RESEARCH Research and Professional Briefs Faster Self-Reported Speed of Eating Is Related to Higher Body Mass Index in a Nationwide Survey of Middle-Aged Women SOOK LING LEONG, MSc; CLARA MADDEN, MSc; ANDREW GRAY; DEBRA WATERS, PhD; CAROLINE HORWATH, PhD ABSTRACT This study is the first nationwide population survey to explore the association between speed of eating and de- gree of obesity. The objective was to cross-sectionally examine the relationship between self-reported speed of eating and body mass index (BMI; calculated as kg/m 2 ) in a nationally representative sample of New Zealand women. In May 2009, a sample of 2,500 New Zealand women aged 40 to 50 years was randomly selected from the nationwide electoral rolls. A 66% participation rate was achieved. Potential participants were mailed a self- administered questionnaire containing questions on self- reported speed of eating, demographics, health condi- tions, menopause status, physical activity, height, and weight. Univariate models were used to examine the as- sociations between demographic, health and behavioral variables, and BMI, while a multivariate model was de- veloped to investigate the relationship between self-re- ported speed of eating and BMI. After adjusting for age, smoking status, menopause status, thyroid condition, ethnicity, socioeconomic status, and physical activity, BMI statistically significantly increased by 2.8% (95% confidence interval: 1.5% to 4.1%; P0.001) for each cat- egory increase in self-reported speed of eating. Although the direction of causality requires confirmation in longi- tudinal and randomized intervention studies, the results suggest that faster eating is associated with higher BMI in middle-aged women. J Am Diet Assoc. 2011;111:1192-1197. S peed of eating has long been of interest as a factor potentially contributing to the development of obe- sity. However, research findings in this area are inconsistent. Studies in a laboratory setting using careful measurements of eating rate have compared obese par- ticipants with normal weight controls. Among obese par- ticipants, a higher eating rate was reported for a Swedish dish of potatoes/onions/meat (1), pasta or yogurt (2), and chocolate pudding (3); however, eating rate was not sub- stantially different for bread with the participant’s pre- ferred filling (4). A recent study has demonstrated that across a wide variety of foods, eating rate is positively associated with the amount of food eaten (5). Studies examining the effects of various strategies intended to slow the rate of eating (eg, pausing between bites (6), putting down utensils between bites, or cutting food into smaller portions (7) have also produced inconsistent re- sults. An experimental study conducted among 30 young women reported that the combination of taking small bites, pausing between bites, and chewing thoroughly decreased the speed of eating and energy intake and enhanced satiation (6). However, two studies (8,9) re- ported that although there was a decrease in eating rate with smaller bites (8) and pauses within meals (9), eating slowly did not reduce energy intake or enhance satiation (8,9). One behavioral weight-loss program incorporating recommendations for slow eating reported that obese women substantially decreased their rate of eating dur- ing treatment (7). Although slower speed of eating was associated with weight loss after 28 weeks, slower eating was not maintained at week 41, and the association be- tween changes in rate of eating and weight was no longer statistically significant (7). Few epidemiological studies have examined the associ- ation between speed of eating and obesity. In the only available prospective study, male fire service personnel (n=438) who reported faster eating rates gained more weight over 7 years (10). To date, only three cross-sec- tional studies have examined the relationship between speed of eating and body mass index (BMI; calculated as kg/m 2 ) in healthy adult populations (11-13). All three studies were conducted among Japanese subjects and reported that faster eating was positively associated with BMI. A small study (n=122) of older Spanish adults re- ported that normal-weight subjects spent a longer time eating their breakfast than obese subjects (14). In a study of Japanese patients with diabetes or hyperlipidemia, faster eating was associated with obesity in men but not women (15). These studies relied on self-rated speed of S. L. Leong and C. Madden are research assistants and postgraduate students and C. Horwath is a senior lec- turer, Department of Human Nutrition, A. Gray is a biostatistician, Department of Preventive and Social Medicine, and D. Waters is a senior lecturer, Depart- ment of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand. Address correspondence to: Caroline Horwath, PhD, Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, New Zealand 9054. E-mail: caroline.matthaei@otago.ac.nz Manuscript accepted: March 24, 2011. Copyright © 2011 by the American Dietetic Association. 0002-8223/$36.00 doi: 10.1016/j.jada.2011.05.012 1192 Journal of the AMERICAN DIETETIC ASSOCIATION © 2011 by the American Dietetic Association