Mindful eating is defined as sustained attention to a sensory element of the eating experience (for example, taste) and non-judgmental (or non-evaluative) awareness of thoughts and feelings that are inconsistent with the sensory elements of the current eating experience [1]. Mindful eating has been associated with healthier eating [2], and helps weight loss through mindfulness-based interventions [3]. The literature suggests that mindfulness-based practices promote healthier eating behaviors, such as a reduction in sweet consumption and an increase in fruit and vegetable intake [4,5]. At the same time, studies have shown that mindful eating has various aspects, such as reducing excessive cravings for foods [6], overeating [5], and consumption of energy-dense foods [7]. Research suggests that mindful eating alters negative situations related to eating, helps slow down the rate of eating, and promotes feeling fuller with smaller portions [8].

Nutrient consumption is controlled by a homeostatic mechanism that encompasses the critical phases of hunger and fullness, designed to fulfill nutritional needs and regulate metabolism in the bloodstream and adipose tissue. Disruption in this homeostatic mechanism elevates food consumption and causes weight gain [9,10]. Hunger and the desire to consume food, arising from pleasurable stimuli rather than homeostatic hunger signals, are termed “hedonic hunger” [11]. Hedonic food consumption, aimed at alleviating or reacting to emotional states, facilitates the enjoyment of palatable foods, influences motivational or reward-punishment eating, and leads to excessive eating behaviors beyond the body’s requirements [12,13] and thus increased energy intake [14,15]. The increase in hedonic hunger, coupled with a persistent increase in energy intake results in weight gain and obesity [16].

Mindful eating is a technique designed to diminish extrinsic motivations for eating and enhance the significance of food’s sensory attributes and intrinsic motivations related to digestion [17]. Consequently, it may facilitate a slow change in eating behavior, reducing the influence of external stimuli, such as a favorite scent, thereby lessening the urge to eat in the absence of physiological hunger cues [18]. It was hypothesized that mindful eating could reduce hedonic hunger levels in individuals and lower calorie intake by reducing the consumption of palatable, high-energy foods, helping in the maintenance of a healthy body weight. Due to the limited research on the impact of mindful eating on hedonic hunger, this study aimed to examine the association between mindful eating, hedonic hunger and obesity in adults living in Türkiye.

Table 1 includes the characteristics of the study participants. A total of 787 individuals, 432 women (54.9%) and 355 men (45.1%) with a mean age of 31.2±11.9 years (age range 19-65 years) participated in the study. Most of the participants had high school or lower education (56.3%). Based on the waist/height ratio, 45.2% had obesity-related health risks. According to the BMI classification, 27.4% of the participants were overweight, and 13.6% were obese. The mean mindful eating score was higher among women (p=0.001). Participants with no risk according to the waist circumference and waist/height ratio had higher mindful eating scores (p=0.001 and p=0.002, respectively). Participants with obesity had lower mindful eating scores than those with normal weight and overweight according to the BMI classification (p<0.001).

Table 2 depicts the multiple regression estimates for the PFS (total and sub-scales) by the MEQ (total and subscale scores) after adjusting for sex, smoking status, and obesity. A one-unit increase in the MEQ total score was associated with a 0.81-unit decrease in the PFS total score (p<0.001). A one-unit increase in the MEQ total score was associated with a 1.05, 0.98, and 0.49-unit decrease in the food availability, food presence, and tasting food components of the PFS, respectively (p<0.001).
Multiple regression estimates for the energy intake and carbohydrate, protein, and fat percentages by the MEQ (total and subscale scores) are reported in Table 3. A one-unit increase in the MEQ total score was associated with a 134.38 kcal decrease in energy intake. A one-unit increase in the MEQ total score was associated with a 2.00% decrease in daily carbohydrate percentage and a 1.99% increase in daily fat percentage (p<0.01).

