Reasons for initiation and cessation of eating in obese men and women and the affective consequences of eating in everyday situations

Self-compassion and reasons individuals stop eating: An exploratory investigation

BACKGROUND

Self-compassion is a prevalent factor that has been explored in eating behaviour and weight loss literature. The present study explored the potential relationship between self-compassion and reasons individuals stop eating.

METHOD

Two hundred and eighty-three participants were recruited from social media platforms and a research participation scheme at a university in the West Midlands, UK, and completed questionnaires on self-compassion and reasons individuals stop eating.

RESULTS

The findings suggested that self-compassion was negatively associated with decreased food appeal, self-consciousness, and decreased food priority, whilst being positively associated with physical satisfaction.

CONCLUSION

Self-compassion plays a prevalent role in the reasons individuals stop eating, and future research should continue exploring the effect of self-compassion on eating behaviour regulation.

Reasons for meal termination, eating frequency, and typical meal context differ between persons with and without a spinal cord injury

Overeating associated with neurogenic obesity after spinal cord injury (SCI) may be related to how persons with SCI experience satiation (processes leading to meal termination), their eating frequency, and the context in which they eat their meals. In an online, cross-sectional study, adults with (n = 688) and without (Controls; n = 420) SCI completed the Reasons Individuals Stop Eating Questionnaire-15 (RISE-Q-15), which measures individual differences in the experience of factors contributing to meal termination on five scales: Physical Satisfaction, Planned Amount, Decreased Food Appeal, Self-Consciousness, and Decreased Priority of Eating. Participants also reported weekly meal and snack frequency and who prepares, serves, and eats dinner with them at a typical dinner meal. Analysis revealed that while Physical Satisfaction, Planned Amount, and Decreased Food Appeal were reported as the most frequent drivers of meal termination in both groups, scores for the RISE-Q-15 scales differed across the groups. Compared to Controls, persons with SCI reported Physical Satisfaction and Planned Amount as drivers of meal termination less frequently, and Decreased Food Appeal and Decreased Priority of Eating more frequently (all p < 0.001). This suggests that persons with SCI rely less on physiological satiation cues for meal termination than Controls and instead rely more on hedonic cues. Compared to Controls, persons with SCI less frequently reported preparing and serving dinner meals and less frequently reported eating alone (all p < 0.001), indicating differences in meal contexts between groups. Individuals with SCI reported consuming fewer meals than Controls but reported a higher overall eating frequency due to increased snacking (p ≤ 0.015). A decrease in the experience of physical fullness, along with a dependence on a communal meal context and frequent snacking, likely contribute to overeating associated with neurogenic obesity after SCI.

Relationship between attentional bias and stimulus control: An observational study of real-world eating patterns

BACKGROUND

Attentional bias towards food related stimuli has been proposed as a potential target for dieting intervention, however the evidence supporting a relationship between attentional bias and food intake is mixed. Theory holds that food related attentional bias should be positively associated with measures of stimulus-controlled eating, and that implicit processes such as impulsivity moderate this association. The aim of the present study was to examine whether the proposed relationship between food-related attentional bias and stimulus control exists, and whether it is moderated by impulsivity.

METHOD

A community sample of 68 participants completed a food-related attentional bias task and impulsiveness scale during a laboratory visit, after which they recorded their real-world eating in real-time over 14 days using Ecological Momentary Assessment (EMA). During this time, participants also responded to 4-5 randomly timed assessments per day. Food outlet presence (e.g., fast food restaurants, cafes, corner stores etc.) was assessed during both eating and non-eating assessments. EMA data was then used to determine levels of stimulus controlled eating for each participant.

FINDINGS

Substantial variation was seen in both our measure of both food-related attentional bias (Range: 33.9 to 80.0) and in the degree to which the participant's eating could be categorised as being under stimulus control (Range: 0.50 to 0.93). However, food-related attentional bias scores were not a significant independent predictor of stimulus control and nor was this relationship moderated by impulsivity.

CONCLUSION

Contrary to theoretical predictions, we found no evidence that of an association between attentional bias, impulsivity, and stimulus control. More work is needed to better understand the implicit processes underlying eating behaviour in the real-world.

Reasons individuals stop eating questionnaire (RISE-Q) among adults in the United Arab Emirates

The relationship between obesity and satiation is complex and bidirectional. Understanding differences in reasons for meal termination may enhance our understanding of overeating risks and susceptibility to overconsumption. This study aimed to investigate the reasons why individuals in the UAE stop eating. A cross-sectional web-based study was conducted among adults ≥18 years in the UAE (n = 1482). Using a self-administered online questionnaire, we collected information on sociodemographic characteristics, lifestyle habits, and eating behavior using the Reasons Individuals Stop Eating-Questionnaire (RISE-Q-15) used twice for breakfast/main meal. The items were categorized into five scales; decreased food appeal (DFA), physical satisfaction (PS), planned amount (PA), self-consciousness (SC), and decreased priority of eating (DPE). All items were scored from 1 to 7 ranging between 3 to 21 on each scale. A paired t-test was used to evaluate the difference between the RISE-Q scores on each scale concerning the two meals. The main reason why participants stopped eating breakfast was under the PS scale (14.91 ± 3.72), followed by the PA scale (14.58 ± 3.00). The main reason why participants stopped eating main meals was under the PS scale (14.78 ± 3.56), followed by the PA scale (14.77 ± 43.81). The mean score of the DPE scale was significantly higher for breakfast than the main meal (p = 0.038). More than half of the participants reported an average eating rate (58.7%). Pearson's chi-square analysis revealed that the eating rate was dependent on BMI (p<0.001). Considering individual mealtimes and addressing factors related to PS and PA of food is crucial when designing nutrition interventions aiming to promote healthy eating habits among adults in the UAE.

Visual Cues and Optimal Defaults in Fast-Food Combo Meals Benefit Health-Concerned Consumers-A Randomized Scenario-Based Experiment

BACKGROUND

The use of low-calorie menu items as optimal defaults and visual cues may nudge consumers to healthier choices at restaurants. However, little is known regarding their effects on emotions and behavioral intentions, particularly among people with different levels of health concern.

