Received: 19 October 2020 | Revised: 6 February 2021 | Accepted: 7 February 2021

DOI: 10.1111/nuf.12561

RESEARCH MANUSCRIPT

Mindful eating, obesity, and risk of type 2 diabetes

in university students: A cross‐sectional study

Duygu Kes PhD, MSc, RN1 | Saadet Can Cicek PhD, MSc, RN2

1
Nursing Department, Faculty of Health
Sciences, Karabuk University, Karabuk, Abstract
Turkey
Background: Understanding gender differences in type 2 diabetes mellitus (T2DM)
2
Nursing Department, Faculty of Health
Sciences, Bolu Abant İzzet Baysal University,
and obesity risk among university students is critical for the development of health
Bolu, Turkey promotion interventions. Mindful eating focuses on how and why eating behavior
occurs rather than what is eaten. Current research on this topic is limited in the
Correspondence
Duygu Kes, PhD, MSc, RN, Nursing university‐aged population.
Department, Faculty of Health Sciences, Purpose: The aim of this study was to (1) assess gender differences in risk of
Karabuk University, Demir‐Celik Campus,
78050 Karabuk, Turkey. developing T2DM and elevated body mass index (BMI)/obesity; (2) explore the
Email: duygukes@karabuk.edu.tr mindful eating levels according to the gender perspective; and (3) evaluate the
relationship between mindful eating, BMI, and the risk of T2DM among young
Turkish adults.
Method: This cross‐sectional correlational study was conducted in Karabuk
University University, Turkey, during the 2017–2018 university calendar year. Eight
hundred young adults were selected by the convenience sampling method. Data
analyses used were the independent t test and Pearson correlational statistics.
Results: BMI values of males were significantly higher than those of females
(p < 0.01). There were no significant differences between males and females re-
garding the risk of developing T2DM (p > 0.05). Mindful eating was significantly
associated with BMI and the risk of developing T2DM in the young adult popula-
tions (p < 0.01).
Conclusions: Our findings can provide a basic reference for developing interven-
tions that improve healthy eating habits and weight‐loss strategies.

KEYWORDS
mindful eating, obesity, type 2 diabetes mellitus, university students, young adulthood

1 | INTRODUCTION Young adulthood (aged 18–25 years), which is the transition

from adolescence to adulthood, is an important target for the pro-
The prevalence of obesity has steadily risen among young adults motion of healthy lifestyles of the adult population.4,8,9 During this
1–4
(aged 18–25 years) worldwide. This condition is also similar period, many go to college or university, and experience great
among young adults in Turkey.2,5,6 The increasing obesity trend changes either positively or negatively in their lifestyles.4,9
might lead to negative health consequences, such as type 2 diabetes Furthermore, they may lack experience in knowing how to form a
mellitus (T2DM).7 Furthermore, obesity and T2DM‐related co- healthy lifestyle for themselves. Unhealthy lifestyles can contribute
morbidities are predicted to positively correlate to increased mor- to the development of T2DM and obesity among university
tality and the cost of health care.7 students.8,10,11 The etiology among females and males may differ due

Nursing Forum. 2021;1–7. wileyonlinelibrary.com/journal/nuf © 2021 Wiley Periodicals LLC | 1

2 | KES AND CAN CICEK

to cultural, lifestyle and social factors, as well as biology.8,9,11 2 | ME THO D S

