title: Clusters of Healthy and Unhealthy Eating Behaviors Are Associated With Body Mass Index Among Adults.
abstract: To identify eating styles from 6 eating behaviors and test their association with body mass index (BMI) among adults.
  
  
  
  Cross-sectional analysis of self-report survey data.
  
  
  
  Twelve primary care and specialty clinics in 5 states.
  
  
  
  Of 11,776 adult patients who consented to participate, 9,977 completed survey questions.
  
  
  
  Frequency of eating healthy food, frequency of eating unhealthy food, breakfast frequency, frequency of snacking, overall diet quality, and problem eating behaviors. The primary dependent variable was BMI, calculated from self-reported height and weight data.
  
  
  
  k-Means cluster analysis of eating behaviors was used to determine eating styles. A categorical variable representing each eating style cluster was entered in a multivariate linear regression predicting BMI, controlling for covariates.
  
  
  
  Four eating styles were identified and defined by healthy vs unhealthy diet patterns and engagement in problem eating behaviors. Each group had significantly higher average BMI than the healthy eating style: healthy with problem eating behaviors (β = 1.9; P < .001), unhealthy (β = 2.5; P < .001), and unhealthy with problem eating behaviors (β = 5.1; P < .001).
  
  
  
  Future attempts to improve eating styles should address not only the consumption of healthy foods but also snacking behaviors and the emotional component of eating.
authors.affiliation: General Pediatrics, Vanderbilt University Medical Center, Nashville, TN; Department of Internal Medicine and Public Health, Vanderbilt University, Nashville, TN; Center for Health Services Research, Vanderbilt University, Nashville, TN. Electronic address: Bill.Heerman@vanderbilt.edu.
authors.forename: William J
authors.initials: WJ
authors.lastname: Heerman
authors.affiliation: Department of Internal Medicine and Public Health, Vanderbilt University, Nashville, TN; Center for Health Services Research, Vanderbilt University, Nashville, TN.
authors.forename: Natalie
authors.initials: N
authors.lastname: Jackson
authors.affiliation: Department of Internal Medicine, Meharry Medical College, Nashville, TN.
authors.forename: Margaret
authors.initials: M
authors.lastname: Hargreaves
authors.affiliation: Department of Internal Medicine and Public Health, Vanderbilt University, Nashville, TN; School of Nursing, Vanderbilt University, Nashville, TN; Department of Biomedical Informatics, Vanderbilt University, Nashville, TN.
authors.forename: Shelagh A
authors.initials: SA
authors.lastname: Mulvaney
authors.affiliation: Center for Health Services Research, Vanderbilt University, Nashville, TN.
authors.forename: David
authors.initials: D
authors.lastname: Schlundt
authors.affiliation: School of Nursing, Vanderbilt University, Nashville, TN.
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Wallston
authors.affiliation: Department of Internal Medicine and Public Health, Vanderbilt University, Nashville, TN; Center for Health Services Research, Vanderbilt University, Nashville, TN.
authors.forename: Russell L
authors.initials: RL
authors.lastname: Rothman
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D004032:Diet / Q000706:statistics & numerical data*; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology
keywords: behavioral science; body mass index; eating patterns; nutrition; obesity