OBJECTIVE

Evaluate optimal defaults and visual cues' effect on anticipated pleasure and order intention depending upon consumers' health concern level.

DESIGN

Between-subjects randomized scenario-based experiment.

PARTICIPANTS/SETTING

In all, 636 US adults recruited through an online crowdsourcing platform in July 2020.

INTERVENTION

Participants saw 1 of 6 menu boards in a fast-food drive-through simulation. Half the menu boards included meal photos with (1) menu items to be arranged as a combo by choice (ie, create-your-own combo); (2) traditional combos that included high-calorie default items; or (3) optimal combos that included low-calorie default items. The remaining 3 boards were identical without photos.

MAIN OUTCOME MEASURES

Anticipated pleasure, order intention, and health concern were evaluated with 7-point Likert scales.

ANALYSIS

Statistical tests included multiple regression, Kruskal-Wallis, χ², and analysis of variance. Education and sex were tested as potential confounders.

RESULTS

Optimal combos negatively affected anticipated pleasure (P = .003) and order intention (P < .001) compared with choice combos. Order intention reduction was the same for traditional and optimal combos (P = .128). The presence of photos changed order intention for optimal combos but varied by consumer's health concern level. When health concern was lower, photos decreased the likelihood of ordering the optimal combos (B = -3.06, P = .001), but when health concern was higher, photos enhanced ordering intention compared with the choice group (B = 0.60, P = .001). The photos did not affect anticipated pleasure for any level of health concern.

CONCLUSIONS

The adverse effect of optimal defaults and how visual cues may reduce their negative effect should be considered in menu design.

Eating rate and bite size were related to food intake across meals varying in portion size: A randomized crossover trial in adults

Serving larger portions leads to increased food intake, but behavioral factors that influence the magnitude of this portion size effect have not been well characterized. We investigated whether measures of eating microstructure such as eating rate and bite size moderated the portion size effect. We also explored how sensory-specific satiety (SSS; the relative hedonic decline of a food as it is eaten) was affected by eating microstructure and larger portions. In a randomized crossover design, 44 adults aged 18-68 y (66% women; 46% with overweight and obesity) ate lunch in the laboratory once a week for 4 weeks. The meal consisted of pasta that was varied in portion size (400, 500, 600, or 700 g) and 700 g of water. Meals were video-recorded to assess bite count and meal duration, which were used to calculate mean eating rate (g/min) and mean bite size (g/bite). At each meal participants also completed an assessment of SSS. The results showed that as larger portions were served, meal intake increased in a curvilinear manner (p < 0.0001). Measures of eating microstructure did not moderate the portion size effect but were related to intake across all portions; faster eating rate, larger bite size, higher bite count, and longer meal duration were associated with greater consumption at all meals (all p < 0.0001). SSS was not influenced by any measure of eating microstructure or by portion size (all p > 0.10). In summary, the portion size effect was not moderated by eating microstructure, but relatively faster eating rates and larger bite sizes at meals, along with large portions, combined to increase food intake.

Snacking for a reason: detangling effects of socio-economic position and stress on snacking behaviour

BACKGROUND

As snacking can be considered a cornerstone of an unhealthy diet, investigating psychological drivers of snacking behaviour is urgent, and therefore the purpose of this study. Socio-economic position (SEP) and stress are known to affect many behaviours and outcomes, and were therefore focal points in the study.

METHODS

In a cross-sectional survey study, we examined whether Socio-economic position (SEP) would amplify associations between heightened stress levels and self-reported negative-affect related reasons for snacking. Next, we investigated whether Socio-economic position (SEP) predicted frequency of snacking behaviour, and how stress and other reasons for snacking could explain this association. Outcome measures were reasons people indicated for snacking, and frequency of snacking behaviour.

RESULTS

Analyses revealed that people seem to find more reasons to snack when they are stressed, and that this association was more pronounced for people with a high compared to low socio-economic position. Furthermore, a higher socio-economic position was associated with a higher frequency of snacking, and both snacking to reward oneself and snacking because of the opportunity to do so remained significant mediators.

CONCLUSION

Whereas low socio-economic position was associated with higher stress levels, this did not translate into increased snacking. Contrarily, those with higher socio-economic position could be more prone to using 'reasons to snack', which may result in justification of unhealthy snacking behaviour.

Snacking patterns throughout the life span: potential implications on health

Eating outside the three main meals - in other words, snacking - is a part of the dietary pattern of individuals in all stages of life. The quality and pattern of snacking have an impact on health during the life span. Thus, the aim of this review was to evaluate various patterns and health outcomes of the snacking habits of different demographical groups, from children to the elderly, throughout their life span. We discuss the snacking pattern among children and adolescents, which is characterized by consuming high energy foods with low nutrient value, and which is associated with increased risk of obesity. During university years, study stress and lack of time were obstacles to a healthy dietary pattern involving nutritious snacks, although awareness of the importance of healthy snacks was higher in this group than among younger age groups. Employment status and skipping regular meals were important factors affecting snacking quality and patterns in adulthood. Unhealthy snacks, high in energy, sugar, and salt and low in nutrients, were demonstrated to have a negative impact on individuals' health, such as oral health, blood pressure, obesity, and diabetes. In conclusion, encouraging individuals to consume healthy snacks that are high in nutrients through education to help them plan for their snacks is important to enhance health and reduce disease risk.

The Satiation Framework: Exploring processes that contribute to satiation

Satiation has been described as a process that leads to the termination of eating and controls meal size. However, studies have shown that the termination of eating can be influenced by multiple behavioral and biological processes over the course of a meal as well as those related to the context in which the meal is consumed. To expand understanding of how individuals experience satiation during a meal, we recently developed the Reasons Individuals Stop Eating Questionnaire (RISE-Q). The development of the RISE-Q revealed five distinct factors reported to contribute to meal termination: Planned Amount, Self-Consciousness, Decreased Food Appeal, Physical Satisfaction, and Decreased Priority of Eating. Thus, we define satiation as a series of dynamic processes that emerge over the course of a meal to promote meal termination. We suggest that each of the factors identified by the RISE-Q represents a distinct process, and illustrate the contribution of each process to meal termination in the Satiation Framework. Within this framework the prominence of each process as a reason to stop eating likely depends on meal context in addition to individual variability. Therefore, we discuss contexts in which different processes may be salient as determinants of meal termination. Expanding the definition of satiation to include several dynamic processes as illustrated in the Satiation Framework will help to stimulate investigation and understanding of the complex nature of meal termination.