Research has been conducted that examined gender disparities in
T2DM and obesity among adult populations, whereas few studies 2.1 | Design, setting, and sample
have been conducted among a nationally representative sample of
young adults such as university or college students in recent This study used a cross‐sectional descriptive correlational design.
years.4,8,12–15 Understanding gender differences in T2DM and obe- The study was carried out in XXX University, located in the north‐
sity risk among young adulthood is critical for the development of west region of Turkey during the 2017–2018 university calendar
health promotion interventions. year. Participants were selected by the convenience sampling
Mindful eating is rooted in the concept of Mindfulness, which method. Criteria for inclusion in the study were (1) an age of
is derived from Buddhist philosophy and meditation practices, 18–25 years; (2) studying at bachelor's level; (3) voluntary partici-
which is related to humanism and an existentialist and cognitive‐ pation in the study; (4) having no communication problems; and
behavioral approach.16,17 Mindfulness is defined as focusing the (5) being able to speak and write Turkish. Exclusion criteria were
attention on what is happening in the present moment in a non- (1) studying at postgraduate degree level; (2) having type 1 dia-
judgmental and accepting way. It is a state of consciousness de- betes, prediabetes, or T2DM; and (3) not agreeing to take part in
pendent on perceiving thoughts, feelings, and sensations in an the study.
open and comprehensible way.17 It has been reported that The sample size was estimated using G*Power 3.1.9.4.24 A power
by focusing attention, individuals are able to make conscious analysis was conducted using Cohen's25 power table for two‐group
choices.16,17 Mindful eating is similarly defined as a nonjudgmental comparison. A total of 676 adults were required to achieve 90%
awareness of emotional (i.e., anger, stress, or anxiety) and physical power so as to detect a medium effect size (f = 0.25), at the 5% level
sensations (hunger and satiety cues) while eating.18,19 It helps to of significance. However, considering the possibility of dropout, a
distinguish why we eat: because we are hungry; or because of total of 850 participants were recruited; of these, 46 refused to
personal triggers such as stress, emotions, social pressures, and participate and four already had type 1 diabetes. The questionnaire
17,18
certain foods, although we are not hungry. Additionally, it surveys were completed by 800 students.
reduces portion sizes and distractions while eating, as well as how
fast one eats.18 Healthy eating behaviors and nutritional intake
can differ across genders. For example, females are more likely to 2.2 | Data collection
experience emotional eating than males. Previous studies re-
ported male students consume more high‐fat content foods and Participants were contacted through their telephone numbers and
greater fibers, whereas females have more fruits and vegetables invited to the researcher's office. The principal investigator inter-
8,9,11,19
daily. Increased awareness of mindful eating can allow an viewed participants face‐to‐face, using the Finnish Diabetes Risk
individual to choose healthier foods and reduce emotional and Score Questionnaire (FINDRISC) and Mindful Eating Questionnaire
binge‐eating behaviors because mindful eating focuses on how and Turkish version (MEQ‐30). Each data collection interview took about
why eating behavior occurs rather than what is eaten. Conse- 15–20 min.
quently, it can contribute to the intake of less energy and balanced The MEQ‐30 was developed by Framson et al. to evaluate
nutrition.18 mindful eating skills among an adult population. The Cronbach α
Previous studies have revealed that mindful eating is correlated coefficient for the total original scales was 0.64, and the subscales
with body mass index (BMI) and reductions in emotional and binge‐ had good internal consistency reliability, ranging from 0.64 to 0.83.19
eating behavior.20–22 Moreover, it has been reported that mindful The validity and reliability of the MEQ‐30 was tested by Kose et al.
eating‐based interventions increased consumption of fruit and ve- with university students. Regarding the reliability of the Turkish
getables, and decreased binge‐eating and eating disinhibition beha- version of the total MEQ‐30, the Cronbach α was 0.733. Concurrent
viors among adults with T2DM.22,23 Alternately, an examination of and construct validities of the MEQ‐30 were achieved by a theore-
the literature showed that there were no studies explaining the tically selected study instrument. The scale measures include seven
correlation between mindful eating and the risk of developing T2DM. domains of mindful eating: disinhibition (mindless eating), mind-
Understanding this relationship may positively impact the prevention fulness, emotional eating, eating control, interferences, eating dis-
of diabetes and improving weight‐loss strategies. Moreover, health cipline, and conscious nutrition.19 A total MEQ‐30 score ranging
education efforts targeted at university students require detailed from 1 to 5 is found by adding all item scores and dividing by 30. The
knowledge about gender differences in T2DM and obesity risk. MEQ‐30 subscale scores are found by adding the item scores for
Hence, the first aim of this study was to assess gender differences in each subscale and dividing by the number of items. A score of ≥3 is
risk of developing T2DM and being overweight or obese. The second considered to indicate a high level of mindful eating for the total
and third aims of the study were to explore mindful eating levels scale and subscale.26
according to the perspective of gender, and whether a relationship The FINDRISC was developed by Lindström and Tuomilehto.27
exists between mindful eating, BMI, and the risk of T2DM among The instrument is used by the International Diabetes Federation
young Turkish adults. (IDF) for population‐based screenings. It requires no laboratory
KES AND CAN CICEK | 3

