Validation of the Positive Eating Scale in Chinese University Students and Its Associations with Mental Health and Eating Behaviors

Abstract

Positive eating behaviors may be linked to improved health outcomes, but reliable assessment tools are scarce. This study aims to translate the Positive Eating Scale (PES) into Chinese (PES-C), culturally adapt it, and examine its psychometric properties and its relationship with psychological symptoms among Chinese college students. A two-stage cross-sectional study was conducted from October 2024 to April 2025. A total of 800 valid questionnaires were collected in Stage 1 and 1882 in Stage 2. PES-C showed good structural validity (CFI = 0.991, RMSEA = 0.067) and high internal agreement (Cronbach α = 0.963), with measurement invariance established across gender and ethnicity. Correlation analysis showed that PES-C score was significantly negatively correlated with depression (PHQ-9, r = −0.24) and anxiety (GAD-7, r = −0.22), positively correlated with the frequency of vegetable consumption (r = 0.13–0.18), and negatively correlated with beverage consumption (r = −0.01–−0.17). These findings indicate that positive eating attitudes help improve psychological symptoms and may also affect food choices. PES-C is a dependable and effective tool for assessing the eating behaviors of Chinese university students, offering both theoretical and practical support for campus nutrition and mental health promotion programs.