Development and validation of the Reasons Individuals Stop Eating Questionnaire (RISE-Q): A novel tool to characterize satiation

A variety of factors can influence satiation, and individual differences in reasons for meal termination may help to explain variability in food intake and susceptibility to overconsumption. We developed and validated a questionnaire to characterize the Reasons Individuals Stop Eating (RISE-Q). The initial RISE-Q was created by reviewing the published literature and identifying 47 reasons why individuals might stop eating. The RISE-Q asks respondents to rate how often each reason influences why they stop eating at a typical dinner meal by using a seven-point scale. Adults (N = 477, 77% women) from a participant database completed a survey online that included the initial RISE-Q and the satiation-related Satiety Responsiveness and Food Responsiveness scales of the Adult Eating Behavior Questionnaire (AEBQ). Self-reported height and weight were collected to calculate body mass index (BMI). The survey also assessed self-reported typical meal size. After factor analysis, the RISE-Q retained 31 items and identified five distinct scales of reasons for stopping eating: Decreased Food Appeal (mean ± SD: 2.6 ± 0.05, Cronbach's α = 0.89), Physical Satisfaction (5.0 ± 0.04, α = 0.85), Planned Amount (4.4 ± 0.05, α = 0.82), Self-Consciousness (2.4 ± 0.05, α = 0.88), and Decreased Priority of Eating (2.3 ± 0.04, α = 0.69). Thus, the most frequently reported reasons for meal termination were related to Physical Satisfaction and Planned Amount. Each RISE-Q scale was significantly correlated with at least one of the satiation-related AEBQ scales, suggesting that the RISE-Q has construct validity. RISE-Q scales were also correlated with BMI and measures of typical meal size. The RISE-Q provides a novel tool to assess differences across individuals in reported reasons for eating cessation. The RISE-Q can aid in further understanding risk factors for overconsumption and has potential clinical utility in the design of targeted weight-management interventions.

Patient descriptions of loss of control and eating episode size interact to influence expert diagnosis of ICD-11 binge-eating disorder

BACKGROUND

Although data suggest that the sense of "loss of control" (LOC) is the most salient aspect of binge eating, the definition of LOC varies widely across eating disorder assessments. The WHO ICD-11 diagnostic guidelines for binge eating do not require an objectively large amount of food, which makes accurate LOC diagnosis even more critical. However, it can be especially challenging to assess LOC in the context of elevated weight status and in the absence of compensatory behaviors. This ICD-11 field sub-study examined how descriptions of subjective experience during distressing eating episodes, in combination with different eating episode sizes, influence diagnoses of binge-eating disorder (BED).

METHOD

Mental health professionals with eating disorder expertise from WHO's Global Clinical Practice Network (N = 192) participated in English, Japanese, and Spanish. Participants were asked to select the correct diagnosis for two randomly assigned case vignettes and to rate the clinical importance and ease of use of each BED diagnostic guideline.

RESULTS

The presence of LOC interacted with episode size to predict whether a correct diagnostic conclusion was reached. If the amount consumed during a typical distressing eating episode was only subjectively large compared to objectively large, clinicians were 23.1 times more likely to miss BED than to correctly diagnose it, and they were 9.7 times more likely to incorrectly diagnose something else than to correctly diagnose BED. In addition, clinicians were 10.8 times more likely to make a false positive diagnosis of BED when no LOC was described if the episode was objectively large. Descriptions of LOC that were reliably associated with correct diagnoses across episodes sizes included two that are similar to those already included in proposed ICD-11 guidelines and a third that is not. This third description of LOC focuses on giving up attempts to control eating because perceived overeating feels inevitable.

CONCLUSIONS

Results highlight the importance of detailed clarification of the LOC construct in future guidelines. Explicitly distinguishing LOC from distressing and mindless overeating could help promote consistent and accurate diagnosis of BED versus another or no eating disorder.

Examining the Effects of Two Mindful Eating Exercises on Chocolate Consumption

Abstract. The present study aimed to investigate and compare the impact of the Mindful Construal Diary (MCD) and the Mindful Raisin Exercise on the sensory tasting experience of chocolate and participants’ chocolate consumption. Participants were randomly allocated into three conditions (MCD, mindful raisin exercise, and mindless control), and engaged with either the MCD, the mindful raisin exercise, or, were asked to read a news article, respectively, while they ate a piece of chocolate. They then rated their satisfaction and desire to consume more chocolate on a 10-point Likert scale, and filled in a state mindful eating scale. Afterward, participants were informed that the study had ended and were asked to wait while the experimenter recorded some information, and any extra chocolate consumption during this time was recorded. Participants in both mindfulness conditions consumed significantly less chocolate after the exercise than participants in the control condition. No significant differences were found between the three conditions on ratings of satisfaction and desire to consume more chocolate. Both the MCD and the raisin exercise can be used to successfully moderate the intake of calorific foods, while the MCD can be utilized as an alternative practice to the typical meditation-based interventions.

Cueing healthier alternatives for take-away: a field experiment on the effects of (disclosing) three nudges on food choices

Background

The current field experiment demonstrates the effectiveness of nudging to promote healthy food choices.

Methods

Three types of nudges were implemented at a take-away food vendor: 1) an accessibility nudge that placed fruits at the front counter; 2) a salience nudge that presented healthy bread rolls to be more visually attractive; and 3) a social proof nudge that conveyed yoghurt as a popular choice. We additionally assessed whether nudging effects would remain robust when a disclosure message was included. The field experiment was conducted over a seven-week period. The measured outcome was the sales of the targeted healthy food products.