testing and has been validated in multiple populations. It has been Table 2 shows a comparison of the students' mean scores on the
translated by the IDF into 15 languages, including Turkish. In a study MEQ‐30 according to gender differences. The mean scores of fe-
evaluating the validity and reliability of the Turkish version, the males on the subscales of eating control, mindfulness, interferences,
sensitivity of the scale was found to be 100%, the specificity 60.3%, and conscious nutrition were found to be statistically significantly
the positive predictive value 7.2%, and the negative predictive value higher than those of males. On the other hand, the mean score of
100%. In the same study, the score was calculated as 0.802 under the males on the subscale of emotional eating was found to be statisti-
receiver operating characteristic (ROC) slope drawn for the pre- cally significantly higher than that of females.
dictive power of newly diagnosed T2DM.28 FINDRISC uses age, BMI, As shown Table 3, the participants' total BMI scores were found
physical activity, vegetable and fruit intake, medical treatment of to be significantly negatively correlated with MEQ‐30 scores for
hypertension, history of hyperglycemia, and family history to de- emotional eating and eating control. The participants' total scores on
termine the risk of developing diabetes. It is scored on a point range the FINDRISC were found to be significantly negatively correlated
of between 0 and 26. The risk of T2DM within 10 years is <7 low— with MEQ‐30 scores on the following domains: disinhibition, emo-
1%; 7–11 slightly elevated—4%; 12–14 moderate—16%; 15–20 high tional eating, eating control, eating discipline, and interferences.
—33%; and >20 very high—50%. 27,28

4 | DISCUSS ION
2.3 | Data analysis
The first aim of this study was to assess gender differences in risk of
Analyses were conducted using SPSS Version 25 (SPSS Inc.). The developing T2DM and being overweight or obese. Turkey is located
skewness and kurtosis were used for testing normality. Independent in both the region of Western Asia and Southeastern Europe.
t test analyses were performed to examine differences between Previous studies indicate male students found significantly higher
gender and mindful eating skills. The χ2 test assessed the differences levels of overweight/obesity and central/truncal obesity in some
in obesity and risk of T2DM according to gender. Pearson correla- Asian (Bangladesh, Indian, Philippines, and Pakistan), North African,
tional statistics were used to analyze the relationship between Eastern European (Poland, Bulgaria, and Lithuania), and Western
mindful eating skill, obesity, and risk of T2DM. All statistical tests Asian (Egypt, Saudi Arabia, Kuwait, and United Arab Emirates)
were two‐tailed, and statistical significance was defined as p < 0.05 countries, which is consistent with the findings of this study.1–3,29,30
and p < 0.01. In contrast, young female obesity was more than young male obe-
Written permission was obtained from the ethics committee sity in some Southern and Western European countries (Germany,
(approval no. 2/13), university rector (approval no. 32469041‐ Denmark, and Spain), sub‐Saharan African (Uganda, Nigeria,
302.14.03/532422), and from the students. The study was con- Madagascar, Mauritius, and Namibia), Latin American and
ducted in accordance with the Declaration of Helsinki. Caribbean (Jamaica, Venezuela, and Barbados) countries.1–3 This
difference among countries may be explained by socioeconomic
status, social disadvantages, lifestyle habits, dietary patterns, nu-
3 | RESULTS tritional habits, and cultural factors. This indicates that nurses
should assess obesity‐related risk factors for both males and
Table 1 shows a comparison of overweight or obesity and the risk females to prevent developing obesity or weight gain.
rates of T2DM by gender. BMI values of males were significantly This study revealed that a difference in gender according to the
higher than those of females (p < 0.01). Of the sample's population, risk of developing diabetes was not statistically significant. Ad-
72.1% of the males and 87.3% of the females were classified as ditionally, 61.7% of the males and 65.4% of the females were clas-
normal according to BMI, whereas 26.9% of the males and 12.7% of sified as low risk. The data obtained showed results similar to studies
the females fell into the overweight or obese category. Central conducted with university students in Northern Cyprus by Gezer,31
obesity was 20.0%; this was significantly higher in males than in in Turkey by Demirağ et al.28 and Çolak,32 in Jordan by Al‐Shudifat
females. According to FINDRISC, 61.7% of the males and 65.4% of et al.,33 in the United States by Hamman et al.,7 and in Poland by
the females were classified as low risk, whereas 29% of the males Morawiec et al.29 However, although the majority of male and female
and 11.3% of the females fell into the slightly elevated risk category. students were classified in the low‐risk group in the present study,
In all, 1.8% of the males and 2.5% of the females were classified as both females and males demonstrated low consumption of fruit and
high/very high risk. There were no significant differences between vegetables. Nurses should promote healthy food consumption in
males and females regarding the risk of developing T2DM. Ad- young adults, because an unhealthy diet is likely to increase the risk
ditionally, the rate of physical inactivity in females was found to be of obesity and T2DM in the long term. Additionally, females reported
statistically significantly higher than in males (39.2% and 54.8%, re- higher physical inactivity than males in the present study, which
spectively). Male students reported consuming fruit and vegetable correlated with the studies of Çolak32 and Moor et al.16 Enhancing
more frequently than females; however, no statistical significance motivation and self‐awareness of daily physical activity may help
was found. change physical activity behaviors.
4 | KES AND CAN CICEK

