity (CVC=0.975) and comprehension (CVC=0.971); except for item 3, all items had values between 0.88 and 1.00. CONCLUSION: The Brazilian Portuguese version of the EBQ-18 had a good understanding by the adolescent public when it comes to investigate the role of dietary beliefs in the maintenance of binge eating episodes. Future studies with adolescents are recommended, jointly assessing risk for and presence of eating disorders in significant clinical and non-clinical samples, as well as its psychometrics properties.

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OBJECTIVES: This study aimed to evaluate the impact of a nutritional behavioral intervention on intuitive eating (IE) scores of overweight non-dialysis-dependent women with chronic kidney disease and to investigate the relationship of IE scores with demographic, nutritional, and quality of life parameters in this group. DESIGN AND METHODS: This is a prospective noncontrolled clinical trial of a behavioral multisession group intervention for dietary management. Each group comprised five to eight participants in 14 weekly or biweekly sessions lasting about 90 minutes each. The IE principles were discussed during the meetings. The IE scale 2, translated and adapted to the study population, with a four-factor model was applied to assess IE attitudes. The 36-Item Short-Form Health Survey questionnaire was applied to assess health-related quality of life. RESULTS: Of the 33 patients who began participation in the study, 23 patients (median [interquartile range]: age = 62.0 years [58.0-68.0]; 52.2% with diabetes; body mass index = 32.6 kg/m2 [30.2-39.3]; estimated glomerular filtration rate = 28.0 mL/min/1.73 m2 [22.0-31.0]) completed the intervention. Except for the IE subscale Body-Food Choice Congruence, the IE total score and all its subscales (Unconditional Permission to Eat, Eating for Physical Rather than Emotional Reasons, Reliance on Hunger and Satiety Cues, and Body-Food Choice Congruence) improved after the intervention. In a cross-sectional analysis, more intuitive eaters were older and had better scores for health-related quality of life. CONCLUSIONS: The nutritional behavioral intervention embracing IE principles was effective to improve IE attitudes for this group of chronic kidney disease patients. These results are promising and may contribute to a paradigm change in the strategies to enhance motivation and adherence to dietary recommendations in this population.

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ABSTRACT Objective: The aim of this study was the cross-cultural adaptation of the Eating Belief Questionnaire (EBQ)—an instrument that assesses positive, negative, and permissive eating beliefs in relation to binge eating episodes—in its shorted version of 18 questions, into Brazilian Portuguese, for female teenagers. Methods: Conceptual, semantic, cultural and operational equivalence of the items were evaluated. The semantic and cultural equivalence involved 12 bilingual people and 12 experts in eating behavior. Operational equivalence consisted of applying the transcultural adapted version of the EBQ-18 to 20 girls with a mean age of 17.55 (SD=1.00) years. Item's clarity and understanding were assessed by the Content Validity Coefficient. Results: Questions 5, 6, 11, 14, 15, 16, 17 and 18, with adequate classification percentage for all equivalences, were not altered. The other items were adapted according to the committee's suggestions and by consensus among researchers. The adapted version of the EBQ-18 in Brazilian Portuguese displayed good content validity coefficient for clarity (CVC=0.975) and comprehension (CVC=0.971); except for item 3, all items had values between 0.88 and 1.00. Conclusion: The Brazilian Portuguese version of the EBQ-18 had a good understanding by the adolescent public when it comes to investigate the role of dietary beliefs in the maintenance of binge eating episodes. Future studies with adolescents are recommended, jointly assessing risk for and presence of eating disorders in significant clinical and non-clinical samples, as well as its psychometrics properties.

RESUMO Objetivo: Conduzir adaptação transcultural, para o português brasileiro, da versão reduzida de 18 questões do Eating Belief Questionnaire (EBQ) ao público de meninas adolescentes. O instrumento avalia crenças positivas, negativas e permissivas do comer com relação a episódios de compulsão. Métodos: Realizou-se avaliação das equivalências conceitual, semântica, cultural e operacional dos itens. A equivalência semântica e cultural envolveu 12 bilíngues e 12 especialistas em comportamento alimentar. A equivalência operacional consistiu na aplicação da versão transcultural adaptada do EBQ-18 em 20 meninas, com média de idade de 17,55 anos (DP=1,00). O grau de clareza e compreensão das questões foi avaliado pelo coeficiente de validade de conteúdo. Resultados: Na avaliação semântica e cultural, 8 itens tiveram classificação adequada para todas as equivalências e não sofreram alterações; 10 itens foram alterados de forma mínima, conforme sugestões dos especialistas e mediante consenso entre pesquisadoras; e apenas o item 3 sofreu adaptação após resultados da equivalência operacional. O modelo adaptado para o português apresentou bom coeficiente de validade de conteúdo para clareza (CVC=0,975) e compreensão (CVC=0,971); com exceção do item 3, todos os itens foram avaliados com valores entre 0,88 e 1,00. Conclusão: A versão em português do EBQ-18 apresentou-se com boa compreensão do público adolescente para investigação do papel de crenças alimentares na manutenção de episódios de compulsão. Recomendam-se trabalhos futuros avaliando conjuntamente risco e presença de transtornos alimentares em amostras significativas clínicas e não clínicas, bem como suas propriedades psicométricas.

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Obesity-related prejudice and discrimination may have a source in health professionals and students. The objective was to assess anti-fat attitudes among Brazilian nutrition undergraduates who reported demographic data, weight, height and responded the Antifat Attitudes Test (AFAT) and the Brazilian Silhouette Scales to assess body image satisfaction and perception. Total and subscales of AFAT scores were compared among categories using the Mann-Whitney U test. Associations of participants' characteristics with the AFAT were analyzed using multiple linear regression. Total AFAT score was positively associated with male sex (ß: .13; p < .001), age (ß: .06; p < .001), educational institution outside capital (ß: .03; p < .05), private institutions (ß: .08; p < .001); and negatively associated with income (ß: -.05; p = .006), participants who perceived themselves with increased BMI (ß: -.15; p < .001) and those at the third year of course (ß: -.05; p = .041). Subscales scores were positively associated with male sex and age; and negatively associated with those who perceived themselves heavier. They have anti-fat attitudes especially if they were man, older, from private institutions, are at the beginning of the course, and have lower household income - and less weight bias if they perceived with increased BMI.

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