Results

The accessibility nudge significantly increased the sales of the fresh fruits. The impact of the salience nudge was limited presumably due to existing preferences or habits that typically facilitate bread purchases. As the sales of the yoghurt shakes remained consistently low over the seven-week period the impact of the social proof nudge remained unexamined. Critically, disclosing the purpose of the nudges did not interfere with effects.

Conclusions

Current findings suggest nudging as an effective strategy for healthy food promotion, and offer implications for topical debate regarding the ethics of nudges.

Enteroendocrine Connections in Congenital Isolated GH Deficiency Due to a GHRH Receptor Gene Mutation

CONTEXT

GH and IGF-1 are crucial for attainment of normal body size and regulation of food intake, nutrient storage, and insulin sensitivity. Enteroendocrine connections exist between the GH-IGF-1 axis and insulin, ghrelin, and glucagon-like peptide 1 (GLP-1). The status of these connections in GH deficiency (GHD) is unknown.

OBJECTIVE

To study the enteroendocrine connections before and after a standard meal test in a homogeneous population of adults with congenital untreated isolated GHD (IGHD) due to a mutation in the GHRH receptor gene.

DESIGN

In a cross-sectional study of 20 individuals with IGHD and 20 control subjects, we measured glucose, insulin, ghrelin, and GLP-1 before and 30, 60, 120, and 180 minutes after a standardized test meal. Homeostasis model assessment index of insulin resistance (HOMA-IR) and homeostasis model assessment (HOMA)-β were calculated. Participants scored feelings of hunger, fullness, and prospective food consumption on a visual analog scale.

MAIN OUTCOME MEASURES

Area under the curve (AUC) values of glucose, insulin, ghrelin, GLP-1, hunger, fullness, and prospective food consumption.

RESULTS

Fasting HOMA-IR and HOMA-β were lower in individuals with IGHD than in control subjects (P = 0.002 and P = 0.023, respectively). AUC was higher for hunger (P < 0.0001), glucose (P = 0.0157), ghrelin (P < 0.0001), and GLP-1 (P < 0.0001) and smaller for fullness (P < 0.0001) in individuals with IGHD compared with control subjects. There was no difference in AUC for prospective food consumption or insulin.

CONCLUSIONS

Untreated IGHD is associated with increased GLP-1 secretion and reduced postprandial ghrelin and hunger attenuation in response to a mixed meal. These enteroendocrine connections can result in a favorable outcome in terms of environmental adaptation and guaranteeing appropriate food intake and can confer metabolic benefits.

Issues in Measuring and Interpreting Human Appetite (Satiety/Satiation) and Its Contribution to Obesity

PURPOSE OF REVIEW

The goals of this paper are to report current research practices in investigations of human appetite control and to assess their relationships with emerging theoretical principles. Appetite is often distinguished by the separation of homeostatic and hedonic processes.

RECENT FINDINGS

This report assesses the validity of a homeostatic toolkit to measure subjectively perceived hunger and its relationship to the developing processes of satiation (control of meal size) and satiety (control of the post-eating period). The capacity of a procedure to measure the influence of hedonic processes on food intake is also evaluated. A major issue is the relationship between the pattern of eating behaviour (influenced by the underlying drive to eat and the inhibition induced by the act of eating itself) and the parallel underlying profile of hormonal and other metabolic biomarkers. Increasing recognition is being given to individual variability in the expression of appetite, and the fact that the use of the average (mean) response conceals important information about the nature of appetite control. There is a growing interest in the identification of satiety phenotypes that operate in parallel to metabolic phenotypes. Interestingly, energy expenditure (metabolic and behavioural) contributes to an energy balance framework for understanding energy intake (appetite).

How does grazing relate to body mass index, self-compassion, mindfulness and mindful eating in a student population?

Contemporary research investigating obesity has focused on grazing (i.e. an uncontrolled and repetitive consumption of small amounts of food). Meanwhile, constructs such as mindfulness, mindful eating and self-compassion have received much attention in assisting individuals with eating behaviours and weight regulation. The association between those constructs and grazing, however, has not been explored. In a cross-sectional study, university students (n = 261) were recruited to explore the relationship of mindfulness, mindful eating and self-compassion with current weight and grazing. Results indicated that all constructs were negatively related to grazing, but only mindful eating related negatively to current weight. In addition, mindful eating mediated the relationship between grazing and current weight. Possible explanations and future directions are discussed further with an emphasis on the need for more empirical work.

A brief review of salient factors influencing adult eating behaviour

A better understanding of the factors that influence eating behaviour is of importance as our food choices are associated with the risk of developing chronic diseases such as obesity, CVD, type 2 diabetes or some forms of cancer. In addition, accumulating evidence suggests that the industrial food production system is a major contributor to greenhouse gas emission and may be unsustainable. Therefore, our food choices may also contribute to climate change. By identifying the factors that influence eating behaviour new interventions may be developed, at the individual or population level, to modify eating behaviour and contribute to society’s health and environmental goals. Research indicates that eating behaviour is dictated by a complex interaction between physiology, environment, psychology, culture, socio-economics and genetics that is not fully understood. While a growing body of research has identified how several single factors influence eating behaviour, a better understanding of how these factors interact is required to facilitate the developing new models of eating behaviour. Due to the diversity of influences on eating behaviour this would probably necessitate a greater focus on multi-disciplinary research. In the present review, the influence of several salient physiological and environmental factors (largely related to food characteristics) on meal initiation, satiation (meal size) and satiety (inter-meal interval) are briefly discussed. Due to the large literature this review is not exhaustive but illustrates the complexity of eating behaviour. The present review will also highlight several limitations that apply to eating behaviour research.