TABLE 1 Comparison of obesity and risk of type 2 diabetes mellitus (T2DM) according to gender (n = 800)

Female (n: 434) Male (n: 366) Total (n: 800) χ2 test p

Age group (years)

18–20 117 (27.0%) 80 (21.9%) 197 (24.6%) 2.783 p > 0.05

21–25 317 (73.0%) 286 (78.1%) 603 (75.4%)

BMI (kg/m2)

Normal (lower than 25.0 kg/m2) 379 (87.3%) 264 (72.1%) 663 (80.4%)
2
Overweight (25.0–29.9 kg/m ) 49 (11.3%) 95 (26.0%) 144 (18%) 29.564 p < 0.01
2
Obese (higher than 30.0 kg/m ) 6 (1.4%) 7 (1.9%) 13 (1.6%)

Waist circumference (cm)

Male < 94, female < 80 377 (58.9%) 263 (41.1%) 640 (80.0%)

Male 94–102, female 80–88 46 (10.6%) 91 (24.9%) 137 (17.1%) 29.564 p <0.01

Male > 102, female > 88 11 (2.5%) 12 (3.3%) 23 (2.9%)

Physical activity

Yes 153 (35.3%) 184 (50.3%) 337 (42.1%) 18.956 p<0.01

No 281 (64.7%) 182 (49.7%) 463 (57.9%)

Fruit and vegetable intake

Every day 174 (40.1%) 139 (38.0%) 313 (39.1%) 0.373 p > 0.05

Not every day 260 (59.9%) 227 (62.0%) 487 (60.9%)

Regular medication for hypertension

No 396 (91.2%) 323 (88.3%) 719 (89.9%) 1.647 p > 0.05

Yes 38 (8.8%) 43 (11.7%) 81 (10.1%)

a
History of high BG

No 377 (86.9%) 314 (45.4%) 691 (86.4%) 0.659 p > 0.05

Yes 57 (13.1%) 52 (14.2%) 109 (13.6%)

Diabetes in relatives

No 274 (63.1%) 239 (65.3%) 513 (64.1%)

Yes, grandparents, cousins, uncle, aunt 103 (23.7%) 85 (23.2%) 188 (23.5%) 0.608 p > 0.05

Yes, parents, siblings, son, daughter 57 (13.1%) 42 (11.5%) 99 (12.4%)

Total risk score (the risk of developing T2DM within 10 years)

<7 points: low (1%) 284 (65.4%) 226 (61.7%) 510 (63.7%) 1.535 p > 0.05

7–11 slightly elevated (4%) 121 (27.9%) 109 (29.8%) 230 (28.7%)

12–14 moderate (16%) 21(4.8%) 22 (6.0%) 43 (5.4%)

15–20 high/very high (33%) 8 (1.8%) 9 (2.5%) 17 (2.1%)

Abbreviations: BG, blood glucose; BMI, body mass index; FINDRISC, Finnish Diabetes Risk Score.
a
Previously measured high blood glucose.

