Validação de uma escala de mindful eating e sua aplicabilidade em indivíduos com diabetes mellitus tipo 2

Abstract

Few studies have investigated the association between mindful eating and food intake in individuals with type 2 diabetes mellitus (T2DM), especially in the Brazilian population. Possibly due to the lack of validated instruments for this public. The objective was: (1) to estimate the psychometric properties of the Mindful Eating Questionnaire (MEQ) in Brazilian adults with T2DM and (2) to investigate the association between mindful eating and food intake. Cross-sectional study carried out with participants included in the baseline of the multicenter study, NUGLIC, between May 2019 and September 2021. In the first stage of the research, the MEQ version previously translated and adapted for the Brazilian population had its psychometric properties estimated using exploratory factor analysis (EFA). The fit and reliability indices of the Brazilian version of the MEQ for adults with T2DM (MEQ-DM) were evaluated. Criterion validity was assessed from the association between the MEQ-DM and sociodemographic, anthropometric and lifestyle variables. In the second stage, 24-hour dietary recalls (R24H) were used to investigate habitual dietary intake of nutrients and to calculate the modified Alternative Healthy Eating Index (mAHEI) and its associations with the MEQ-DM. In the first stage of the research, 370 participants aged 61 (54 – 67) years old participated, 60.8% of whom were female. The EFA results supported the three-factor structure of the MEQ-DM: disinhibition (10 items), awareness (7 items) and distraction (3 items). Scores in these domains are to be used separately. Fit indices (RMSEA = 0.03; CFI = 0.97 and TFI = 0.96) and reliability test (disinhibition = 0.77; awareness = 0.76 and distraction = 0.55) indicated adequacy of the model. Criterion validity indicated that the MEQ-DM subscales correlated with age, sex, marital status, education and BMI (p < 0.05). In the second stage of the research, the majority of participants were 332 individuals aged 61 (54 – 67) years, 58.4% of whom were female. Only 23.4% of participants had adequate calorie intake and 44.0% excessive protein intake. However, poor quality of food, with a mean total mAHEI score of 26.2 ± 8.0. The median of the MEQ-DM subscales was: disinhibition [3.1 (2.7 – 3.4)], awareness [2.6 (2.1 – 3.2)] and distraction [3.0 (2. 0 - 3.7)]. There was no association between the MEQ-DM and the overall mAHEI score (p > 0.05). Higher scores on the MEQ-DM subscales, especially on the disinhibition and awareness subscales, were correlated with lower habitual intake of calories, nutrients and fewer servings consumed daily (p < 0.05). The MEQ-DM is a reliable and valid tool to measure mindfulness of eating in Brazilian adults with T2DM, and these can benefit from mindful eating, due to the positive impact on their ability to moderate portion size and, consequently, intake calories and nutrients. Encouraging a mindful eating approach can be a positive strategy to be included in the treatment of individuals with T2DM.