An Exploratory Study on the Influence of Psychopathological Risk and Impulsivity on BMI and Perceived Quality of Life in Obese Patients

The present study aimed to assess the psychological profiles of adult male and female obese patients, as well as to verify the possible influence of their psychopathological risk and impulsivity on their body mass index (BMI) and perceived quality of life. A total of 64 obese subjects accessing a center for care of their obesity were assessed through anthropometric and psychometric measurements. All anthropometric measures in men were higher than in women, while in turn, women showed higher psychopathological symptoms. Furthermore, the symptoms of somatization and psychoticism were predictors for a higher BMI in men, but there was no effect of psychopathological symptoms on the perceived quality of life (QoL) of male subjects. Moreover, in women, somatization and attentional impulsivity were predictors for a higher BMI, whereas no correlation was found between their psychopathological risk and perceived QoL. The results of regression analysis underlined that somatization is a “core” psychopathological symptom in obese subjects regardless of their sex, which is a potential predictor for a higher BMI. The psychological difficulties of the subjects had no effect on their perceived QoL, suggesting that they find it difficult to reflect on the impact that obesity has on their life.

Distraction, restrained eating and disinhibition: An experimental study of food intake and the impact of ‘eating on the go’

To assess the impact of distraction on subsequent eating, 60 females consumed a cereal bar while watching TV, walking or talking, and their subsequent desire to eat and food intake were assessed. No effects were found for desire to eat. But while those higher in restrained eating consumed less overall and fewer calories after watching TV or talking, they consumed more overall and more calories (specifically five times more chocolate) if the cereal bar was eaten while walking. ‘Eating on the go’ may disinhibit restrained eaters either as a form of distraction or by offering a justification to overeat.

Intuitive eating is inversely associated with body weight status in the general population-based NutriNet-Santé study

OBJECTIVE

To examine the relationship between intuitive eating (IE), which includes eating in response to hunger and satiety cues rather than emotional cues and without having forbidden foods, and weight status in a large sample of adults.

METHODS

A total of 11,774 men and 40,389 women aged ≥18 years participating in the NutriNet-Santé cohort were included in this cross-sectional analysis. Self-reported weight and height were collected as well as IE levels using the validated French version of the Intuitive Eating Scale-2. The association between IE and weight status was assessed using multinomial logistic regression models.

RESULTS

A higher IE score was strongly associated with lower odds of overweight or obesity in both men and women. The strongest associations were observed in women for both overweight [quartile 4 vs. 1 of IE: odds ratio, 95% confidence interval: (0.19, 0.17-0.20)] and obesity (0.09, 0.08-0.10). Associations in men were as follows: for overweight (0.43, 0.38-0.48) and obesity (0.14, 0.11-0.18).

CONCLUSIONS

IE is inversely associated with overweight and obesity which supports its importance. Although no causality can be inferred from the reported associations, these data suggest that IE might be relevant for obesity prevention and treatment.

Impact of nutritional labelling on 10-d energy intake, appetite perceptions and attitudes towards food

The purpose of this study was to investigate the impact of nutritional labelling on energy intake, appetite perceptions and attitudes towards food. During a 10-d period, seventy normal-weight (BMI<25 kg/m2) and seventy-one obese women (BMI≥30 kg/m2) were given three meals per d under ad libitum conditions. Participants were randomly assigned to one of three experimental labelling groups in which the only difference was the label posted on lunch meal entrée: (1) low-fat label, (2) energy label (energy content of the entrée and average daily needs) and (3) no label (control). Average energy intake was calculated by weighing all foods before v. after daily consumption. Hunger and fullness perceptions were rated on visual analogue scales immediately before and after each meal. Satiety efficiency was assessed through the calculation of the satiety quotient (SQ). The appreciation and perceived healthiness of the lunch entrées were rated on eight-point Likert scales. There was no difference in energy intake, SQ and attitudes towards food between the three labelling groups. Fasting hunger perception was higher in the low-fat label group compared with the two others groups (P=0·0037). No interactions between labelling groups and BMI categories were observed. In conclusion, although labelling does not seem to influence energy intake, a low-fat label may increase women’s fasting hunger perceptions compared with an energy label or no label.

Effect of extended morning fasting upon ad libitum lunch intake and associated metabolic and hormonal responses in obese adults

Background/Objectives:

Breakfast omission is positively associated with obesity and increased risk of disease. However, little is known about the acute effects of extended morning fasting upon subsequent energy intake and associated metabolic/regulatory factors in obese adults.

Subjects/Methods:

In a randomised cross-over design, 24 obese men (n=8) and women (n=16) extended their overnight fast by omitting breakfast consumption or ingesting a typical carbohydrate-rich breakfast of 2183±393 kJ (521±94 kcal), before an ad libitum pasta lunch 3 h later. Blood samples were obtained throughout the day until 3 h post lunch and analysed for hormones implicated in appetite regulation, along with metabolic outcomes and subjective appetite measures.

Results:

Lunch intake was unaffected by extended morning fasting (difference=218 kJ, 95% confidence interval −54 kJ, 490 kJ; P=0.1) resulting in lower total intake in the fasting trial (difference=−1964 kJ, 95% confidence interval −1645 kJ, −2281 kJ; P<0.01). Systemic concentrations of peptide tyrosine–tyrosine and leptin were lower during the afternoon following morning fasting (P⩽0.06). Plasma-acylated ghrelin concentrations were also lower following the ad libitum lunch in the fasting trial (P<0.05) but this effect was not apparent for total ghrelin (P⩾0.1). Serum insulin concentrations were greater throughout the afternoon in the fasting trial (P=0.05), with plasma glucose also greater 1 h after lunch (P<0.01). Extended morning fasting did not result in greater appetite ratings after lunch, with some tendency for lower appetite 3 h post lunch (P=0.09).

Conclusions:

We demonstrate for the first time that, in obese adults, extended morning fasting does not cause compensatory intake during an ad libitum lunch nor does it increase appetite during the afternoon. Morning fasting reduced satiety hormone responses to a subsequent lunch meal but counterintuitively also reduced concentrations of the appetite-stimulating hormone-acylated ghrelin during the afternoon relative to lunch consumed after breakfast.