The second and the third aims of the study were to explore the Moor et al.16 To the contrary, another study has shown no significant
mindful eating level according to gender, and whether there was a relationship between mindful eating and BMI.20 Assessing differ-
relationship between mindful eating, BMI, and the risk of T2DM ences between all study findings, may derive results from the eating
among young Turkish adults. The results of the present study in- pattern differences between the sample groups.
dicate higher overall mindful eating scores are associated with lower A few studies have examined the difference in MEQ‐30 scores
BMIs. These results correlate with previous research conducted by between male and female participants.35,36 Kose and Çıplak36 found
Mantzois et al.,34 Pintado‐Cucarella and Rodriguez‐Salgado,17 and no statistically significant difference in MEQ‐30 scores according to
KES AND CAN CICEK | 5

T A B L E 2 Comparison of mean scores

Female (n: 434), Male (n: 366),
on the MEQ‐30 according to Variable mean ± SD mean ± SD t p
gender (n = 800)
MEQ‐30

Disinhibition 3.11 ± 0.7 3.11 ± 0.7 −0.017 p > 0.05

Emotional eating 3.02 ± 0.9 3.30 ± 0.9 −4.368 p < 0.01

Eating control 3.62 ± 0.8 3.27 ± 0.7 6.197 p < 0.01

Eating discipline 2.80 ± 0.7 2.88 ± 0.7 −1.480 p > 0.05

Mindfulness 3.15 ± 0.5 3.07 ± 0.5 2.487 p < 0.05

Interferences 3.44 ± 0.8 3.31 ± 0.8 2.090 p < 0.05

Conscious nutrition 3.16 ± 0.5 3.08 ± 0.5 1.980 p < 0.05

Mean total score 3.19 ± 0.4 3.15 ± 0.3 0.832 p > 0.05

Abbreviation: MEQ‐30, Mindful Eating Questionnaire.

T A B L E 3 Correlations between the MEQ‐30, the BMI, and the results were obtained in a study with Finnish men and women in the
FINDRISC (n = 800) 25–64‐year age group by Konttinen et al.39 These are congruent
1 2 with our findings, which are results from using similar coping stra-
tegies to deal with different stressors.
(1) FINDRISC
The present study indicated that the Eating Control scores of
(2) BMI 0.376, p < 0.01 –
males were significantly higher than females. In contrast, Durukan
(3) Disinhibition −0.114, p < 0.01 −0.032, p > 0.05 and Gül37 found a significantly higher eating control subscale score
(4) Emotional eating −0.141, p < 0.01 −0.108, p < 0.01 of females. Moreover, Kose and Çıplak36 and Özkan and Bilici35
found no statistically significant difference in eating control scores
(5) Eating control −0.140, p < 0.01 −0.255, p < 0.01
according to gender. Comparing these different findings is extremely
(6) Eating discipline −0.079, p < 0.05 0.037, p > 0.05
challenging because the findings were heterogeneous, highlighting a
(7) Mindfulness −0.014, p > 0.05 0.007, p > 0.05 need for additional research to examine the difference between
(8) Interferences −0.095, p < 0.01 −0.067, p > 0.05 males and females in terms of their eating control skills.
One of the basic principles of mindful eating is reducing the
(9) Conscious nutrition −0.020, p > 0.05 −0.067, p > 0.05
speed of eating.18 Eating control is explained as one's ability to adjust
(10) MEQ‐30 −0.177, p < 0.01 −0.147, p < 0.01
eating speed and excessive food intake when eating.26 A systematic
Abbreviations: BMI, body mass index; FINDRISC, Finnish Diabetes Risk review and meta‐analysis indicated that fast eating is related to an
Score; MEQ‐30, Mindful Eating Questionnaire. increase in body weight and obesity.40 Another longitudinal study
similarly reported fast eating was correlated with weight increase—
increasing the risk of obesity by 4.40 times.41 One possible ex-
gender. Another study similarly indicated that there was no statis- planation for this might be that eating quickly could increase the
tically significant difference between female and male participants in intake of energy and decrease satiety which leads to overeating.40,41
35
terms of mean MEQ‐30 scores. Findings of this present study are Another possible explanation is that eating quickly may lead to in-
similar to previous studies.35,36 However, males had a significantly sulin sensitivity or insulin resistance, and a disrupted energy bal-
higher emotional eating subscale score than females, which corre- ance.40,41 In the MEQ‐30 scale used in this study, there are four
37 36
sponds with the studies of Durukan and Gül and Kose and Çıplak. items assessing eating control, where the content of three of these is
This may be because young males and females differ in coping concerned with determining eating speed.26 Thus, the result of the
strategies of stressful events. For example, young females use present study was partly consistent with previous studies.
emotion‐focused strategies to cope with stressful events, whereas The interferences subscale assesses the relationship between
males use more problem‐focused strategies.38 distractions and eating behaviors during the eating process.26 For
Emotional‐eating behavior is the excessive or constant con- example, research has reported that watching television or listening
sumption of food to cope with negative feelings or thoughts. In to music while eating increases consumption of high‐fat foods and
studies with university students by Moor et al.16 in the United States frequency of meals.18 We found that young females had a sig-
21
and Lazarevich et al. in Mexico, it was stated there was a significant nificantly higher interference subscale score than males. In contrast,
negative correlation between emotional eating and BMI. Similar Kose and Çıplak36 found a significantly higher interference subscale
6 | KES AND CAN CICEK