Table 4 indicates the binary logistic regression analyses predicting obesity and health-related risks with the waist circumference, waist/height ratio, and BMI classification by the MEQ (total and subscale scores). Higher MEQ total scores were significantly associated with lower odds of having risk/high risk of health according to the waist circumference (OR=0.55, 95% CI: 0.40–0.76, p<0.001), lower odds of having health risk according to the waist/height ratio (OR=0.68, 95% CI: 0.49–0.94, p<0.05) and also associated with lower odds of being obese according to the BMI classification (OR=0.34, 95% CI: 0.22–0.55, p<0.001). Disinhibition, control of eating, eating discipline, and mindfulness subscales scores were significantly associated with lower odds of having risk/high risk of health according to the waist circumference, having a health risk according to the waist/height ratio, and being obese according to the BMI classification.

The present study sought to broaden the possible associations between mindful eating and hedonic hunger, obesity, energy, and macronutrient intake in adults. Minimal research has been conducted on this topic in the literature, particularly in Türkiye; hence, this study is one of the few, and it has significant findings. The main results of this study were as follows: Mindful eating scores are higher in women, non-smokers, and those with a waist circumference with no risk, waist/height ratio with no risk, and normal BMI. Mindful eating total scores are inversely correlated with hedonic hunger as well as energy intake. Furthermore, the higher total score for mindful eating and the following sub-scores: disinhibition, control of eating, eating discipline, and mindfulness are associated with reduced risk of health according to waist circumference and waist/height ratio, as well as reduced risk of obesity according to BMI. Briefly, higher mindful eating is inversely associated with hedonic hunger, energy intake, and obesity indicators in adults.

The analysis of mindful eating scores revealed that demographic variables exhibited variances, with women attaining higher scores in mindful eating. Contrary to these results, Ozkan and Bilici [30] reported no difference in mindful eating according to gender in adults aged 20–45 years. There are also other studies that have found no statistically significant difference between the MEQ total score according to gender in adults [31,32]. In the non-smokers, mindful eating scores were higher in the current study. Aside from this, Adams et al. [33] reported that mindfulness-based interventions may help reduce disordered eating in female smokers. Similar to Demirbaş et al. [31], no association was found between the total MEQ scores and age group, marital status, and educational status. Another study also did not find a difference according to age group (considered according to generations) [32]. Even so, there are studies that have reported that younger individuals are concerned about mindful nutrition [31,34]. In another study, a relationship was found between advanced age and awareness, and it was reported that with advancing years, it may become increasingly crucial for well-being to have a tendency to be present-oriented and adopt a non-judgmental attitude [35].

In line with the literature, it was observed that the participants with a normal BMI had higher total MEQ scores [31]. In the present study, higher MEQ total scores were associated with lower odds of having risk/high risk of health according to the waist circumference, lower odds of having health risk according to the waist/height ratio, and also associated with lower odds of being obese according to the BMI classification. Obesity is a multifactorial disease, and several mechanisms might be involved in this outcome. The simplest definition of obesity is the imbalance between energy intake and expenditure; thus, it can be considered that the findings herein support this association. Hence, energy intake was negatively associated with the MEQ total score, as well as disinhibition, control of eating, mindfulness subscales, and interference subscales. Fisher et al. [36] showed that a brief mindful attention induction could reduce food intake even when craving and hunger were experienced. Additionally, Allirot et al. [37] reported a decrease in high-energy-dense foods and energy intake after single mindful eating induction in adult women. In that study, the reduction in high-energy food consumption following the introduction of mindful eating also led to considerably reduced intakes of fat and protein when compared to the controls, but not of carbohydrates [37]. Contrary to this, the current study found that lower carbohydrate intake and higher fat intake (percentages) were associated with higher MEQ total scores. The increase in palatable, highly processed foods that are high in fat and sugar is among the dietary factors associated with obesity [38]. In addition, it has been determined that the foods consumed due to hedonic hunger are typically high in energy content, salty, sugary, and fatty foods [39]. Studies have suggested that eating awareness and the motivation to eat delicious foods were inversely related to weight gain. Accordingly, eating awareness was associated with a lower BMI as well as reduced fat and sugar consumption [18,40]. It may be a predictable outcome that mindful eating habits or mindfulness scores will have a positive impact on dietary fat intake, as fat is a key ingredient in palatable foods and is associated with high BMI values. However, at this point, considering the level of meeting the nutritional intake recommendations of individuals will reveal more accurate results.

