Department of Nutrition, University of Tennessee, Knoxville, TN.
Department of Nutrition, University of Tennessee, Knoxville, TN.
J Acad Nutr Diet. 2021 Apr;121(4):709-727.e1. doi: 10.1016/j.jand.2020.10.019. Epub 2020 Dec 3.
Stimuli that promote eating in the absence of the physiological need for food are pervasive and can facilitate excessive energy intake. The practices of mindful eating (ME) and intuitive eating (IE) have been developed to minimize external drivers of energy intake by helping individuals emphasize the sensory properties of foods and internal indicators of hunger and fullness.
To enhance understanding about the effect of ME and IE interventions on dietary intake, this systematic review included randomized trials of ME and IE interventions that examined dietary intake, defined as energy intake or diet quality, in adults of varying weight status without a diagnosis of an eating disorder.
The selection of literature followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review process, in which PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and PsycINFO databases were searched for studies published between January 1980 and November 2019. Studies were included if they met the following criteria: randomized trial design in which 1 arm was an intervention with an ME or IE component and there was at least 1 control or active comparison arm; enrolled participants were of a healthy weight or with overweight or obesity and reported not having an eating disorder (ie, anorexia, bulimia nervosa, or binge eating disorder) or other health conditions in which dietary restrictions were applied; were at least 18 years of age; and outcomes of energy intake or diet quality were reported at baseline and post intervention. The modified Downs and Black checklist was used to assess risk of bias for each study that met inclusion criteria.
A total of 13 studies, including 8 investigating ME interventions and 5 investigating IE interventions, represented in 14 articles, were included in the review. Seven of the 9 articles reporting on energy intake did not find significant group differences. Eight of the 12 articles reporting on diet quality did not find significant group differences. The mean bias assessment score was 13.6 out of 28, indicating poor quality.
Little evidence suggests that ME and IE interventions influence energy intake or diet quality. To draw strong conclusions about the effect of ME and IE on dietary intake, future research using study designs of high rigor are needed.
促进在没有生理需求的情况下进食的刺激因素无处不在,并且可以促进过多的能量摄入。正念饮食(ME)和直觉饮食(IE)的实践旨在通过帮助个人强调食物的感官特性以及饥饿和饱腹感的内部指标,最大限度地减少能量摄入的外部驱动因素。
为了更深入地了解 ME 和 IE 干预措施对饮食摄入的影响,本系统评价纳入了 ME 和 IE 干预措施的随机试验,这些试验检查了不同体重状态的成年人的饮食摄入,定义为能量摄入或饮食质量,且这些成年人没有饮食失调的诊断。
文献选择遵循系统评价和荟萃分析的首选报告项目(Preferred Reporting Items for Systematic Reviews and Meta-Analyses)系统评价过程,在该过程中,检索了 1980 年 1 月至 2019 年 11 月期间发表的 PubMed、CINAHL(Cumulative Index to Nursing and Allied Health Literature)和 PsycINFO 数据库中的文献。如果符合以下标准,则纳入研究:随机试验设计,其中 1 组为具有 ME 或 IE 成分的干预组,并且至少有 1 个对照组或活性对照组;纳入的参与者为健康体重或超重或肥胖,并且报告没有饮食失调(即神经性厌食症、神经性贪食症或暴食障碍)或其他应用饮食限制的健康状况;年龄至少 18 岁;并且报告了能量摄入或饮食质量的结果,基线和干预后。使用改良的 Downs 和 Black 清单对符合纳入标准的每项研究进行风险评估。
共有 13 项研究,包括 8 项 ME 干预研究和 5 项 IE 干预研究,在 14 篇文章中进行了报道,纳入了本综述。7 篇报告能量摄入的文章没有发现组间差异有统计学意义。8 篇报告饮食质量的文章没有发现组间差异有统计学意义。平均偏倚评估得分为 28 分中的 13.6 分,表明质量较差。
几乎没有证据表明 ME 和 IE 干预措施会影响能量摄入或饮食质量。为了得出关于 ME 和 IE 对饮食摄入影响的有力结论,需要使用严格的研究设计进行未来的研究。