score of young males. This may be because young adults are dis- Mindful eating was associated with BMI and risk of developing
tracted during eating. T2DM in the young adult populations (aged 18–25 years).
To the best of our knowledge, this study was the first to in- Nurses should regularly screen weight changes and assess its
vestigate the association of mindful eating with the risk of devel- related factors in young adults, as well as organize health education
oping T2DM. Interventional studies showed data indicating that programs tailored to different gender groups. Mindful eating might
mindful eating‐based practices had a positive effect on the care improve eating patterns by increasing vegetable and fruit con-
outcomes of T2DM patients, but no studies were found presenting sumption and reducing intake of energy‐dense foods. Therefore, in-
data on how mindful eating affected the risk of T2DM.22,23 The clusion of mindful eating components into weight management
findings of this present study indicated that a decrease in the level of programs could promote decreased BMI and maintenance of glucose
mindful eating was associated with an increased risk of T2DM. One regulation in young adults. Future research should examine the ef-
possible explanation for this might be that better mindful eating fect of mindful eating interventions on BMI and the risk of devel-
skills may reduce diabetes risk factors such as obesity, and an un- oping T2DM.
healthy diet. This result suggests that better mindful eating skills may
help young adults develop more healthful eating patterns. Further CO N FLI CT O F I N TER E S TS
studies are needed to clarify the relationships between mindful The authors declare that there are no conflict of interests.
eating and the risk of developing T2DM among younger people and
culturally diverse groups. Our study outcome may contribute to A U T H OR C O N T R I B U T I ON S
nursing practice and research. Study conception and design: Duygu Kes and Saadet Can Cicek. Data
collection: Duygu Kes. Data analysis and interpretation: Duygu Kes and
Saadet Can Cicek. Drafting of the article: Duygu Kes and Saadet Can
4.1 | Methodological consideration Cicek. Critical revision of the article: Duygu Kes and Saadet Can Cicek.

According to the priori power analysis, this study had sufficient OR C ID

power to evaluate statistical significance. However, the present Duygu Kes https://orcid.org/0000-0003-0996-7915
study has several limitations. First, because of the difficulties of Saadet Can Cicek https://orcid.org/0000-0003-3087-983X
contacting students in online courses, a limited number of young
Turkish adults were included in the sample, therefore, limiting REFER E NC ES
the generalizability of the study. Additionally, the educational level 1. Poobalan A, Aucott L. Obesity among young adults in developing
was generally high. Selection bias of group differences would be a countries: a systematic overview. Curr Obes Rep. 2016;5(1):2‐13.
2. Peltzer K, Pengpid S, Samuels T, et al. Prevalence of overweight/
potential risk.
obesity and its associated factors among university students from
Additional study limitations include using waist circumference 22 countries. Int J Environ Res Public Health. 2014;11:7425‐7441.
and BMI values based on self‐reported data rather than objective 3. Pengpid S, Peltzer K. Prevalence of overweight/obesity and central
measurements. Additionally, in determining the risk of T2DM, scale obesity and its associated factors among a sample of university
students in India. Obes Res Clin Pract. 2014;8:e558‐e570.
instruments depend on self‐reporting and are used in addition to
4. Sa J, Cho BY, Chaput JP, et al. Sex and racial/ethnic differences in
invasive approaches. the prevalence of overweight and obesity among U.S. college stu-
In developing countries, valid and reliable instruments depen- dents, 2011–2015. J Am Coll Health. 2019;5:1‐9.
dent on self‐reporting are preferred, as they are cost‐effective and 5. Cam HH, Karasu F. A study of the frequency of overweight, obesity
and metabolic syndrome among university students. Turk J Public
reliable. In addition, IDF recommends that self‐reporting measure-
Health. 2019;17(3):294‐303 (Original work published in Turkish).
ment instruments should be used in determining the risk of diabetes 6. Dülger H, Mayda AS. Nutritional habits and obesity prevalence of
and followed by the blood glucose measurement of high‐risk parti- students at Bartin University Vocational School of Health Services.
cipants.42 Therefore, the data may not be refined enough to distin- DÜ Sağlık Bil Enst Derg. 2016;6(3):173‐177 (Original work published
in Turkish).
guish between gender groups. Although self‐report measures are
7. Hamman RF, Bell RA, Dabelea D, et al. The SEARCH for diabetes in
commonly used in the risk of developing T2DM, future longitudinal youth study: rationale, findings, and future directions. Diabetes Care.
studies or laboratory‐based experiments could examine relationships 2014;37(12):3336‐3344.
between mindful eating and glucose level. 8. Li KK, Concepcion RY, Lee H, et al. An examination of sex differ-
ences in relation to the eating habits and nutrient intakes of uni-
versity students. J Nutr Educ Behav. 2012;44(3):246‐250.
9. Amuta AO, Jacobs W, Barry AE, Popoola OA, Crosslin K. Gender
5 | C O N CL U S I O N S differences in type 2 diabetes risk perception, attitude, and pro-
tective health behaviors: a study of overweight and obese college
Our findings revealed that BMI and waist circumference values of students. Am J Health Educ. 2016;47(5):315‐323.
10. Ansari WE, Suominen S, Samara A. Eating habits and dietary intake:
young Turkish males were significantly higher than those of females.
is adherence to dietary guidelines associated with importance of
Additionally, there were no significant differences between young healthy eating among undergraduate university students in Finland?
Turkish males and females regarding the risk of developing T2DM. Cent Eur J Public Health. 2015;23(4):306‐313.
KES AND CAN CICEK | 7