The increase in overweight and obesity and the associated health risks has become a critical issue for most Western countries, and the results of the studies about mindfulness are promising [18]. Eating is an over-learned behavior, often subordinated to other daily tasks, so eating automatically is inevitable. Nevertheless, mindful awareness brings the eater’s focus back to what they are eating, involves the development of autonomous regulation and motivation, de-automates eating, and improves craving responses, and helps with better weight regulation [18,41]. In consonance with the results of this study, mindfulness intervention could be recommended as a cost-effective method to support treatment since mindfulness scores were found to be low in individuals with obesity and individuals at risk in terms of waist circumference and waist/height ratio. Salvo et al. [42] reported a significant decrease in body weight (1.9±0.6 kg) from pre- to post-intervention in overweight and obese women after Mindfulness-Based Eating Awareness Training.

In the current study, the MEQ total score and subscale scores (excluding focusing and eating discipline) were inversely associated with the PFS total score and sub-scale scores. Hedonic hunger is associated with binge eating behavior disrupting the inhibitory control mechanism that stops food intake [43]. Therefore, the inverse relationship between the MEQ disinhibition score and the PFS scores was an expected finding. Some studies have found a link between hedonic hunger and some forms of disordered eating [39,44]. Moreover, among people who are extremely sensitive to the food environment, self-control may help them avoid overeating, which may operate as a protective factor that lowers the chance of becoming overweight [12]. In this line, the negative relationship between the emotional eating and control of eating subscales and the PFS reported in the current study is consistent with the literature. For this reason, methods that will help to regulate the hedonic hunger mechanism are necessary to prevent adverse conditions such as unhealthy nutrition and obesity caused by hedonic hunger. One of the indicators of hedonic hunger is hypersensitivity to food availability. Individuals who are hypersensitive to food availability have high appetite urges to consume delicious foods available in their environment [12]. In one study, it was shown that people who are sensitive to food availability but have high levels of self-control have a lower frequency of consumption of unhealthy and delicious foods, as well as a lower frequency of overeating and snacking. In other words, self-control may be a protective factor that reduces the risk of obesity in individuals who are hypersensitive to the availability of foods, one of the hedonic hunger indicators, by preventing overeating [12]. There are also study results supporting a weak association between hedonic hunger (assessed with the PFS) and BMI [16,45]. From this point of view, behavioral interventions such as mindful eating that will help individuals control their eating behaviors are seen as a potential factor that can reduce unhealthy eating behaviors associated with hedonic hunger.

The present study had several limitations that must be addressed. The cross-sectional design of the study herein could not indicate causation. Experimental studies evaluating the long-term impact of mindful eating intervention on hedonic hunger and related factors (energy intake and obesity) may help to prove the causality of the relationship shown in the current study. The fact that the data were selected from a single region is a factor that reduces the representativeness of the individuals to the adult population in Türkiye and is another limitation of the study. In addition, since the participants in this study consisted of individuals living in Türkiye, studies conducted in different countries will help support the results. Another limitation of the study is that the anthropometric indicators of obesity were limited to BMI, waist circumference, and waist/height ratio, and valid anthropometric indicators of obesity, such as neck circumference and waist/hip ratio, were not included.

This study provides important data about the interactions among mindful eating, hedonic hunger, obesity, energy, and nutrient intake in adults, as there are not many articles specifically investigating the relationship between mindful eating and hedonic hunger. Important associations were found between mindful eating and hedonic hunger as well as mindful eating and obesity parameters. Considering the effects of mindful eating on obesity and eating behavior, it is believed that interventions will be effective in gaining healthy lifestyle habits. Therefore, future research should focus on explaining the potential explanations and directions between mindful eating and hedonic hunger. The disinhibition of hedonic hunger can be evaluated by further studies incorporating mindful eating interventions. Future studies can be focused on assessing the impact of mindfulness-based therapies on individuals’ dietary preferences, as well as their energy and nutrient consumption.