Measurement properties of instruments assessing mindful eating in adults: A COSMIN systematic review

Mindful eating is a promising approach to improving individuals' relationships with food, with evidence of behavioral and health benefits. However, there is no consensus on the most suitable instrument to assess it. This study aimed to identify self-report measures of mindful eating in adults, appraise their measurement properties, and provide recommendations for their use. This systematic review, registered in PROSPERO (CRD42022337733), adhered to the COSMIN methodology and PRISMA-COSMIN guidelines. Seven databases were searched up to October 2025 for studies on self-reported mindful eating instruments in adults. Measurement properties were assessed with the COSMIN risk of bias checklist and criteria for good measurement properties. The quality of evidence was classified using a modified GRADE approach. Twenty-five studies were included, describing seven original instruments and 19 cross-cultural versions. None met the criteria for recommendation. For sixteen, conclusions could not be drawn due to insufficient "high" quality evidence, and ten were contraindicated because of "high" quality evidence for "insufficient" results, particularly for structural validity or internal consistency. The Mindful Eating Inventory (MEI) showed the most promising evidence. Overall, the instrument demonstrated sufficient results for all measurement properties assessed, although the quality of evidence varied: very low (relevance and measurement invariance), low (comprehensibility and reliability), moderate (construct validity), and high (structural validity and internal consistency). There is a need for methodologically rigorous research that adheres to COSMIN standards to strengthen the psychometric evidence and ensure the validity, reliability, and responsiveness of mindful eating assessment tools.