Last time I checked, men eat.
Since men eat, they also have the ability to engage in healthy, unhealthy, and pathological eating.
A man also has a body.
Given this, men can form problematic relationships with their bodies (e.g., they can feel uncomfortable in their body, feel sexually objectified, constantly scrutinize their physique, etc…).
It seems these truths have historically not been priorities in clinical psychology research. The preponderance of research on body image, eating behaviors, and the association between the two have been dominated by research on women (even more specifically on young-adult women) (Tiggemann, 2015). Extant research in men and eating and body image has also overlooked men of color to a large extent.
Defining Terms and Models
First of all, by “healthy eating” does not necessarily mean eating vegetables, fruits, low fat foods, etc…. And by “body image” is not negative body image such as “disliking one’s appearance and body.”
This study is more concerned with “body appreciation,” “body functionality,” and “intuitive eating.” Body functionality can be defined as a tendency to focus on how one’s body feels internally (e.g., hunger cues) and what one’s body can do (e.g., flexibility), rather than how one’s body appears externally (e.g., weight) (Alleva et al., 2017). Body appreciation is defined as accepting, respecting, and honoring one’s body, holding favorable opinions of one’s body, and a sense of gratitude for abilities (Tylka & Wood-Barcalow, 2015). Last, intuitive eating has been defined as eating in response to genuine hunger and satiety cues, not labelling certain foods as inherently forbidden or bad, and eating in response to physical cues, not emotional cues (Tylka & Kroon Van Diest, 2013).
As a guiding framework for scholarship, some time ago Avalos and Tylka (2006) proposed a comprehensive theoretical model called the Acceptance Model of Intuitive Eating (AMIE) which illuminates how these variables relate. For the sake of brevity, this model proposes that general unconditional acceptance is positively associated with body acceptance by others (Path A) as well as positively associated with body functionality (Path B). Likewise, body acceptance by others is expected to be positively associated with body functionality (Path C). Avalos and Tylka (2006) further suggest that when individuals focus on what their body can do and what their body needs, they appreciate their bodies more (i.e., Path D), which then allows them to more readily use internal cues to guide their eating (intuitive eating) (i.e., Path E).
The AMIE has received considerable empirical support. Cross-sectional studies in young-adult men and women isolating bivariate associations between body functionality, body appreciation, and/or intuitive eating have routinely found significant positive associations as specified in the model (e.g., Oswald et al., 2017; Tylka & Iannantuono, 2016; Tylka & Wood-Barcalow, 2015). Except for Path B, cross-sectional studies using path analysis or structural equation modeling (SEM) also provide support for the model as a whole in young-adult women (Avalos & Tylka, 2006), young-adult women athletes (Oh et al., 2012), middle-aged women (Augustus-Horvath & Tylka, 2009), as well as adolescent girls (Andrew et al., 2015). Only one study (Tylka & Homan, 2015) has examined the model in a predominantly (i.e., 88.5%) sample of White men (mean age under 20).
The Benefits of Cultivating Intuitive Eating
Cross-sectional research in men and women has shown that intuitive eating is associated with decreased eating disorder symptoms (Linardon & Mitchell, 2017). Similar research has shown that intuitive eating is associated with less anxiety and depression among adults (Alleva et al., 2017; Camilleri et al., 2015) as well as greater self-esteem (Alleva et al., 2017). Concerning physical health in adults, intuitive eating is inversely associated with body mass index (BMI) and likelihood of obesity (Camilleri et al., 2016). In women, intuitive eating is associated with higher HDL cholesterol, lower triglycerides, and lower cardiovascular risk (i.e., blood lipid profile) (Hawks et al., 2005). Additionally, among adolescents with Type 1 diabetes, intuitive eating is associated with greater glycemic control (Wheeler et al., 2016). A cross-sectional study over 9,000 men and 31,000 women found that specific subscales of the IES-2 were associated with greater fruit, vegetable, and whole grain consumption, and lower intake of sweet and fatty foods (Camilleri et al., 2016).
