Food cue reactivity and craving predict eating and weight gain: a meta-analytic review

Intranasal oxytocin reduces attentional bias to food stimuli

Attentional biases to food-related stimuli have been demonstrated in response to hunger as well as during restrained eating. Such biases are often associated with obesity, but healthy-weight individuals who do not self-report hunger have also demonstrated attentional biases to stimuli signalling food using laboratory-based cognitive tasks. Levels of the anorectic neuropeptide oxytocin are elevated by food intake and, when administered intranasally, oxytocin inhibits food intake in the laboratory. To investigate whether oxytocin can affect appetite via an action on attentional processes, 40 adults (29 women; mean age 24.0 years old) self-administered 24 IU of oxytocin or placebo intranasally. Forty minutes after administration, participants ate a small snack to maintain alertness and ameliorate deprivation-induced hunger before starting a computerized dot-probe attentional bias task that presented 180 trials of paired visual stimuli comprising neutral, food, social and/or romantic images (500 ms presentation time). Reaction times to probe stimuli that appeared after the offset of the visual images indicated a significant attentional bias to food pictures after placebo; this effect was significantly attenuated by oxytocin, p < .001. The effect of oxytocin on attentional bias to the food pictures was not altered by the type of stimulus paired with the food image, and was independent of BMI, age, sex, self-rated eating behaviour, and self-reported parental bonding; however, the effect was modulated by self-reported food cravings and trait stress. The findings support and extend previous work which has suggested that oxytocin can counteract attentional biases to food-related stimuli in a sample with anorexia by demonstrating the same effect for the first time in a cohort who do not have an eating disorder.

Exploring the wider benefits of semaglutide treatment in obesity: insight from the STEP program

Obesity negatively impacts patients' health-related quality of life (QOL) and is associated with a range of complications such as type 2 diabetes (T2D), cardiovascular disease, and sleep apnea, alongside decreased physical function, mobility, and control of eating. The Semaglutide Treatment Effect in People with obesity (STEP) trials compared once-weekly subcutaneous semaglutide 2.4 mg with placebo in adults with overweight or obesity, with or without T2D. This article reviews the effects of semaglutide 2.4 mg on QOL, control of eating, and body composition. Weight-related QOL was assessed using the Impact of Weight on Quality of Life-Lite Clinical Trials Version (IWQOL-Lite-CT), and health-related QOL was assessed with the 36-item Short Form Health Survey version 2 (SF-36v2®). Control of eating was evaluated using the Control of Eating questionnaire in a subgroup of participants in one trial. Body composition was evaluated via dual-energy x-ray absorptiometry in another trial, in a subgroup of participants with a body mass index of ≤40 kg/m². All IWQOL-Lite-CT scores (Physical Function, Physical, Psychosocial, and Total Score) improved with semaglutide 2.4 mg significantly more than with placebo. Across the trials, changes in SF-36v2 scores were generally in favor of semaglutide versus placebo. There were significant improvements in all Control of Eating questionnaire domains (craving control, craving for savory, craving for sweet, and positive mood) up to week 52 with semaglutide treatment versus placebo, with improvements in craving control and craving for savory remaining significantly different at week 104. Body composition findings showed that reductions in total fat mass were greater with semaglutide versus placebo. These findings highlight the wider benefits that patients can experience with once-weekly subcutaneous semaglutide 2.4 mg, in addition to weight loss, including improvements in patients' wellbeing and ability to perform daily activities. Taken together, these are important considerations for primary care when incorporating pharmacotherapy for weight management.

External food cue responsiveness and emotional eating in adolescents: A multimethod study

Eating in response to external food cues (i.e., external eating) and internal emotional experiences (i.e., emotional eating) are associated with obesity. While external and emotional eating co-occur, little is known about how external food cue responsiveness may interact with internal emotional cues to influence eating episodes in adolescents. The current study examined how trait-level external food cue responsiveness modulates momentary associations between affective states and eating in adolescents. Participants were drawn from a prior study of siblings (N = 78; ages 13-17) who completed an ecological momentary assessment protocol to assess eating episodes and affective states. External food cue responsiveness was determined by comparing energy consumption following presentation of an appetizing food (pizza) on one day and a control activity (reading) on another day. Generalized linear mixed models examined positive and negative affective states, cue responsiveness, and their interactions as predictors of the likelihood of eating. The relationship between affective states and likelihood of eating was stronger among adolescents with higher versus lower external food cue responsiveness. Among adolescents with higher cue responsiveness, endorsing negative affect was associated with a lower likelihood of eating, whereas endorsing positive affect was associated with a higher likelihood of eating (within-person effects). Findings suggest that high sensitivity to external food cues and greater proclivity for emotional eating may be likely to coincide such that any cue, internal or external, is likely to disrupt sensitivity to internal hunger and satiety signals. Future studies are needed to elucidate how sensitivities to internal and external cues may interact to influence obesity risk.

Disentangling craving- and valence-related brain responses to smoking cues in individuals with nicotine use disorder

Tobacco smoking is one of the leading causes of preventable death and disease worldwide. Most smokers want to quit, but relapse rates are high. To improve current smoking cessation treatments, a better understanding of the underlying mechanisms of nicotine dependence and related craving behaviour is needed. Studies on cue‐driven cigarette craving have been a particularly useful tool for investigating the neural mechanisms of drug craving. Here, functional neuroimaging studies in humans have identified a core network of craving‐related brain responses to smoking cues that comprises of amygdala, anterior cingulate cortex, orbitofrontal cortex, posterior cingulate cortex and ventral striatum. However, most functional Magnetic Resonance Imaging (fMRI) cue‐reactivity studies do not adjust their stimuli for emotional valence, a factor assumed to confound craving‐related brain responses to smoking cues. Here, we investigated the influence of emotional valence on key addiction brain areas by disentangling craving‐ and valence‐related brain responses with parametric modulators in 32 smokers. For one of the suggested key regions for addiction, the amygdala, we observed significantly stronger brain responses to the valence aspect of the presented images than to the craving aspect. Our results emphasize the need for carefully selecting stimulus material for cue‐reactivity paradigms, in particular with respect to emotional valence. Further, they can help designing future research on teasing apart the diverse psychological dimensions that comprise nicotine dependence and, therefore, can lead to a more precise mapping of craving‐associated brain areas, an important step towards more tailored smoking cessation treatments.

Promoting Fruit and Vegetable Consumption for Childhood Obesity Prevention

Currently, food marketing for unhealthy foods is omnipresent. Foods high in fat, salt, and sugar (HFSS) are advertised intensively on several media platforms, including digital platforms that are increasingly used by children, such as social media, and can be bought almost everywhere. This could contribute to the obesity epidemic that we are facing. As the majority of children and adolescents do not eat the recommended amount of fruits and vegetables (F&V), which leads to chronic diseases, we need to change the obesogenic environment to a healthogenic environment. Reducing the marketing of energy-dense snacks to children and increasing the promotion of healthier foods, such as fruits and vegetables, may be an effective and necessary instrument to improve the dietary intake of children and reduce the risk of their experiencing some chronic diseases later in life. With this focused narrative review, we provide an overview of how children and adolescents react to food promotions and how food promotional efforts might be a useful tool to increase the attractiveness of fruit and vegetables. This review therefore contributes to the question of how changing the advertising and media environment of children and adolescents could help create a world where the healthy choice is the easier choice, which would reduce childhood obesity and improve children’s health, as well as to make the food system more sustainable.

The transdiagnostic role of food craving: An application of substance use models

Food craving is a transdiagnostic process underlying clinically significant disordered eating behaviors and eating disorder diagnoses. However, the lack of literature examining the role of food craving as it relates to the full spectrum of disordered eating behaviors, including restrictive eating and compensatory behaviors, may be due to the traditional definition of food craving as the desire to consume particular foods. Applying motivational models of substance use craving to food craving may help to explain inconsistencies within existing literature. Three motivational models of craving from the substance use literature may be particularly applicable to (1) provide a clear definition of food craving as a motivational process, (2) understand the role of that motivational process as it underlies the full spectrum of disordered eating behavioral patterns, (3) provide insight for the most appropriate ways in which to accurately assess food craving, and (4) establish ways in which food craving may represent a useful motivational process to target in eating disorder treatments. This narrative review describes three models of substance use craving and provides suggestions for utilizing motivational models to understand the transdiagnostic role of food craving as it relates to the full spectrum of disordered eating behaviors in both research and clinical work.