Psychological predictors of opportunistic snacking in the absence of hunger

Increased frequency of eating in the absence of homeostatic need, notably through snacking, is an important contributor to overconsumption and may be facilitated by increased availability of palatable food in the obesogenic environment. Opportunistic initiation of snacking is likely to be subject to individual differences, although these are infrequently studied in laboratory-based research paradigms. This study examined psychological factors associated with opportunistic initiation of snacking, and predictors of intake in the absence of homeostatic need. Fifty adults (mean age 34.5years, mean BMI 23.9kg/m(2), 56% female) participated in a snack taste test in which they ate a chocolate snack to satiation, after which they were offered an unanticipated opportunity to initiate a second eating episode. Trait and behavioural measures of self control, sensitivity to reward, dietary restraint and disinhibited eating were taken. Results showed that, contrary to expectations, those who initiated snacking were better at inhibitory control compared with those who did not initiate. However, amongst participants who initiated snacking, intake (kcal) was predicted by higher food reward sensitivity, impulsivity and BMI. These findings suggest that snacking initiation in the absence of hunger is an important contributor to overconsumption. Consideration of the individual differences promoting initiation of eating may aid in reducing elevated eating frequency in at-risk individuals.

Food consumption as affect modulation in borderline personality

The present study examined relationships among negative affect, borderline personality features, and eating behavior through the experimental manipulation of mood. Undergraduate women (N = 307) completed a baseline mood assessment, viewed a 39-minute sad film either with or without concurrent food presentation, then completed a second mood assessment and questionnaires assessing personality and eating attitudes/behaviors. Women reporting more borderline personality features exhibited greater negative affect across time and were more reactive to the sad film. Food presentation appeared to have a small ameliorative effect on sadness and general negative affect. However, quantity of food consumption was associated with improvements in mood only for women reporting higher levels of borderline personality features. These data suggest that women with borderline personality characteristics may be at elevated risk for developing problems with binge eating, because consuming larger quantities of food appeared to have a tempering effect on their negative mood and feelings of sadness.

Mindfulness, Eating Behaviours, and Obesity: A Review and Reflection on Current Findings

Mindfulness and mindful eating have become popular in recent years. In this review, we first explore what mindfulness is in the context of psychological research, and why it offers promise for eating behaviours and weight loss. Second, we review the main empirical findings for weight loss in mindfulness-based intervention programmes. Third, contradictions in the findings are explored in more depth, and suggestions are made regarding why they may be occurring. Fourth, the benefits of adding self-compassion (and compassion) training to mindfulness practise to assist weight loss is discussed. Finally, the limitations of the research literature (and possible solutions) are explored. Overall, it is concluded that while mindfulness meditations that specifically focus on eating may be extremely helpful in promoting better eating behaviours, and assist in weight regulation, work is still needed to make such interventions appeal to a wider audience.

It's my party and I eat if I want to. Reasons for unhealthy snacking

Investigating the reasons that people give for unhealthy snacking behavior is important for developing effective health interventions. Little research, however, has identified reasons that apply to a large audience and most studies do not integrate multiple factors, precluding any conclusions regarding their relative importance. The present study explored reasons for unhealthy snacking among a representative community sample. Participants (N = 1544) filled out the newly developed Reasons to Snack inventory assessing an elaborate range of motives at baseline and 1-month follow-up. Exploratory and replication factor analyses identified six categories: opportunity induced eating, coping with negative emotions, enjoying a special occasion, rewarding oneself, social pressure, and gaining energy. The highest mean scores were obtained for enjoying a special occasion and opportunity induced eating. Regression analyses with participant characteristics as independent variables and each category of reasons as dependent variables showed differences for age. For all reasons except to enjoy a special occasion, younger people reported a higher score. Women indicated a higher score than men on coping with negative emotions, enjoying a special occasion and gaining energy. People who diet to a stronger extent reported a higher score for snacking because of social pressure, to reward oneself and to cope with negative emotions, with the latter also being related to a higher BMI. Finally, a higher education was associated with enjoying a special occasion. Future health interventions could allocate more attention to diminishing unhealthy snacking with regard to the six identified categories, specifically focusing on enjoying a special occasion and opportunity induced eating.

Metabolic Phenotyping Guidelines: studying eating behaviour in humans

The study of human appetite and eating behaviour has become increasingly important in recent years due to the rise in body weight dysregulation through both obesity and eating disorders. Adequate control over appetite is paramount for the control of body weight and in order to understand appetite, it is necessary to measure eating behaviour accurately. So far, research in this field has revealed that no single experimental design can answer all research questions. Each research question posed will require a specific study design that will limit the findings of that study to those particular conditions. For example, choices will be made among the use of laboratory or free-living studies, time period for examination, specific measurement techniques and investigative methodologies employed. It is important that these represent informed decisions about what design and which methodology will provide the most meaningful outcomes. This review will examine some of the 'gold standard' study designs and methodologies currently employed in the study of human appetite and eating behaviour.

The portion size effect on food intake. An anchoring and adjustment process?

People consistently over-eat when served a large compared with a small (appropriate) portion of food. However, the mechanism underlying this so-called portion size effect is not well understood. We argue that the process of anchoring and adjustment naturally describes this effect, such that the size of a presented portion works as an anchor that strongly influences consumption. The classical anchoring and adjustment paradigm was applied to six hypothetical eating situations. Participants were asked to imagine being served either a small or a large portion of food (i.e., low and high anchor) and to indicate whether they would consume more or less than this amount. Then, they indicated how much they would eat. These estimates were compared with a no-anchor condition where participants did not imagine a specific portion size but only indicated how much they would eat. In addition, half of participants in the anchoring conditions received a discounting instruction stating that the portion size they had been asked to imagine was randomly selected and thus not informative for their consumption estimate. As expected, participants who imagined to be served larger portions estimated to consume significantly more food than participants in the no-anchor condition, and participants who imagined to be served smaller portions estimated to consume significantly less food than participants in the no-anchor condition. The discounting manipulation did not reduce this effect of the anchors. We suggest that the process of anchoring and adjustment may provide a useful framework to understand the portion size effect and we discuss implications of this perspective.

