This study aimed to associate Eating Competence (EC) with food consumption and health outcomes in the Brazilian adult population. Researchers developed a questionnaire to associate EC with sociodemographic information, health outcomes, and food consumption. Data on body weight and height was referred to by participants in the questionnaire, and body mass index (BMI) was calculated and classified. A question to evaluate the perception of body size was included. After constructing the questionnaire items, content validation and semantic evaluation were performed following the Delphi method with a group of judges composed of 26 health professionals. The judges evaluated the sociodemographic information, health outcomes, and food consumption items associated with the eating competence instrument (previously validated in Brazilian-Portuguese). The final version of the questionnaire was composed of 33 items. Our results confirmed good reliability, responsiveness, and internal consistency. A total of 1810 Brazilians answered the questionnaire. Most of the participants were female, up to 40 years old, with a high education level and high income. Most of the participants did not report diabetes or hypertension. The EC total score did not differ among males and females. Individuals up to 40 years old presented a lower total score. The increase in educational level and income also increased EC total score. Excess weight individuals showed lower EC compared to the normal weight/underweight. Individuals who consumed fruits and/or vegetables five or more days/week presented the best scores for total EC.

This study aimed to translate and validate the Satter Eating Competence Inventory (ecSI2.0TM) from English to Brazilian Portuguese. The process included three steps: (i) translation and back-translation of the original ecSI2.0TM to Brazilian Portuguese; (ii) evaluation of its reproducibility; (iii) a pilot study to validate the Brazilian version of the Satter Eating Competence Inventory (ecSI2.0TMBR) for a selected sample of the Brazilian adult population (internal consistency and factor validity). The reproducibility (test–retest reliability) was verified using the intraclass correlation coefficient (ICC) obtained by the responses of 32 Brazilian adults. All domains of the ecSI2.0TMBR and the total score showed ICC > 0.8. Considering the entire questionnaire, none of the domains presented significant divergences among the participants’ responses (p < 0.001). In the pilot study with 662 individuals, 74.9% (n= 496) were female, mean age was 40.33 ± 12.55, and they presented a higher level of schooling and income. Analyses revealed Cronbach’s alpha coefficients of 0.869 for the ecSI2.0TMBR total scale, 0.793 for Eating Attitudes, 0.527 for Internal Regulation, 0.728 for Food Acceptance, and 0.822 for Contextual Skills. In general, the ecSI2.0™BR presented good acceptability, showing total floor and ceiling effects of ≤0.6%. Factor validity was examined by confirmatory factor analysis. The four domains presented a good fit in the confirmatory factor analysis: RMSEA = 0.0123 (95% CI: 0–0.0266); CFI = 0.998; χ2 = 75.9; df = 69; p = 0.266. The ecSI2.0TMBR is the first tool designed to measure eating competence (EC) in the Brazilian population, showing good reproducibility and internal consistency. We expect the ecSI2.0TMBR will support innovative research to investigate the association of EC and health outcomes, as well as new strategies based on emerging behavioral theories to enhance nutritional education policy.

Eating Competence (EC) is one behavioral perspective of eating practices that has been associated with a healthy lifestyle. It emphasizes eating pleasure, self-regulation of eating, body weight satisfaction, and regular meal frequency that includes food variety without focusing on dietary guidelines. EC is composed of four components (Eating Attitude, Food Acceptance, Internal Regulation, and Contextual Skill), and its assessment is performed using the Eating Competence Satter Inventory (ecSI2.0™), developed and validated in English for an adult population. EC has been associated with diet quality and health indicators for various population groups and the development of skills that increase EC might be a strategy to improve nutritional health, and prevent obesity and other chronic diseases. In this sense, this study presents an overview of the background, concepts, features, and possible associations among EC, food consumption, and health outcomes. The high prevalence of diseases associated with food/nutrition draws attention to the necessity to broaden the view on food and its relationship with health and well-being, considering not only nutrients and food combinations but also the behavioral dimensions of eating practices. Healthy nutritional recommendations that take into account attitudes and behaviors are in accordance with the EC behavioral model. Studies on eating behavior emphasize the need to better understand attitudes towards food and eating in the general population using validated instruments. In this context, measuring EC and its association with health outcomes seems to be relevant to nutritional health. The complexity of food choices has been examined in social, behavioral, and biological sciences, representing a great challenge for applying unique and simple theoretical models. Multiple methods are required, as no single theory can fully explain food selection.

This cross-sectional study aims to assess eating competence (EC—an intra-individual approach to food, behaviors, and attitudes related to food) and aspects related to a gluten-free diet (GFD) in Brazilian adults with gluten-related disorders (GRDs). The research was conducted using an online survey with a self-reported instrument consisting of 40 items, organized into three parts: (I) Socioeconomic and demographic data; (II) the Brazilian version of the Eating Competence Satter Inventory (ec-SI2.0™BR); and (III) questions about adherence and difficulties in following the gluten-free diet. EC was measured by the ecSI2.0™BR instrument, with scores ≥32 were considered competent eaters. The instrument was applied nationwide through the GoogleForms® platform from 14 February 2022 to 30 March 2022. The publicity for the recruitment was supported by Brazilian celiac local and national associations (Acelbras and Fenacelbra), pages of food services or personal pages of tips and posts about gluten-related disorders, and specialized stores that offer gluten-free foods. The recruitment occurred through social networks (emails, Facebook groups, WhatsApp, and Instagram). A total of 1030 Brazilians with GRDs answered the questionnaire. Most participants were female, aged 40 years or older, with an income >R$3000, and a high education level. The main difficulty regarding adherence to GFD was the high cost of gluten-free foods. Individuals younger than 40 years old had lower EC scores, with no differences between men and women. Increasing socioeconomic status, schooling, and culinary practices increased the total score. Participants who “never/almost never” felt socially judged because their diet had higher scores for total EC. Competent eaters GRD individuals (EC ≥ 32) were mostly individuals aged ≥ 40 y/o; with income > R$3000; following a GFD; satisfied with purchased gluten-free products; consuming gluten-free products prepared at home, mainly by themselves; who do not feel judged because of the GRD and who feel that they can live a normal life with GRD. Our study showed that individuals who strictly adhere to the GFD have higher scores on eating competence than those who sometimes follow the treatment.

The coronavirus pandemic started a worldwide emergency, and tight preventive actions were necessary to protect the population, changing individuals’ daily habits. Dwelling and working at home can change dietary habits, affect food choice and access, as well as the practice of physical activity. In this regard, this study’s goal was to compare eating competence (EC) among Brazilian adults before and during the coronavirus pandemic, using the Brazilian version of the eating competence Satter inventory (ecSI2.0™BR) with the “retrospective post-then-pre” design. This cross-sectional study was performed from 30 April to 31 May 2021 among a convenience sample of the Brazilian adult population using an online platform (Google® Forms). In the studied sample (n = 302 in which 76.82% were females), EC total score lowered during the pandemic (31.69 ± 8.26 vs. 29.99 ± 9.72; p < 0.005), and the decrease was worst after the beginning of the pandemic among those who reported weight gain, decreased the consumption of fruit and vegetables, and increased the consumption of sugary beverages. The contextual skill component seems relevant in this scenario, where our life and routines were changed entirely, demonstrating that the ability to manage the food context is essential, especially when sanitary and economic situations represent a new challenge.