Associations between State-Level Obesity Rates, Engagement with Food Brands on Social Media, and Hashtag Usage

Food advertisement exposure is associated with increased caloric intake, but little is known about food/beverage placements in the digital media environment. We aimed to examine the correlation between the number of people who follow food and beverage brand social media accounts (i.e., user engagement) and state-level obesity rates; quantify social media followers' use of "healthy" vs. "unhealthy" hashtags; and analyze the relationship between user engagement and hashtag usage. We identified the 26 fast-food and beverage brands with the highest advertising expenditures and used Demographics Pro to determine the characteristics of social media users amongst the 26 brands. A series of regression analyses were conducted that related the mean percentage of brand followers and state-level obesity rates. We then identified 733 hashtags on Instagram and 703 hashtags on Twitter, coding them as "healthy", "unhealthy", "neutral", or "unrelated to health". Intercoder reliability was established using ReCal2, which indicated a 90% agreement between coders. Finally, we conducted ANCOVA to examine the relationship between the mean percentage of brand followers and their hashtag usage. There was a significant, positive correlation between the state-level obesity rate and the mean percentage of followers of sugary drink or fast-food brands on Instagram and Twitter, but such a correlation between obesity and low-calorie drink brand followers was only found on Twitter. Our findings illustrate the relationship between the social media food environment and obesity rates in the United States. Given the high rates of engagement with food brands on social media, policies should limit digital advertisements featuring fast-food, sugary drink, and low-calorie drink brands.

The ironic effects of dietary restraint in situations that undermine self-regulation

Dietary restraint, defined as the cognitive effort to restrict eating, can paradoxically make individuals more susceptible to unhealthy eating when their ability to self-regulate is threatened. Past experiments have found that, in situations that elicit low self-control and/or unhealthy cravings, participants with higher dietary restraint eat more than those with lower restraint. However, these relationships have never been examined in a free-living environment. The current daily diary study examined if dietary restraint would exacerbate the associations between poor self-control and unhealthy cravings with overconsumption, namely, eating more than usual and binge eating. College women (N = 121, M age = 19) reported their restrained eating behavior and completed seven daily surveys. Multilevel analyses showed a significant interaction between dietary restraint and daily self-control on eating more than usual (b = -0.13, p = .001) and binge eating (b = -0.22, p < .001). Lower daily self-control was associated with eating more than usual and with more binge eating that day, but only among women with higher dietary restraint. Dietary restraint also moderated the effect of cravings on eating more than usual (b = 0.10, p = .007); this relationship was stronger for women with higher restraint. Stronger cravings were associated with more binge eating regardless of restraint. Results suggest that situations that undermine self-control are more strongly associated with overeating among those with higher dietary restraint. Findings can inform strategies to reduce overconsumption among restrained eaters.

Factors modulating the incubation of drug and non-drug craving and their clinical implications

It was suggested in 1986 that cue-induced cocaine craving increases progressively during early abstinence and remains high during extended periods of time. Clinical evidence now supports this hypothesis and that this increase is not specific to cocaine but rather generalize across several drugs of abuse. Investigators have identified an analogous incubation phenomenon in rodents, in which time-dependent increases in cue-induced drug seeking are observed after abstinence from intravenous drug or palatable food self-administration. Incubation of craving is susceptible to variation in magnitude as a function of biological and/or the environmental circumstances surrounding the individual. During the last decade, the neurobiological correlates of the modulatory role of biological (sex, age, genetic factors) and environmental factors (environmental enrichment and physical exercise, sleep architecture, acute and chronic stress, abstinence reinforcement procedures) on incubation of drug craving has been investigated. In this review, we summarized the behavioral procedures adopted, the key underlying neurobiological correlates and clinical implications of these studies.

Brain Responses to High-Calorie Visual Food Cues in Individuals with Normal-Weight or Obesity: An Activation Likelihood Estimation Meta-Analysis

Overconsumption of high-calorie or unhealthy foods commonly leads to weight gain. Understanding people’s neural responses to high-calorie food cues might help to develop better interventions for preventing or reducing overeating and weight gain. In this review, we conducted a coordinate-based meta-analysis of functional magnetic resonance imaging studies of viewing high-calorie food cues in both normal-weight people and people with obesity. Electronic databases were searched for relevant articles, retrieving 59 eligible studies containing 2410 unique participants. The results of an activation likelihood estimation indicate large clusters in a range of structures, including the orbitofrontal cortex (OFC), amygdala, insula/frontal operculum, culmen, as well as the middle occipital gyrus, lingual gyrus, and fusiform gyrus. Conjunction analysis suggested that both normal-weight people and people with obesity activated OFC, supporting that the two groups share common neural substrates of reward processing when viewing high-calorie food cues. The contrast analyses did not show significant activations when comparing obesity with normal-weight. Together, these results provide new important evidence for the neural mechanism underlying high-calorie food cues processing, and new insights into common and distinct brain activations of viewing high-calorie food cues between people with obesity and normal-weight people.

Agricultural policy and societal factors influence patients' ability to follow a healthy diet

•

Cardiovascular and cardiometabolic diseases are largely preventable, and are propagated by a poor diet.

•

Poor diet may be due to a lack of supply and access to healthy foods, agricultural subsidies, and marketing.

•

Improving national dietary intake starts with enhancing dietary guidelines, enacting legislative changes to optimize agricultural subsidies and food advertising, and incentivizing a plant-forward diet.

Visual cues associated with sweet taste increase short-term eating and grab attention in healthy volunteers

Most studies that examine responses to food cues use images of actual foods as stimuli. Since foods are rewarding in multiple ways, it then becomes difficult to try and partial out the role of the importance of different aspects of food reward. Here we aimed to evaluate the impact of novel visual cues specifically associated with the immediate sensory reward from a liked sweet taste. In the training phase, one visual cue (CSsweet) was associated with the experience of sweet taste (10%sucrose) and a second, control cue (CSneutral) with a neutral taste (artificial saliva) using a disguised training procedure. In Experiment 1, participants (n = 45) were given an ad libitum snack intake test 30 min post-training, either labelled with CSsweet or CSneutral. Total caloric consumption was significantly higher in the CSsweet (650 ± 47 kcal) than CSneutral (477 ± 45 kcal) condition, but ratings of liking for the snacks did not differ significantly between conditions. In Experiment 2, participants (n = 80) exhibited an overall attentional bias (22.1 ± 9.9 ms) for the CSsweet relative to CSneutral cue (assessed using a dot-probe task), however rated liking for the CSsweet did not change significantly after cue-sweet training. Likewise, measures of expected satiety for drinks labelled with CSsweet did not differ significantly from CSneutral. Overall these two experiments provide evidence that associations between neutral visual cues and the experience of a liked sweet taste leads to cue-potentiated eating in the presence of the CSsweet cue. With no evidence that cue-sweet training altered rated liking for the visual cues, and in keeping with extant literature on the dissociation of hedonic and rewarding properties of food rewards, we propose this potentiation effect to reflect increased incentive salience.

Striatal Dopamine Transporter Availability Is Not Associated with Food Craving in Lean and Obese Humans; a Molecular Imaging Study

Brain dopamine signaling is essential for the motivation to eat, and obesity is associated with altered dopaminergic signaling and increased food craving. We used molecular neuroimaging to explore whether striatal dopamine transporter (DAT) availability is associated with craving as measured with the General Food Craving Questionnaire-Trait (G-FCQ-T). We here show that humans with obesity (n = 34) experienced significantly more craving for food compared with lean subjects (n = 32), but food craving did not correlate significantly with striatal DAT availability as assessed with ¹²³I-FP-CIT single-photon emission computed tomography. We conclude that food craving is increased in obesity, but the scores for food craving are not related to changes in striatal DAT availability.