Reasons for eating 'unhealthy' snacks in overweight and obese males and females

BACKGROUND

Snack foods are often high in fat and sugar. Thus, reducing snack consumption may be a useful weight management strategy. However, individuals may snack for a variety of reasons with different implications for intervention. The present study examined the perceived reasons for eating main meals, 'unhealthy' snacks (i.e. snacks high in fat or sugar) and 'healthy' snacks in overweight and obese participants.

METHODS

Over a period of 5 days, 28 males and 27 females completed a food diary every time they ate. As well as providing details about the type of eating episode and food eaten, they also rated their agreement with 13 different reasons for eating (identified from relevant literature and a pilot study).

RESULTS

Across a total of 1084 eating episodes, 358 were coded as snacks, 79% of which were high in either fat or sugar. The results showed that hunger and temptation (external eating) were reported as a reason for eating unhealthy snacks in 49% and 55% of all episodes, respectively. Eating because the individual was feeling fed up, bored or stressed (emotional eating) was given as a reason in 26% of episodes.

CONCLUSIONS

These findings point to the potential utility of intervention strategies that target cravings, enhance self-control or promote stimulus control.

Behavioural strategies to control the amount of food selected and consumed

Several factors within the food environment may stimulate overconsumption. The present study aimed to (1) identify behavioural strategies to cope with this environment to control the amount of food consumed, (2) examine the feasibility and usefulness of the strategies, and (3) evaluate the association between the strategies and body mass index (BMI). After the literature was screened for evidence of factors that contribute to the consumption of large amounts of food, 32 behavioural strategies were identified to overcome these influences (study 1). Subjectively reported feasibility and usefulness of the 32 behavioural strategies in weight management were explored using a pretest post-test study (study 2: n = 52). Additionally, two cross-sectional questionnaire studies (study 3a: n = 120 and study 3b: n = 278) were conducted to evaluate the association between the 32 behavioural strategies and BMI. The strategies were subjectively reported as feasible and useful in weight management. Frequent use of strategies discriminated non-overweight from overweight individuals, but did not discriminate overweight from obese individuals. In conclusion, the findings provided preliminary evidence for the acceptability and validity of the strategies. The effectiveness of the strategies for controlling the amount consumed should be further investigated, especially in overweight and obese participants.

Effects of mindful eating training on delay and probability discounting for food and money in obese and healthy-weight individuals

Obese individuals tend to behave more impulsively than healthy weight individuals across a variety of measures, but it is unclear whether this pattern can be altered. The present study examined the effects of a mindful eating behavioral strategy on impulsive and risky choice patterns for hypothetical food and money. In Experiment 1, 304 participants completed computerized delay and probability discounting tasks for food-related and monetary outcomes. High percent body fat (PBF) predicted more impulsive choice for food, but not small-value money, replicating previous work. In Experiment 2, 102 randomly selected participants from Experiment 1 were assigned to participate in a 50-min workshop on mindful eating or to watch an educational video. They then completed the discounting tasks again. Participants who completed the mindful eating session showed more self-controlled and less risk-averse discounting patterns for food compared to baseline; those in the control condition discounted similarly to baseline rates. There were no changes in discounting for money for either group, suggesting stimulus specificity for food for the mindful eating condition.

Overweight and obese humans overeat away from home

The built environment has been implicated in the development of the epidemic of obesity. We investigated the differences in the meal patterns of normal weight vs. overweight/obese individuals occurring at home vs. other locations. The location of meals and their size in free-living participants were continuously recorded for 7 consecutive days. Study 1: 81 males and 84 females recorded their intake in 7-day diet diaries and wore a belt that contained a GPS Logger to record their location continuously for 7 consecutive days. Study 2: 388 males and 621 females recorded their intake in diet diaries for 7 consecutive days. In both studies, compared to eating at home, overweight/obese participants ate larger meals away from home in both restaurants and other locations than normal weight participants. Overweight/obese individuals appear to be more responsive to environmental cues for eating away from home. This suggests that the influence of the built environment on the intake of overweight/obese individuals may contribute to the obesity epidemic.

Body composition, dietary composition, and components of metabolic syndrome in overweight and obese adults after a 12-week trial on dietary treatments focused on portion control, energy density, or glycemic index

BACKGROUND

Given the rise in obesity and associated chronic diseases, it is critical to determine optimal weight management approaches that will also improve dietary composition and chronic disease risk factors. Few studies have examined all these weight, diet, and disease risk variables in subjects participating in recommended multi-disciplinary weight loss programs using different dietary strategies.

METHODS

This study compared effects of three dietary approaches to weight loss on body composition, dietary composition and risk factors for metabolic syndrome (MetS). In a 12-week trial, sedentary but otherwise healthy overweight and obese adults (19 M & 138 F; 38.7±6.7 y; BMI 31.8±2.2) who were attending weekly group sessions for weight loss followed either portion control, low energy density, or low glycemic index diet plans. At baseline and 12 weeks, measures included anthropometrics, body composition, 3-day food diaries, blood pressure, total lipid profile, HOMA, C-reactive protein, and fasting blood glucose and insulin. Data were analyzed by repeated measures analysis of variance.

RESULTS

All groups significantly reduced body weight and showed significant improvements in body composition (p<0.001), and components of metabolic syndrome (p<0.027 to 0.002), although HDL decreased (p<0.001). Dietary energy, %fat and %saturated fat decreased while protein intake increased significantly (p<0.001). There were no significant differences among the three groups in any variable related to body composition, dietary composition, or MetS components.

CONCLUSION

Different dietary approaches based on portion control, low energy density, or low glycemic index produced similar, significant short-term improvements in body composition, diet compositin, and MetS components in overweight and obese adults undergoing weekly weight loss meetings. This may allow for flexibility in options for dietary counseling based on patient preference.

