Participants
This cross-sectional study is included 227 female subjects aged 19-35 who were living in Famagusta, North Cyprus. All participants in the study signed the informed consent form and participated in the study voluntarily. The exclusion criteria were as follows: (1) being younger than 19, (2) being older than 35, (3) being male, (4) being pregnant and (5) breastfeeding.
The study was approved by the Ethics Committee of Eastern Mediterranean University (No: 2020/06 and Date 29/09/2020). The data collection was carried out from September 2020 to June 2021. The participants were recruited both by word of mouth and by advertisements through social media. Face-to-face interviews were conducted using a questionnaire, which was consisted of questions about demographic characteristics and health status. Mindful Eating Questionnaire (MEQ) and Eating Attitudes Test (EAT-26) were used. In addition, anthropometric data were obtained by researchers.
It was determined that a sample size of 203 people would be needed at a 95% confidence level and a 5% confidence interval, aiming to have a statistical power of 80% and above. Considering the unpredictable changes that may cause a decrease in statistical power in the research conditions, it was decided to increase the sample size by approximately 10% to 227 people.
Eating attitudes test (EAT-26)
EAT-26 was developed to measure the eating attitudes of participants between the ages of 11-70 and possible disorders in their eating behaviours [16]. The validity and reliability study was adapted into Turkish by Ergüney-Okumuş and Sertel-Berk. The Cronbach's alpha internal consistency coefficient was 0.84, and the test-retest stationarity coefficient was 0.78. The EAT-26 is a six-point Likert-type scale and has 3 sub-scores: dieting, bulimia and preoccupation, and oral control. Scores of 20 and above from the EAT-26 scale indicate the elevated risk of disorders in eating attitudes [17].
Mindful eating questionnaire (MEQ)
MEQ was developed to determine the associations between eating behaviour, awareness and emotional state can be questioned [18]. The validity and reliability study was adapted into Turkish by Kose et al.. The Cronbach alpha consistency coefficient was found to be 0.733. MEQ is a Likert-type scale consisting of 30 questions. The MEQ has 7 sub-scores: disinhibition, emotional eating, eating control, focus, eating discipline, awareness, and interference. The higher the score of the scale indicates the higher the awareness of eating [19].
Anthropometric measurements
Weight and body composition were measured on a scale (Tanita BC-543, Amsterdam, The Netherlands) and height was measured with a portable stadiometer (Seca 213, Hamburg, Germany). Body mass index (BMI) was calculated from the recorded height and weight. Data from the World Health Organization were used for BMI classification [20]. A BMI below 18.5 kg/m2 is considered underweight, 18.5-24.9 kg/m2 is considered normal weight, 25.0-29.9 kg/m2 is considered overweight, whereas a BMI above 30.0 is considered as obese [20].
Neck circumference (NC) was measured using a graduated tape from the middle point between the base of the neck and the upper part of the sternum. NCs above ³34 cm are classified as high risk for abdominal obesity [21]. Waist circumference (WC) was measured halfway between the top of the lateral iliac crest and the lowest rib. The cut-off points for WC are >80 cm and >88 cm, described as risk and high risk, respectively. Hip circumference (HC) was measured at the point yielding the maximum circumference over the buttocks using a tape measure and waist-to-hip ratio (WHR) was calculated. WHR above 0.85 is described as a risk for non-communicable diseases. The waist-to-height ratio (WHtR) were calculated using measured waist circumference and height. Cut-offs for WHtR <0.50, between ≥0.50 and <0.60, and ≥0.60 are described as no risk, risk and high risk for non-communicable diseases, respectively [22].
Statistical analysis
Frequency and percentage for qualitative variables and arithmetic mean and standard deviation for quantitative variables were calculated as descriptive statistics. Parametric assumptions, including the Kolmogorov-Smirnov test of normality, were controlled and all statistical analyses were performed with non-parametric methods. Kruskal-Wallis test was applied to understand the statistical significance of differences between BMI categories. In case of significance, the Mann-Whitney U test was performed to investigate pairwise group differences. Spearman rho was calculated to analyse the associations between variables. For whole calculations and analysis, SPSS (Version 26.0 for Mac) software was used. Graphs were created using the Microsoft Excel programme. Statistical significance was accepted to be 0.05.