Influence of visual food cues on autonomic activity and craving

In this study, we tested the hypothesis that autonomic control of the stomach is related to craving and is modulated by visual food cues. Twenty-nine healthy human participants were shown pictures of either high- or low-appeal food, as well as non-food pictures, and were asked to rate how much they wanted to eat each item using a 7-point Likert scale. Simultaneously, the electrogastrogram, electrocardiogram, electrodermal activity, respiration rate, and pupil diameter were recorded. After the ingestion of a 500-kcal liquid meal, participants were asked to perform the task a second time. Despite changes in craving ratings, we did not find changes in the amplitude of the gastric rhythm, but we found increases in pupil diameter for the high appeal food pictures. Moreover, craving ratings were mostly related to increases in pupil and tonic electrodermal activity, compatible with an increase in arousal and a heightened motivational response to food.

Social reward from giving food to others affects food craving and brain potentials: An imagery-based event-related potential study

The interactions between social and eating behaviors can be quite pronounced and are mediated by overlapping neural circuits. The present event-related potential study tested whether the imagery of a specific prosocial behavior (giving chocolates to grateful children) can influence food cue reactivity. A total of 92 females (mean age = 23.5 years) were randomly assigned to one of three guided imagery conditions. The participants listened to an audio recording and were instructed to imagine one of three possible scenes; giving 30 M&Ms to children, eating 30 M&Ms, or sorting 30 marbles. Directly after the imagery task, the participants were presented with images of M&Ms and marbles while their electroencephalogram was recorded. We examined the Late Positive Potential (LPP) across a fronto-central and a parieto-occipital cluster, M&M craving, and subsequent consumption of (real) M&Ms. The mental imagery of offering M&Ms to children was associated with lower M&M craving and higher fronto-central LPP amplitudes (300-600 ms after picture onset) compared to the other imagery conditions. The consumption of M&Ms did not differ between the groups. The LPP is sensitive to the implementation of craving regulation strategies. Furthermore, heightened LPPs are reliably observed in response to motivationally significant stimuli, conflict, and social context. Future studies are needed to specify the specific psychological processes that are associated with the observed LPP effect. In conclusion, this study demonstrated that mental imagery of receiving a social reward from giving food to others can change components of food cue reactivity in healthy females.

A meta-analysis of the relationship between eating restraint, impaired cognitive control and cognitive bias to food in non-clinical samples

AIM

Food restriction is argued to be a precursor for unhealthy preoccupation with food, possibly leading to the development of an eating disorder. We updated previous meta-analyses that examined the relationship between eating restraint and deficits in either general or food-related attentional and inhibitory control. We hypothesized that inconsistencies in the literature around eating restraint, impaired cognitive control, impulsivity and cognitive biases for food could be attributed to the scale used to measure eating restraint.

METHOD

A (preregistered) subgroup meta-analysis examined whether patterns of impaired cognitive control and cognitive bias for food in predominantly healthy (non-clinical) samples differed as a function of the scale used to measure eating restraint. A series of exploratory meta-analyses were carried out for specific attentional bias tasks. In total 57 datasets were included.

RESULTS

The subgroup analysis did not provide evidence that the relationship between eating restraint and impaired or biased cognitions differed significantly as a function of restraint scale. Heterogeneity across studies was high. When examining specific attentional bias tasks there was no evidence that increased eating restraint was associated with increased attentional bias or distraction by food cues, regardless of which scale was used to measure eating restraint.

CONCLUSIONS

There is little experimental evidence for the common narrative that increased eating restraint is related to impaired cognitive control generally or increased cognitive bias for food, in non-clinical samples.

Love, joy and necessity - A phenomenological study of food and meals in adolescents and young adults with cancer receiving high-emetogenic chemotherapy

PURPOSE

This study explored how the phenomenon of meals appeared in the interrelationship between adolescents and young adults (AYAs) receiving high-emetogenic chemotherapy, their next of kin and health professionals in the clinical setting.

METHOD

Data were collected by 140 h of participant observation conducted to gain insights into the nature of how meals appeared in the interrelationship between 12 AYAs (age 15-29 years), their next-of-kin and health professionals. The AYAs were patients with oncological and haematological diseases recruited from three university hospital departments. Data analysis was guided by van Manen's hermeneutic-phenomenological approach.

RESULTS

The essential meaning of the phenomenon may be characterized by the overarching theme; 'Seeking the joy of meals in the shadow of treatment' and the following three themes: 'Meals as a necessary evil' (AYAs); 'Meals as a matter of love' (next-of-kin); and 'Meals in the shadow of medical treatment' (health professionals).

CONCLUSIONS

Meals is a multi-facetted and complex phenomenon that has different meanings to AYAs, next-of-kin and health professionals. To the AYAs, meals emerged as a necessary evil in connection with which urges to eat occurred as glimpses of desire. Prominent feelings of powerlessness and food as love were highlighted by the next-of-kin, whereas food and meals appeared secondary to treatment for health professionals, reflecting the traditional biomedical paradigm. The findings revealed that adopting a holistic approach to AYAs concerning meals can have the potential to increase their food intake.

Daily associations between alcohol and sweets craving and consumption in early AUD recovery: Results from an ecological momentary assessment study

INTRODUCTION

Alcohol cravings can predict relapse in persons with alcohol use disorder (AUD). Consuming sweets is a commonly recommend strategy to quell alcohol cravings in early recovery from AUD, yet research is equivocal on whether consuming sweets mitigates alcohol cravings or relapse risk. The current study used ecological momentary assessment (EMA) data to examine real-time alcohol cravings, sweet cravings, and consumption of sweets among adults in early recovery from AUD.

METHODS

We used EMA methods to follow 25 adults (n = 14 women, 56%; M. age 40, S.D. 10.68) recently discharged from a partial hospitalization program for AUD for 21 days. Prompts were sent to the participants for completion four times per day via a mobile app. EMA data were disaggregated prior to analysis to examine between- and within-person effects. A series of three mixed linear models tested: 1) the contemporaneous effect of sweet and alcohol cravings, 2) alcohol cravings predicting sweet consumption later in the day, and 3) sweet consumption predicting alcohol craving later in the day.

RESULTS

The results of the first model revealed alcohol cravings were associated with sweet cravings early in recovery. In the second model, no effect occurred between alcohol cravings earlier in the day predicting sweet consumption later in the day. The third model suggested consuming sweets earlier in the day predicted higher alcohol cravings later in the day.

DISCUSSION

Sweet craving and consumption are associated with alcohol cravings among adults in early recovery from AUD. These findings suggest consuming sweets may increase alcohol cravings. If future studies can replicate this result, consuming sweets in early recovery may emerge as a potential risk for relapse in this population.

The Role of Negative Affect in Emotional Processing of Food-Related Images in Eating Disorders and Obesity

The aim of the present study was to analyze differences in the emotional processing (valence, arousal, and dominance) of food-related information in patients with eating disorders (ED), patients with obesity, and healthy women. Moreover, the mediator role of negative affect and the moderating role of the diagnostic group (ED vs. non-ED) were analyzed.

METHOD

The sample consisted of 94 women (39 with eating disorders, 19 with obesity, and 36 healthy participants).

MEASURES

International Affective Picture System (IAPS) food picture exposure task; Self-Assessment Manikin Analog-Visual Scale (SAM) appraising Arousal, Valence, and Dominance; Eating Attitudes Test (EAT-26); Positive and Negative Affect Schedule (PANAS).

RESULTS

Patients with purging symptomatology rated food images as more unpleasant than healthy women. Patients with purging and restrictive eating symptomatology showed higher levels of arousal and less dominance over the emotions experienced, compared to patients with obesity and healthy women. The mediation analysis showed that negative affect mediated the relationship between eating symptomatology (EAT-26) and the Valence of food images, as well as the control over the emotions experienced when viewing food images (Dominance). For the moderation analysis participants were regrouped into two groups (ED patients vs. non-ED patients). The direct relationship between eating symptomatology and food image valence was moderated by the diagnostic group. However, the group did not moderate the direct relationship between the EAT-26 and dominance over experienced emotions, or the indirect effect on eating symptomatology through negative affect. These results show the relevance of negative affect in the emotional processing of food-related information, and they support an eating disorder-disordered eating dimensional perspective.