Men’s Experience Health Issues That Might Be Improved by Intuitive Eating
Men appear to encounter specific health problems related to diet. Consuming a healthy diet is associated with lower risk of heart disease, stroke, diabetes, and obesity (Dubowitz et al., 2008; Serdula et al., 1996). However, men often do not identify diet as a factor in lowering the risk of these diseases (Wolf et al., 2008). Black men experience earlier onset of chronic health conditions related to early mortality compared to White men (Howlander et al., 2010), and experience undiagnosed medical conditions that are exacerbated by obesity more so than other racial groups in the US (Griffith et al., 2011). Black, Latino, and Asian individuals are 2-3 times more likely to have Type 2 Diabetes (T2D) than similar-aged White individuals. Black men in particular are less likely to meet recommended dietary guidelines than non-Hispanic white men (Wolf et al., 2009). As such, learning what contributes to intuitive eating in men is critically needed.
Need For and Goal(s) of the Proposed Study:
It is unclear whether the AMIE is valid among men; in particular men of different ethnicities and races. We simply do not know what contributes to intuitive eating among men, and as such, applying interventions that aim to increase intuitive eating (which were developed for and tested on women) seems quite inappropriate. Assuming that the AMIE, is wholly translatable to Black and Latino men in particular, seems tantamount to transgressing principles of multicultural competence and the notion that clinical interventions should be rooted in a particular cultural context (Benish et al., 2011). As such, the goal of this proposed study is to investigate the validity of the Acceptance Model of Intuitive Eating (Avalos & Tylka, 2006) in Black, Latino, and White men between 18 and 30 in the United States.
The proposed study would be a cross-sectional, self-report, empirical study of which several scales would be administered online through Qualtrics. After IRB approval, Prolific Academic would be utilized to recruit roughly equal numbers of non-Hispanic Black, Latino, and non-Hispanic White men. Following best practices in online data collection (Kees et al., 2017) all scales will be counterbalanced and several attention checks will be included. Each participant will be compensated for full participation (and passing all attention checks).
Structural equation modeling (SEM) would be utilized for analyses in this study. SEM is specifically attuned to assess complex relationships among multiple latent variables at once (e.g., testing a theoretical model), and accounts for measurement error, which makes it the optimal analysis for investigating multivariate models, mediation/indirect effects via bootstrapping, and measurement and structural invariance across groups (Byrne, 2016). In this analysis, confirmatory factor analytic measurement models would be estimated for each group of men separately via a multigroup configural model, followed by estimating a multigroup structural model, and ending with the invariance testing process of Byrne (2016). Before any analysis data would be through screened for a) missing data and type of “missingness” (e.g., via Little’s MCAR test), b) univariate and multivariate outliers (e.g., via Mahalanobis D2), c) normality (e.g., Kolmogorov-Smirnov Tests), linearity and homoscedasticity, d) multicollinearity and influential cases (e.g., via VIF, leverage), and numerous other SEM assumptions.
Participants & Sample Size Estimation
465 Black men, 465 Latino men, and 465 White men between 18 and 30 years of age will be recruited (total = 1,395). There will be no exclusionary criteria based on any other demographic factor. This was based on the most minimal sample size guidelines and confirmed with a Monte Carlo Study in R. This is the most minimally-appropriate size based on “rule of thumb” recommendations (Weston & Gore, 2006) which suggest a minimum of 5 participants per parameter estimated.
Amount Requested and How Funding Would be Spent
The grant award would solely go to compensating research participants. Participants would be compensated $3.00 per participant. Given the estimated sample size requirements the cost and requested amount of funding for participant payment is $4,185.00 (i.e., 1,395 x 3.00). The 33% Prolific charge per participant (0.99 in this case) brings the total cost requested to $5,566.05 (i.e., 1,395 x 3.99)
This study has been pre-registered (see link). All measures to be used are presented there as well. All data sets will be made available to others upon request.