The positive eating scale: relationship with objective health parameters and validity in three countries

Abstract

Background: The prevailing focus regarding eating behavior is on restriction, concern, worry, and pathology. In contrast, the purpose of the present studies was to focus on a positive relationship with eating in non-clinical samples from Germany, the USA, and India. Methods: In Study 1, the Positive Eating Scale (PES) was tested and validated in a large longitudinal sample of German adults (T1: N = 772; T2: N = 510). Health risk status was measured with objective health parameters (fasting serum glucose, triglycerides, high-density lipoprotein cholesterol, blood pressure, waist circumference, BMI). In Study 2, the PES was tested in online samples from the USA, India, and Germany (total N = 749) in confirmatory factor analyses. Results: Study 1 revealed acceptable psychometric properties of the PES, internal consistency (α = .87), as well as test-retest-reliability after six months (r = .67). Construct validation provided evidence for convergent and discriminant validity. Importantly, a positive relationship with eating was associated with decreased health risk factors six months later, for example risk for metabolic syndrome, OR = .59, 95% CI [.42-.82], B = -0.54, p = .002, pointing to a health protective role. In Study 2, the structure of the PES was confirmed for German, Indian, and US-American adults, demonstrating validity across remarkably different eating environments. Conclusion: A positive relationship with eating might be a fruitful starting point for prevention and intervention programs to promote physical and psychological health.