Changing the visualization of food to reduce food cue reactivity: An event-related potential study

Visual food cues automatically capture our attention. Moreover, food cue exposure is associated with an increased desire to eat (craving) and food consumption. We attempted to reduce the attentional bias to images depicting a specific food (M&Ms), craving, and consumption through mental imagery in a sample of 98 females (mean age = 23.82 years). The participants either listened to a guided imagery script that described the crushing of M&Ms to reduce the appetitive value of the chocolates, or they envisioned the sorting of M&Ms, or marbles (as control conditions). Afterward, participants were presented with images of M&Ms (not crushed) and marbles while their electroencephalogram, craving ratings, and M&M consumption were measured. The visualization of crushing M&Ms was associated with increased early (P200) and late positivity (P300, early LPP) to M&M pictures, which indicate automatic (P200/P300) and deliberate attention (LPP). M&M sorting increased craving but did not influence M&M consumption. Our findings show that imaginary M&M crushing cannot reduce attention to M&M images and even has the opposite of the intended effect.

Improving the touchscreen-based food approach-avoidance task: remediated block-order effects and initial findings regarding validity

Approach biases to foods may explain why food consumption often diverges from deliberate dietary intentions. Yet, the assessment of behavioural biases with the approach-avoidance tasks (AAT) is often unreliable and validity is partially unclear. The present study continues a series of studies that develop a task based on naturalistic approach and avoidance movements on a touchscreen (hand-AAT). In the hand-AAT, participants are instructed to respond based on the food/non-food distinction, thereby ensuring attention to the stimuli. Yet, this implies the use of instruction switches (i.e., 'approach food - avoid objects' to 'avoid food - approach objects'), which introduce order effects. The present study increased the number of instruction switches to potentially minimize order effects, and re-examined reliability. We additionally included the implicit association task (IAT) and several self-reported eating behaviours to investigate the task's validity. Results replicated the presence of reliable approach biases to foods irrespective of instruction order. Evidence for validity, however, was mixed: biases correlated positively with external eating, increase in food craving and aggregated image valence ratings but not with desire to eat ratings of the individual images considered within participants or the IAT. We conclude that the hand-AAT can reliably assess approach biases to foods that are relevant to self-reported eating patterns.

The role of an individual's olfactory discriminability in influencing snacking and habitual energy intake

Recent studies have revealed close links between human olfaction, appetite, and food choice. However, it remains unclear whether olfactory sensitivity plays a direct role in determining food and energy intake. The present study addresses this question by assessing relationships between individual olfactory discriminability (at a suprathreshold level), snacking, and habitual energy intake. A total of 92 healthy Caucasian males (mean age = 26.1, SD = 5.8) were tested for their olfactory discriminability (measured by d') to three food-related odorants (O1 - Vanillin, O2 - Methional, and O3 - Maltol/Furaneol mixture) with a 2-AFC method of constant stimuli. These sensory data were then analysed with two separate measures of food consumption - (1) snack energy intake within an ad libitum buffet setting; (2) habitual energy intake using four-day weighed food records. Univariate analyses of variance revealed significant results with regards to O1. Specifically, individuals with higher discriminability consumed significantly less energy from snacking as opposed to their less sensitive counterparts (p = 0.05). However, no significant relationship was found between individual olfactory discriminability and habitual energy intake. While recent years have seen increasing research focus on how external olfactory cues affect food consumption, our study offers particularly novel insights regarding the role of individual olfactory sensitivity in shaping eating behaviour.

Food cravings and loss-of-control eating in youth: Associations with gonadal hormone concentrations

OBJECTIVE

Among youth with overweight, food cravings (FC) are associated with loss-of-control (LOC)-eating, but the impact of sex-associated biological characteristics on this relationship is unknown. We examined whether sex and gonadal hormone concentrations moderated the relationships between FC and LOC-eating severity among healthy boys and girls across the weight strata in natural and laboratory environments.

METHOD

Using ecological momentary assessment (EMA), FC, and LOC-eating severity were reported 3-5 times a day for 2 weeks. In the laboratory, participants reported FC, consumed lunch from a buffet test meal designed to simulate LOC-eating, and rated LOC-eating severity during the meal.

RESULTS

Eighty-seven youth (13.0 ± 2.7 years, 58.6% female, 32.2% with overweight/obesity) participated. EMA measured general and momentary FC were positively associated with LOC-eating severity (ps < .01), with no differences by sex (ps = .21-.93). Estradiol and progesterone significantly moderated the relationships between FC and LOC-eating such that general FC and LOC-eating severity were only positively associated among girls with greater (vs. lower) estradiol (p = .01), and momentary FC and LOC-eating severity were only positively associated among girls with greater (vs. lower) progesterone (p = .01). Boys' testosterone did not significantly moderate the associations between FC and LOC-eating severity (ps = .36-.97). At the test meal, pre-meal FC were positively related to LOC-eating severity (p < .01), without sex or hormonal moderation (ps = .20-.64).

DISCUSSION

FC were related to LOC-eating severity in boys and girls. In the natural environment, gonadal hormones moderated this relationship in girls, but not boys. The mechanisms through which gonadal hormones might affect the relationship between FC and LOC-eating warrant investigation.

Consuming media, consuming food: investigating concurrent TV viewing and eating using a 7-d time use diary survey

OBJECTIVE

One explanation for the relationship between TV viewing and obesity is that people may (over)eat while watching TV. The current study investigated associations between TV viewing and the time spent on (concurrent) eating in a naturalistic setting among a general population sample.

DESIGN

Preregistered secondary data analyses were performed of a diary survey in which respondents reported their time use in 10-min blocks for 7 d.

SETTING

Concurrent TV viewing and eating was operationalised as all blocks in which TV viewing and eating occurred simultaneously. Furthermore, the TV content respondents watched was coded as food-related (i.e. culinary content) or non-food related.

PARTICIPANTS

The sample composed of 2292 adults (58·9 % female) in the Netherlands, aged ≥ 20 years, from all educational levels (18·1 % low, 29·8 % middle and 51·4 % high).

RESULTS

More than half of the respondents (51·3 %) reported concurrent TV viewing and eating at least once during the 7-d diary period. The average eating occasion was longer in duration while watching TV (v. without media use), and the total time spent on eating was longer on days of concurrent TV viewing and eating (v. days of eating without media use). The percentage of TV viewing time spent on concurrent eating did not differ between food-related and non-food-related TV content.

CONCLUSIONS

Eating while watching TV was related to an increased time spent on eating. Even though energy intake was not assessed, these findings from a naturalistic setting provide further evidence that concurrent TV viewing and eating may contribute to overeating.

Associations between ghrelin and leptin and neural food cue reactivity in a fasted and sated state

Food cue exposure can trigger eating. Food cue reactivity (FCR) is a conditioned response to food cues and includes physiological responses and activation of reward-related brain areas. FCR can be affected by hunger and weight status. The appetite-regulating hormones ghrelin and leptin play a pivotal role in homeostatic as well as hedonic eating. We examined the association between ghrelin and leptin levels and neural FCR in the fasted and sated state and the association between meal-induced changes in ghrelin and neural FCR, and in how far these associations are related to BMI and HOMA-IR. Data from 109 participants from three European centers (age 50±18 y, BMI 27±5 kg/m²) who performed a food viewing task during fMRI after an overnight fast and after a standardized meal were analyzed. Blood samples were drawn prior to the viewing task in which high-caloric, low-caloric and non-food images were shown. Fasting ghrelin was positively associated with neural FCR in the inferior and superior occipital gyrus in the fasted state. This was partly attributable to BMI and HOMA-IR. These brain regions are involved in visual attention, suggesting that individuals with higher fasting ghrelin have heightened attention to food cues. Leptin was positively associated with high calorie FCR in the medial prefrontal cortex (PFC) in the fasted state and to neural FCR in the left supramarginal gyrus in the fasted versus sated state, when correcting for BMI and HOMA-IR, respectively. This PFC region is involved in assessing anticipated reward value, suggesting that for individuals with higher leptin levels high-caloric foods are more salient than low-caloric foods, but foods in general are not more salient than non-foods. There were no associations between ghrelin and leptin and neural FCR in the sated state, nor between meal-induced changes in ghrelin and neural FCR. In conclusion, we show modest associations between ghrelin and leptin and neural FCR in a relatively large sample of European adults with a broad age and BMI range. Our findings indicate that people with higher leptin levels for their weight status and people with higher ghrelin levels may be more attracted to high caloric foods when hungry. The results of the present study form a foundation for future studies to test whether food intake and (changes in) weight status can be predicted by the association between (mainly fasting) ghrelin and leptin levels and neural FCR.