11. Gan WY, Mohd Nasir MT, Zalilah MS, Hazizi AS. Differences in 29. Morawiec R, Janikowski K, Zawisza J, Lelonek M. StudHeart–diabetes
eating behaviours, dietary ıntake and body weight status between mellitus t.2 risk factors in senior medical students. Cent Eur J Med.
male and female Malaysian university students. Malays J Nutr. 2011; 2013;8(5):608‐617.
17(2):213‐228. 30. Al‐Nakeeb Y, Lyons M, Collins P, et al. Obesity, physical activity
12. Hernandez DC, Reesor LM, Murillo R. Food insecurity and adult and sedentary behavior amongst British and Saudi Youth: a cross‐
overweight/obesity: gender and race/ethnic disparities. Appetite. cultural study. Int J Environ Res Public Health. 2012;9(4):
2017;1(117):373‐378. 1490‐1506.
13. Tsai SA, Lv N, Xiao L, Ma J. Gender differences in weight‐related 31. Gezer C. The assesment of relatİon between waist/height ratio and
attitudes and behaviors among overweight and obese adults in the type 2 diabetes risk among nursing students. J Food Health Sci. 2017;
United States. Am J Mens Health. 2014;10(5):389‐398. 3(4):141‐149 (Original work published in Turkish).
14. Yuan Y, Li F, Meng P, You J, Wu M, Li S. Gender difference on the 32. Çolak M. Physical activity levels and type 2 diabetes risk scores of
association between dietary patterns and obesity in Chinese middle‐ university students. Stud Ethno‐Med. 2015;9(3):401‐409.
aged and elderly populations. Nutrients. 2016;8(8):448. 33. Al‐Shudifat AE, Al‐Shdaifat A, Al‐Abdouh AA. Diabetes risk score in
15. Liu J, Park YM, Berkowitz SA, Hu Q, Han K, Ortaglia A. Gender a young student population in Jordan: a cross‐sectional study.
differences in the association between food insecurity and insulin J Diabetes Res. 2017;2017:8290710.
resistance among U.S. adults: National Health and Nutrition Ex- 34. Mantzios M, Egan H, Bahia H, Hussain M, Keyt R. How does grazing
amination Survey, 2005–2010. Ann Epidemiol. 2015;25(9):643‐648. relate to body mass index, self‐compassion, mindfulness and mindful
16. Moor KR, Scott AJ, McIntosh D. Mindful eating and its relationship eating in a student population? Health Psychol Open. 2018;5(1):
to body mass index and physical activity among university students. 2055102918762701.
Mindfulness. 2013;4(3):269‐274. 35. Özkan N, Bilici S. Are anthropometric measurements an indicator of
17. Pintado‐Cucarella S, Rodríguez‐Salgado P. Mindful eating and its intuitive and mindful eating? Eat Weight Disord. 2020. https://doi.
relationship with body mass index, binge eating, anxiety and nega- org/10.1007/s40519‐020‐00904‐9
tive affect. J Behav Health Soc. 2016;8(2):19‐24. 36. Kose G, Çıplak ME. Does mindful eating have a relationship with
18. Monroe JT. Mindful eating: principles and practice. Am J Lifestyle gender, body mass index and health promoting lifestyle? Prog Nutr.
Med. 2015;9(3):217‐220. 2020;22(2):528‐535.
19. Framson C, Kristal AR, Schenk J, Littman AJ, Zeliadt S, Benitez D. 37. Durukan A, Gül A. Mindful eating: differences of generations and