"The thought is gonna come and the thought is gonna go": A qualitative study on how non-meditators learn and apply brief mindfulness-based instructions for food cravings

While brief mindfulness-based interventions have emerged as tools to modulate automatic responding in various domains of health and wellbeing, findings are primarily based on quantitative experimental research. However, these group-level findings do not capture the rich subjective experiences of individuals learning mindfulness. In the following qualitative study, we explored how non-meditators learn and apply brief mindfulness instructions in the domain of food cravings. Ten non-meditators listened to 'normal viewing' instructions, which asked them to view foods in the way that they normally would. They then viewed a video of attractive foods, and were interviewed about their experiences of learning and applying the instructions. Next, participants listened to a 5-min recording of mindfulness instructions, viewed another food video while applying the mindfulness instructions, and were interviewed again. The data were analysed using thematic analysis. When participants applied brief mindfulness, their relationship to the food stimuli changed such that they started perceiving their experiences as transient. Certain factors (e.g., use of visual metaphors) and processes (e.g., listening to the 'normal viewing' instructions first) facilitated this change. The ease of applying the instructions fluctuated with food preferences and perceived strength of cravings. Participants reported that they would apply the instructions in daily life if they felt a need for this, including in domains other than food. However, they anticipated challenges such as remembering and finding time to apply. Our findings highlight the specific aspects that influence how brief mindfulness instructions are learned and applied. These insights may change how brief mindfulness is studied empirically, and may inform the development of simple and empowering techniques that can promote wellbeing in daily life.

Increased Brain Reward Responsivity to Food-Related Odors in Obesity

OBJECTIVE

Food odors serve as powerful stimuli signaling the food quality and energy density and direct food-specific appetite and consumption. This study explored obesity-related brain activation in response to odors related to high- or low-energy-dense foods.

METHODS

Seventeen participants with obesity (BMI > 30 kg/m² ; 4 males and 13 females) and twenty-one with normal weight (BMI < 25 kg/m² ; 9 males and 12 females) underwent a functional magnetic resonance imaging scan in which they received chocolate (high-energy-dense food) and cucumber (low-energy-dense food) odor stimuli. Participants' olfactory and gustatory functions were assessed by the "Sniffin' Sticks" and "Taste Strips" tests, respectively.

RESULTS

Compared with normal-weight controls, participants with obesity had lower odor sensitivity (phenylethyl alcohol) and decreased odor discrimination ability. However, participants with obesity demonstrated greater brain activation in response to chocolate compared with cucumber odors in the bilateral inferior frontal operculum and cerebellar vermis, right ventral anterior insula extending to putamen, right middle temporal gyrus, and right supramarginal areas.

CONCLUSIONS

The present study provides preliminary evidence that obesity is associated with heightened brain activation of the reward and flavor processing areas in response to chocolate versus cucumber odors, possibly because of the higher energy density and reinforcing value of chocolate compared with cucumber.

Food reinforcement and habituation to food are processes related to initiation and cessation of eating

An individual bout of eating involves cues to start eating, as well as cues to terminate eating. One process that determines initiation of eating is food reinforcement. Foods with high reinforcing value are also likely to be consumed in greater quantities. Research suggests both cross-sectional and prospective relationships between food reinforcement and obesity, food reinforcement is positively related to energy intake, and energy intake mediates the relationship between food reinforcement and obesity. A process related to cessation of eating is habituation. Habituation is a general behavioral process that describes a reduction in physiological or affective response to a stimulus, or a reduction in the behavioral responding to obtain a stimulus. Repeated exposure to the same food during a meal can result in habituation to that food and a reduction in consumption. Habituation is also cross-sectionally and prospectively related to body weight, as people who habituate slower consume more in a meal and are more overweight. Research from our laboratory has shown that these two processes independently influence eating, as they can account for almost 60% of the variance in ad libitum intake. In addition, habituation phenotypes show reliable relationships with reinforcing value, such that people who habituate faster also find food less reinforcing. Developing a better understanding of cues to start and stop eating is fundamental to understanding how to modify eating behavior. An overview of research on food reinforcement, habituation and food intake for people with a range of weight status and without eating disorders is provided, and ideas about integrating these two processes that are related to initiation and termination of a bout of eating are discussed.

The impact of food packaging on measured food intake: A systematic review of experimental, field and naturalistic studies

Chronic, excess energy intake contributes to overweight and obesity. Solutions are needed to guide consumers towards portion control, especially for high energy density (HED), palatable foods. Food packaging, a key element of the eating environment, offers a potential solution. To investigate whether packaging design influences measured food intake, a systematic search was undertaken in four electronic databases (Ovid Medline; Ovid PsycInfo; Ovid Embase and Web of Science) across the previous decade. This process yielded 1671 discrete papers, of which 23 articles containing 40 relevant studies were retrieved. Most (n = 36) of the manipulated packaging features influenced consumption quantity with the largest effect sizes observed for packaging which guided consumers either by on-pack cues or structural features. For example, images on the front of the pack, packaging size, as well as partitioning and resealability all helped to reduce food intake. However, individual differences and attentional focus mediate packaging effects. Overall, packaging features can help to limit intake of HED foods and increase intake of nutrient-dense foods (e.g., carrots). Future studies on packaging for portion control (downsizing) might benefit from long term, randomised control trials to test effects outside of the laboratory context and applied to everyday consumer usage.

Bad mood food? Increased versus decreased food cue reactivity in anorexia nervosa and bulimia nervosa during negative emotions

OBJECTIVE

Emotion regulation difficulties in anorexia nervosa (AN) and bulimia nervosa (BN) might underlie bingeing and purging in BN, extreme fasting in AN, or combinations of these symptoms in binge-purge type AN. In this study, we tested for decreased food cue reactivity in response to negative emotions in AN, and the opposite pattern for BN. Furthermore, we explored subgroup differences (restrictive vs. binge-purging AN; history of AN in BN).

METHOD

Patients with AN (n = 41), BN (n = 39), and matched controls (n = 70) completed an emotional eating questionnaire. In a laboratory experiment, we induced negative emotions and measured food cue reactivity (pleasantness, desire to eat (DTE), and corrugator muscle activity).

RESULTS

AN reported emotional undereating, while BN reported emotional overeating. In the laboratory task, BN showed increased DTE and an appetitive corrugator response during negative emotions, selectively towards high-calorie foods. AN showed generalized reduced cue reactivity to high-calorie food regardless of emotional state. This pattern appears to be characteristic of restrictive AN, while cue reactivity of both BN subgroups pointed towards emotional overeating.

CONCLUSIONS

The emotional over- versus undereating framework might help to explain bingeing and restricting along the anorectic-bulimic disorder spectrum, which calls for novel transdiagnostic theories and subgroup-specific treatments.

Feasibility of a virtual reality-based approach to improve behavioral weight management outcomes

Background

Behavioral weight loss interventions promote clinically significant weight loss over 12 months, but weight regain remains problematic and a substantial proportion of participants do not achieve long-term weight loss maintenance. Novel methods are needed that instill habit strength for sustaining weight control behaviors long term. Virtual reality (VR) has the potential to provide opportunities within behavioral treatment for patients to practice desired weight control behaviors in the frequency and magnitude necessary to build durable habits. A pilot randomized trial was done to test the feasibility integrating virtual reality (VR) into standard behavioral weight loss treatment.

Methods

Participants were 15 adults (43 years; 46.7% Hispanic), with overweight or obesity who were randomly assigned to a 4-week Standard Behavioral Weight Loss plus Non-Weight-Related VR app (i.e., Control Group) or Standard Behavioral Weight Loss plus Weight-Related VR app (i.e., Intervention Group). The Intervention’s VR tool was designed to enable practice of behavioral skills taught in weekly group meetings, including managing social and home environmental cues for eating and activity.

Results

Participants were recruited over 3 months, and retention at the final assessment visit was high (86.6%). The VR footage and resulting app were rated as highly realistic (6.7 on a 10-point scale), and the VR program overall was rated as highly satisfactory (3.6 on a 4-point scale). Adverse effects of eye strain and motion sickness were minimal (~ 2 on a 7-point scale). As expected, the intervention and control groups both lost weight and unadjusted means (SD) averaged 3.4% (2.7) and 2.3% (3.6), respectively, over the 4 weeks. Overall, participants reported preferring a VR approach above traditional weight loss programs (rating of 5 on a 7-point scale).

Conclusions

Future research is needed to develop and test the feasibility of using VR for other weight control skills with a larger sample size and longer evaluation period to determine if VR can improve standard behavioral weight loss outcomes by intensifying practice opportunities and building habit strength for weight loss maintenance.

Trial registration

NCT04534088; date of registration: 09/01/2020, retrospectively registered.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40814-021-00865-5.

Is Food Addictive? A Review of the Science

As ultraprocessed foods (i.e., foods composed of mostly cheap industrial sources of dietary energy and nutrients plus additives) have become more abundant in our food supply, rates of obesity and diet-related disease have increased simultaneously. Food addiction has emerged as a phenotype of significant empirical interest within the past decade, conceptualized most commonly as a substance-based addiction to ultraprocessed foods. We detail (a) how approaches used to understand substance-use disorders may be applicable for operationalizing food addiction, (b) evidence for the reinforcing potential of ingredients in ultraprocessed foods that may drive compulsive consumptions, (c) the utility of conceptualizing food addiction as a substance-use disorder versus a behavioral addiction, and (d) clinical and policy implications that may follow if ultraprocessed foods exhibit an addictive potential. Broadly, the existing literature suggests biological and behavioral parallels between food addiction and substance addictions, with ultraprocessed foods high in both added fat and refined carbohydrates being most implicated in addictive-like eating. Future research priorities are also discussed, including the need for longitudinal studies and the potential negative impact of addictive ultraprocessed foods on children. Expected final online publication date for the Annual Review of Nutrition, Volume 41 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

A Content Analysis of Video Advertisements for Dietary Supplements in Japan

Dietary supplements are widely advertised and the market is expanding worldwide. Research suggests that dietary supplement advertising may lead consumers to make inappropriate health-related decisions, to express behaviors such as overdosing, and to neglect healthy lifestyle behaviors. We conducted a content analysis of video advertisements for dietary supplements and described the content of advertisements with high numbers and frequent views. We analyzed 82 video advertisements on YouTube that promoted fat-reduction effects. We extracted 22 themes and classified them into 10 categories. The categories with the highest numbers of advertisements were “Exemption” (i.e., consuming the product frees the audience from refraining from binge eating) (20 ads, 24.4%) and “Health Concerns” (i.e., the product intake solves the health concerns of the audience) (19 ads, 23.2%). These advertisements may stimulate negative audience attitudes toward appropriate health behaviors. The category with the most frequent views was “Lifestyle” (i.e., adding product intake to a healthy lifestyle) (3,035,298 views). “Lifestyle” advertisements portray physical activity in a positive light and may promote appropriate health behaviors in the audience. We discuss the possible effects of the advertisements on audiences and consider issues for future research and practice.

Is There a "Gestalt Bias" in Indulgence? Subjectively Constructing Food Units Into Wholes (vs. Parts) Increases Desire to Eat and Actual Consumption

In the present work we extend research into the unit bias effect and its extension—the portion size effect—by demonstrating the existence of a “Gestalt bias.” Drawing on the tenets of Gestalt psychology, we show that a unit bias effect can be observed for food portions that are composed of identical basic units, but which are subjectively grouped into, or perceived as a Gestalt—a larger whole. In three studies, we find that such subjectively constructed food wholes constitute a new (perceptual) unit that is perceived bigger than the units it is constructed from, thereby prompting increased eating and desire to eat.

The differential effects of viewing short-form online culinary videos of fruits and vegetables versus sweet snacks on adolescents' appetites

Social media culinary videos are a prominent feature across various social media platforms and constitute one of many media platforms that expose audiences to food. Given that there is a link between exposure to food content through food media and nutrient intake, our study aimed to investigate the effects of exposure to social media culinary videos on adolescents' appetites. We conducted a pre- and posttest study with 126 middle school children (M_age = 13.9, SD = 1.2). Participants saw a social media culinary video either demonstrating the preparation of a sweet snack (n = 50) or a fruit and vegetable snack (n = 76). As dependent variables, we examined hunger, general desire to eat, liking of the foods portrayed, intentions to eat and prepare the portrayed foods, and actual food choice behavior. The findings showed that the videos had no effects on hunger or general desire to eat but influenced food choice behavior, liking of the foods, and intentions to eat and prepare the foods portrayed. The sweet snacks video reduced the liking of fruits and vegetables and indirectly reduced the odds of choosing a fruit over a cookie, through intentions to eat sweet snacks. The fruits and vegetables video reduced the liking of sweet snacks and resulted in higher intentions to prepare healthy snacks. In conclusion, a single exposure to short-form culinary videos had effects on various food-related outcomes. While the positive effects of the fruits and vegetable video frame these videos as potential platforms to stimulate healthy eating and food preparation, the effects of the sweet snacks video warn of negative influences. Further research on prolonged repetitive exposure is warranted.

Helpless against food cues: the influence of pro- and anti-sugar videos on instrumental food-seeking behaviour in a Pavlovian-to-instrumental transfer paradigm

OBJECTIVE

External food cues can trigger food seeking by means of associative Stimulus-Outcome-Response learning mechanisms. These mechanisms can contribute to cued overeating. The present study aims at investigating if (cued) food-seeking behaviour can be influenced by pro- and anti-sugar videos.

DESIGN

Participants (N = 81) completed a Pavlovian-to-instrumental transfer (PIT) task: in an instrumental training, they learned associations between button presses and resulting sugary or sugar-free snacks. In a subsequent Pavlovian training, the snacks were paired with different cues. During the following transfer test, participants performed free button presses to win snacks while the cues were present or not.

MAIN OUTCOME MEASURES

The number of button presses for the different snacks in the transfer test was analysed.

RESULTS

We observed an outcome specific PIT effect, i.e. higher response rates for cued snacks. The videos did not affect the PIT effect. However, exploratory analyses revealed that the anti-sugar video led to fewer button presses for sugary snacks (compared to the pro-sugar video).

CONCLUSION

While snack-seeking behaviour was unaffected by the video's messages in the presence of food cues, in the absence of food cues there was evidence for a reduction of sugary snack choices by the anti-sugar video.

Differences in Food Craving in Individuals With Obesity With and Without Binge Eating Disorder

Overeating behavior is supposedly a major contributing factor to weight gain and obesity. Binge eating disorder (BED) with reoccurring episodes of excessive overeating is strongly associated with obesity. Learning models of overeating behavior and BED assume that mere confrontation with food leads to a conditioned response that is experienced as food craving. Accordingly, individuals with obesity and BED were shown to have high trait food cravings. To date, little is known about differences in state food cravings and cue reactivity at the sight of palatable food in individuals with obesity and BED compared to individuals with obesity without BED. Therefore, the aim of our study was to examine differences in cue-induced, state and trait food cravings in people with obesity with and without BED. We found that all aspects of food cravings were more prevalent in individuals with obesity and BED than in individuals without BED. By implementing a food cue reactivity paradigm, our results show that individuals with obesity with BED have more cue-induced cravings than individuals with obesity without BED. Moreover, these cue-induced cravings in individuals with obesity and BED were highest for high-fat and high-sugar foods as opposed to low-calorie foods. Thus, our results emphasize the role of increased cue reactivity and craving at the sight of palatable foods in individuals with obesity and BED. Hence, our findings support etiological models of conditioned binge eating and are in line with interventions targeting cue reactivity in BED.