Development and validation of the mindful eating questionnaire. relationship of mindful eating with BMI. Int J Gastron Food Sci. 2019;
J Am Diet Assoc. 2009;109(8):1439‐1444. 18:1001722.
20. Anderson LM, Reilly EE, Schaumberg K, Dmochowski S, 38. Meléndez CJ, Mayordomo T, Sancho P, Tomás JM. Coping strate-
Anderson DA. Contributions of mindful eating, intuitive eating, and gies: gender differences and development throughout life span. Span
restraint to BMI, disordered eating, and meal consumption in col- J Psychol. 2012;15(3):1089‐1098.
lege students. Eat Weight Disord. 2016;21(1):83‐90. 39. Konttinen H, Männistö S, Sarlio‐Lähteenkorva S, Silventoinen K,
21. Lazarevich I, Irigoyen Camacho ME, Velázquez‐Alva MDC, Haukkala A. Emotional eating, depressive symptoms and self‐
Zepeda Zepeda M. Relationship among obesity, depression, and reported food consumption. A population‐based study. Appetite.
emotional eating in young adults. Appetite. 2016;1(107):639‐644. 2010;54(3):473‐479.
22. Carrière K, Khoury B, Günak MM, Knäuper B. Mindfulness‐based 40. Ohkuma T, Hirakawa Y, Nakamura U, Kiyohara Y, Kitazono T,
interventions for weight loss: a systematic review and meta‐ Ninomiya T. Association between eating rate and obesity: a
analysis. Obes Rev. 2018;19(2):164‐177. systematic review and meta‐analysis. Int J Obes. 2015;39(11):
23. Miller CK, Kristeller JL, Headings A, Nagaraja H. Comparison of a 1589‐1596.
mindful eating ıntervention to a diabetes self‐management ınter- 41. Yamane M, Ekuni D, Mizutani S, et al. Relationships between eating
vention among adults with type 2 diabetes: a randomized controlled quickly and weight gain in Japanese university students: a long-
trial. Health Educ Behav. 2014;41(2):145‐154. itudinal study. Obesity. 2014;22(10):2262‐2266.
24. Faul F, Erdfelder E, Buchner A, Lan A. Statistical power analyses 42. International Diabetes Federation. November 10, 2016. https://www.
using G*Power 3.1: tests for correlation and regression analyses. idf.org/e‐library/guidelines/128‐idf‐clinical‐practice‐recommendations‐
Behav Res Methods. 2009;41(4):1149‐1160. for‐managing‐type‐2‐diabetes‐in‐primary‐care.html
25. Cohen J. A power primer. Psychol Bull. 1992;112(1):155‐159.
26. Kose G, Tayfur M, Birincioğlu İ, Dönmez A. Adaptation study of the
Mindful Eating Questionnaire (MEQ) into Turkish. J Cogn Behav
Psychother Res. 2016;5(3):125‐134.
27. Lindström J, Tuomilehto J. The diabetes risk score: a practical tool How to cite this article: Kes D, Can Cicek S. Mindful eating,
to predict type 2 diabetes risk. Diabetes Care. 2003;26(3):725‐731. obesity, and risk of type 2 diabetes in university students: a
28. Demirağ H, Hintistan H, Tuncay B, Cin A. The vocational school of
cross‐sectional study. Nursing Forum. 2021;1–7.
health services students' determination of diabetes risks. J Inonu
Univ Health Services Vocation School. 2018;6(2):25‐35 (Original work
https://doi.org/10.1111/nuf.12561
published in Turkish).