The food craving inventory in an Iranian population: post-hoc validation and individual differences

PURPOSE

The present study was performed to develop the Persian version of food craving inventory (FCI) (FCI-P) and to assess food craving in Iranian adult population. In addition, individual differences, including sex and body mass index (BMI) in food craving were assessed.

METHODS

Eight hundred and twenty subjects who participated in the same study Hill (Proc Nutr Soc 66: 277-285, 2007) were studied (540 women and 280 men). The FCI-P, International Physical Activity Questionnaire (IPAQ), Three-Factor Eating Questionnaire (TFEQ), and a questionnaire pertaining to demographic characteristics were completed for all participants.

RESULTS

Good content, construct, and convergent validity was observed for the FCI-P. A good reliability was found for both aggregate scores of the FCI-P and scores of its five factors. Exploratory factor analysis showed a five-factor model including "sweets," "high-fat foods," "fast food fats," "carbohydrates/starches" and "high-fat meats". These five factors accounted for 47.31% of the total variance. The scores of "uncontrolled eating" and "emotional eating" of the TFEQ were significantly correlated with the scores of the FCI-P factors and its total score. A significant correlation was found between BMI and the FCI-P score (r = 0.199). Significant differences were observed in the mean age and physical activity score among normal weight, overweight, and obese participants. Normal weight and overweight groups were more active than obese group. Obese participants had higher FCI-P score (P < 0.001) than the normal and overweight groups. FCI-P score was significantly higher in women than men.

CONCLUSIONS

FCI-P can be used as a valid and reliable measure to assess food craving in Iranian populations. Obese individuals experienced food craving more than normal weight subjects. Similarly, women may experience food craving more than men.

LEVEL OF EVIDENCE

Level V, cross sectional study.

Food Palatability Directs Our Eyes Across Contexts

It is often believed that attentional bias (AB) for food is a stable trait of certain groups, like restrained eaters. However, empirical evidence from this domain is inconsistent. High-calorie foods are double-faceted, as they are both a source of reward and of weight/health concern. Their meaning might depend on the food-related context (i.e., focus on health or on enjoyment), which in turn could affect AB for food. This study primed 85 females with hedonic, healthy, and neutral contexts successively and examined whether food-related context affected AB for food and if effects were moderated by dietary restraint. Both the mean tendencies of AB for food and variability of AB for food were assessed in a food dot-probe task with a recording of both reaction times and eye movements. Contrary to our hypotheses, AB for food was not significantly affected by either context or the interaction between context and dietary restraint. Instead, liking of the presented food stimuli was related to longer initial fixations and longer dwell time on the food stimuli. In addition, in line with prior research, body mass index (BMI) was correlated with variability of AB for food instead of mean AB for food. In conclusion, this study did not find any support that AB for food is dependent on food-related context, but interestingly, reaction time-based variability of AB for food seems to relate to BMI, and eye movement-based mean AB seems to relate to appetitive motivation.

Low craving control predicts increased high energy density food intake during the COVID-19 lockdown: Result replicated in an Australian sample

This research aimed to replicate a previous UK-based finding that low craving control predicts increased intake of high energy density foods (HED) during the COVID-19 lockdown, and extend this finding to adults living in Victoria, Australia. The study also assessed whether acceptance coping moderates the relationship between craving control and increased HED food intake, and examined the associations between trait disinhibition, perceived stress and changes to HED food intake. An online survey completed by 124 adults living in Victoria, Australia (total eligible n = 147; 38.5 ± 12.9 years) during the COVID-19 lockdown showed that 49% of participants reported increased overall food intake, and 21-29% reported increased intake of HED sweet and savoury foods during the COVID-19 lockdown. Of the eating behaviour traits assessed, low craving control was the only significant predictor of increased HED sweet and savoury food intake (cognitive restraint, disinhibition and emotional eating were non-significant predictors). Perceived stress was associated with reported increases in overall savoury and sweet snack intake, but was not significantly associated with changes to specific HED food groups (sweet and savoury). In this sample, acceptance coping did not significantly moderate the relationship between craving control and increased HED food intake. Based on these replicated findings, further trials should now consider interventions targeting craving control to promote controlled food intake in individuals at-risk of weight gain during the current COVID-19 and future potential lockdowns.

Determinants of Cue-Elicited Alcohol Craving and Perceived Realism in Virtual Reality Environments among Patients with Alcohol Use Disorder

The identification of variables that can modulate the efficacy of cue exposure using virtual reality (VR) is crucial. This study aimed to explore determinant variables of cue-elicited alcohol craving and perceived realism (PR) of environments and alcoholic beverages during a VR cue-exposure session among alcohol use disorder (AUD) outpatients. A prospective cohort study was conducted amongst 72 outpatients with AUD from a clinical setting. Alcohol craving experienced during VR exposure and PR of virtual environments and alcoholic drinks were evaluated after a VR session of exposure to alcohol-related contexts and cues. Sociodemographic, psychological and consumption characteristics were examined as possible predicting variables. Multiple linear regression analyses showed that the AUD severity and PR of beverages were predictors of cue-elicited alcohol craving. Educational level, PR of beverages and age were predictors of the PR of VR environments. In relation to the PR of VR beverages, cue-elicited alcohol craving and the PR of environments were predictors. A simple mediational model was also performed to analyze the influence of the PR of beverages on the relationship between the AUD severity and alcohol craving experienced during VR exposure: an indirect or mediational effect was found. PR of alcoholic beverages was (1) a key predictor of the PR of VR environments (and vice versa) and the alcohol craving (and vice versa) experienced during VR cue-exposure sessions using ALCO-VR software among AUD patients and (2) a mediator between AUD severity and cue-elicited alcohol craving.

Exploring Strategies to Optimise the Impact of Food-Specific Inhibition Training on Children's Food Choices

Food-specific inhibition training (FSIT) is a computerised task requiring response inhibition to energy-dense foods within a reaction-time game. Previous work indicates that FSIT can increase the number of healthy foods (relative to energy-dense foods) children choose, and decrease calories consumed from sweets and chocolate. Across two studies, we explored the impact of FSIT variations (e.g., different response signals, different delivery modes) on children's food choices within a time-limited hypothetical food-choice task. In Study 1, we varied the FSIT Go/No-Go signals to be emotive (happy vs. sad faces) or neutral (green vs. red signs). One-hundred-and-fifty-seven children were randomly allocated to emotive-FSIT, neutral-FSIT, or a non-food control task. Children participated in groups of 4-15. No significant FSIT effects were observed on food choices (all values of p > 0.160). Healthy-food choices decreased over time regardless of condition (p < 0.050). The non-significant effects could be explained by lower accuracy on energy-dense No-Go trials than in previous studies, possibly due to distraction in the group-testing environment. In Study 2, we compared computer-based FSIT (using emotive signals) and app-based FSIT (using neutral signals) against a non-food control with a different sample of 206 children, but this time children worked one-on-one with the experimenter. Children's accuracy on energy-dense No-Go trials was higher in this study. Children in the FSIT-computer group chose significantly more healthy foods at post-training (M = 2.78, SE = 0.16) compared to the control group (M = 2.02, SE = 0.16, p = 0.001). The FSIT-app group did not differ from either of the other two groups (M = 2.42, SE = 0.16, both comparisons p > 0.050). Healthy choices decreased over time in the control group (p = 0.001) but did not change in the two FSIT groups (both p > 0.300) supporting previous evidence that FSIT may have a beneficial effect on children's food choices. Ensuring that children perform FSIT with high accuracy (e.g., by using FSIT in quiet environments and avoiding group-testing) may be important for impacts on food choices though. Future research should continue to explore methods of optimising FSIT as a healthy-eating intervention for children.

A reward and incentive-sensitization perspective on compulsive use of social networking sites - Wanting but not liking predicts checking frequency and problematic use behavior

The use of Social Networking Sites (SNSs) has exponentially increased over the past decade, leading to warnings about the addictive potential of this technology. Yet, the idea of SNS addiction remains controversial and more theory-driven research is required to understand the mechanisms of excessive and compulsive SNS use and to facilitate the development of targeted interventions helping affected users. In the present article we propose to utilize a reward-based approach to further our understanding of these behaviors. In particular, we suggest that concepts borrowed from the drug addiction literature that focus on incentive processes (incentive-sensitization and cue reactivity) can explain some SNS behaviors, such as compulsive checking. One elemental finding of the neurobiological drug addiction literature is that repeated exposure to a rewarding substance can render the brain's reward system oversensitive to cues related to the drug. We report preliminary findings from 358 participants showing that cue-elicited urges to use SNSs characterized both excessive and problematic use behaviors. Moreover, desires and urges to use SNSs (wanting responses) could be reliably dissociated from the enjoyment and pleasure (liking responses) associated with SNSs, with the latter being less predictive of the intensity and problematicity of behaviors than the former. Such divergence between motivational and hedonic processes is another hallmark finding in the literature on drug and food rewards. Together our initial findings thus suggest that examining alterations of reward processes holds promise to explain the compulsive use of SNSs and to identify potential avenues to help affected individuals.

Parental peritraumatic distress and feelings of parental competence in relation to COVID-19 lockdown measures: What is the impact on children's peritraumatic distress?

The objective of this study was to measure, via an online survey, the peritraumatic impact of COVID-19-related lockdown measures on parents and their sense of parental competence, as well as the link with their children's peritraumatic distress. We investigated the links between the distress felt by the parent and the distress felt by the child in the lockdown from March to May 2020. Participants were 287 parents and 161 children. The results of our study indicated that there is a significant association between the parents' and the children's peritraumatic stress. We also found a significant relationship between the sense of parental competence and the trauma suffered as a result of the lockdown. We also showed that people who usually felt more stressed have lower peritraumatic distress. In addition, the data indicated that mothers were more affected than fathers by the lockdown, whereas there was no difference between girls and boys in the sample of children. The peritraumatic feelings appeared to be more related to the difficulty of combining teleworking with the daily management of children than to the fear of the virus itself. All these results bear witness to the differences in the experience of lockdown between mothers and fathers, and the impact on their children's well-being.

How can different psychological and behavioural constructs be used to personalise weight management? Development of the diet styles

The aim of this study was first, to explore whether distinct combinations of key psychological and eating-related characteristics, could be identified and, second, whether these styles were related to measures of dieting success such as weight status and the number of previous weight loss attempts. Participants were any person 18 years or older with access to the internet and were recruited through Facebook to complete a 30-min, online survey. The survey included 23 different measures of factors related to personality, eating behaviours and current weight management. 1047 (68.3% of starters) completed the full survey. These people were 82.4% female with a mean age of 42.54 years (SD = 14.07). Factor analysis using Maximum Likelihood Extraction method with Promax rotation resulted in the extraction of 5 novel factors: Temptation (including experiencing cravings and difficulty controlling eating); Foodie (higher engagement and involvement with food); Overthinking (neuroticism, behavioural inhibition and perfectionistic tendencies); Social (extroversion and agreeableness); Impulsivity (impulsivity, lower conscientiousness, higher fun-seeking). Each of the factors associated bivariately, and in the expected direction, with behaviours such as vegetable consumption, frequency of diet attempts, and self-rated health. Each possible diet style is described further and interpreted in the context of existing literature with a focus on how understanding these could help personalise future interventions. Future work will validate this structure in different samples.

Media multitasking is associated with higher risk for obesity and increased responsiveness to rewarding food stimuli

Obesity among children and adolescents has dramatically increased over the past two to three decades and is now a major public health issue. During this same period, youth exposure to media devices also became increasingly prevalent. Here, we present the novel hypothesis that media multitasking (MMT)-the simultaneous use of and switching between unrelated forms of digital media-is associated with an imbalance between regulatory processes and reward-related responses to appetitive food stimuli, resulting in a greater sensitivity to external food cues among high media multitaskers. This, in turn, may contribute to overeating and weight gain over time. To test this hypothesis, we conducted two studies examining research participants who grew up during the recent period of escalating multitasking and obesity-and among whom 37% are overweight or obese. In Study 1, participants' propensity to engage in MMT behaviors was associated with a higher risk for obesity (as indicated by higher body mass index and body fat percentage). Next, in Study 2, a subset of participants from Study 1 were exposed to appetitive food cues while undergoing functional neuroimaging and then, using passive mobile sensing, the time participants spent in various food points-of-sale over an academic term was inferred from GPS coordinates of their mobile device. Study 2 revealed that MMT was associated with an altered pattern of brain activity in response to appetizing food cues, specifically an imbalance favoring reward-related activity in ventral striatum and orbitofrontal cortex-relative to recruitment of the frontoparietal control network. This relationship was further tested in a mediation model, whereby increased MMT, via a brain imbalance favoring reward over control, was associated with greater time spent in campus eateries. Taken together, findings from both studies suggest the possibility that media multitasking may be implicated in the recent obesity epidemic.

The impact of COVID-19 lockdown and of the following "re-opening" period on specific and general psychopathology in people with Eating Disorders: the emergent role of internalizing symptoms

BACKGROUND

We assessed the impact of the coronavirus disease 2019 (COVID-19) pandemic on specific Eating Disorder (ED) and general psychopathology in people with an ED diagnosis during the lockdown period and after the end of the related containment measures.

METHODS

People with clinically defined diagnosis and undergoing treatment for an ED completed an online survey, which included adapted questions from standardized psychometric scales. Data relative to three different time periods (before, during and after the end of lockdown) were collected. Psychopathological changes over these periods were investigated and compared through one-way analysis of variance or covariance with repeated measures.

RESULTS

Three hundred twelve people completed the survey (57.4% diagnosed with Anorexia Nervosa (AN) or atypical AN, 20.2% with Bulimia Nervosa, 15.4% with Binge Eating Disorder, 7.05% with Other Specified Feeding or Eating Disorders). The severity of both specific and general psychopathology increased during the lockdown and the rise of general symptoms persisted in the following re-opening phase, except for suicide ideation. Almost all of these findings were not affected by ED diagnosis, participants' age and illness duration.

LIMITATIONS

The retrospective nature of data collection is the main limitation of the study.

CONCLUSIONS

People with EDs showed a COVID-19 emergency-induced worsening of both general and specific psychopathology. The effect on general psychopathology persisted in the re-opening period. These findings suggest a high stress vulnerability of ED individuals with important effects on internalizing symptoms, which are worth of attention by clinicians.

Food cue images and subjective appetitive responses in obese children

BACKGROUND

Food decision-making is based on various intrinsic and extrinsic factors of an individual. Food preferences and food cue sensitivity influence energy intake, which in turn affects body weight.

AIM

The present study assessed the subjective appetite of obese children in response to food cue images.

METHODS

A total of 70 obese children (37 boys and 33 girls) of the age group 7-10 years were recruited for the study; 34 images of food items grouped under ten food blocks were used as cues to study the self-reported hunger, appetite and satiety sensations among the participants. A visual analogue scale (VAS) was used to measure participant responses for each food block.

RESULTS

The mean (standard deviation (SD)) body mass index-for-age 'Z' scores (BAZ) of the participants was found to be 2.15 (0.36). The subjective appetitive responses assessed using VAS showed that the hunger ratings of participants were found to be higher in response to images of cereals and cereal products (92.86%), and sweets (97.14%); satiety ratings of the participants were observed to be higher for milk and milk products (87.14%); cereals and savoury foods (78.57%); and higher appetite ratings of participants were recorded for sweets (97.14%) and cereals (92.86%).

CONCLUSION

Sophisticated neuroimaging techniques are well established in measuring appetite, but our study focused on the subjective analysis of appetite using cost-effective tools such as food cue images and visual analogue scales to further expand the research platform in appetite regulation and obesity.