Ecological momentary assessment of obesogenic eating behavior: combining person-specific and environmental predictors

Obesity has been promoted by a food environment that encourages excessive caloric intake. An understanding of how the food environment contributes to obesogenic eating behavior in different types of individuals may facilitate healthy weight control efforts. In this study, Ecological Momentary Assessment (EMA) via palmtop computers was used to collect real-time information about participants' environment and eating patterns to predict overeating (i.e., greater than usual intake during routine meals/snacks, and eating outside of a participant's normal routine) that could lead to weight gain. Thirty-nine women (BMI = 21.6 ± 1.8; age = 20.1 ± 2.0 years; 61% white) of normal weight (BMI 18.5-25) completed the Three Factor Eating Questionnaire and the Power of Food Scale (PFS), and carried a palmtop computer for 7-10 days, which prompted them to answer questions about eating events, including a count of the types of good tasting high-calorie foods that were available. None of the self-report measures predicted overeating, but BMI interacted with the number of palatable foods available to predict overeating (P = 0.035). Compared to leaner individuals who reported a relatively low frequency of overeating regardless of the availability of palatable food, the probability of overeating among heavier individuals was very low in the absence of palatable food, but quickly increased in proportion to the number of palatable foods available. Our findings suggest that the eating behavior of those with higher relative weights is susceptible to the presence of palatable foods in the environment. Individuals practicing weight control may benefit from limiting their exposure to good tasting high-calorie food in their immediate environment.

Effects of high and low glycemic load meals on energy intake, satiety and hunger in obese Hispanic-American youth

Some short-term pediatric studies have suggested beneficial effects of low glycemic load (LGL) meals on feelings of hunger and on energy intake. However, the effects of LGL diets have not been systematically studied in obese Hispanic children, who stand to benefit from successful interventions.

OBJECTIVE

To examine the effects of LGL and high-GL (HGL) meals on appetitive responses and ad libitum energy intake of obese Hispanic youth.

METHODS

A total of 88 obese Hispanic youth aged 7-15 years were enrolled in a community-based obesity intervention program and randomly assigned to consume meals designed as either LGL (n = 45) or HGL (n = 43). After 12 weeks, participants were admitted for a 24-hour metabolic study. Following the morning test meal, subjects serially reported hunger, fullness, and satiety using a visual analog scale. Blood insulin and glucose were measured. After 5 hours, participants were fed another test meal and given a snack platter from which to eat ad libitum. All test food was weighed and the energy, macronutrients, and glycemic load (GL) of consumed foods were calculated.

RESULTS

The HGL group had significantly higher insulin (p = 0.0005) and glucose (p = 0.0001) responses to the breakfast meal compared with the LGL group. There were no significant between-group differences in energy consumed from the snack platter (1303 vs. 1368 kcal, p = 0.5), or in the subjective feelings of hunger (p = 0.3), fullness (p = 0.5) or satiety (p = 0.3) between the two groups.

CONCLUSIONS

Our study provides no evidence that, for obese Hispanic youth, changing the GL of the diet affects short-term hunger, fullness, satiety, or energy intake. ClinicalTrials.gov Identifier: NCT01068197.

What determines real-world meal size? Evidence for pre-meal planning

The customary approach to the study of meal size suggests that 'events' occurring during a meal lead to its termination. Recent research, however, suggests that a number of decisions are made before eating commences that may affect meal size. The present study sought to address three key research questions around meal size: the extent to which plate-cleaning occurs; prevalence of pre-meal planning and its influence on meal size; and the effect of within-meal experiences, notably the development of satiation. To address these, a large-cohort internet-based questionnaire was developed. Results showed that plate-cleaning occurred at 91% of meals, and was planned from the outset in 92% of these cases. A significant relationship between plate-cleaning and meal planning was observed. Pre-meal plans were resistant to modification over the course of the meal: only 18% of participants reported consumption that deviated from expected. By contrast, 28% reported continuing eating beyond satiation, and 57% stated that they could have eaten more at the end of the meal. Logistic regression confirmed pre-meal planning as the most important predictor of consumption. Together, our findings demonstrate the importance of meal planning as a key determinant of meal size and energy intake.

A health assessment tool for multiple risk factors for obesity: age and sex differences in the prediction of body mass index

The aim was to establish the relative importance of multiple dietary, activity and other risk factors in determining BMI. A cross-sectional survey was conducted with 322 adults (71 % female; aged 18-79 years; BMI 16.5-40.9 kg/m2) using a previously developed, psychometrically tested, seventy-three-item questionnaire covering a wide range of obesity risk factors (consisting of five dietary, five activity and seven other risk factor subscales). Outcome was self-reported weight and height for BMI, cross-validated with items on clothes size and perceived need to lose weight. Stepwise regression analysis predicted 25-55 % of the variance in BMI with physical activity participation, current and past dieting behaviour, amount eaten, and age being the most important predictors. The association of lower BMI and younger age appeared to be due to higher activity levels, as younger participants reported much less healthy eating behaviour than the older age group. Amount eaten and physical activity participation were stronger predictors of BMI than other factors including healthy eating and use of mechanised transport. Results showed that the relationship between various risk factors and obesity may differ by both sex and age group, suggesting that different interventions may need to be targeted at different groups. The higher-risk eating behaviour observed in younger participants is of concern and needs to be addressed, if the current trend of rising obesity levels is to be halted.

Appetite control: methodological aspects of the evaluation of foods

This report describes a set of scientific procedures used to assess the impact of foods and food ingredients on the expression of appetite (psychological and behavioural). An overarching priority has been to enable potential evaluators of health claims about foods to identify justified claims and to exclude claims that are not supported by scientific evidence for the effect cited. This priority follows precisely from the principles set down in the PASSCLAIM report. The report allows the evaluation of the strength of health claims, about the effects of foods on appetite, which can be sustained on the basis of the commonly used scientific designs and experimental procedures. The report includes different designs for assessing effects on satiation as opposed to satiety, detailed coverage of the extent to which a change in hunger can stand alone as a measure of appetite control and an extensive discussion of the statistical procedures appropriate for handling data in this field of research. Because research in this area is continually evolving, new improved methodologies may emerge over time and will need to be incorporated into the framework. One main objective of the report has been to produce guidance on good practice in carrying out appetite research, and not to set down a series of commandments that must be followed.

Managing the pandemic of obesity: siding with the fox or the hedgehog?

Obesity is a major public health problem of pandemic proportion. Despite its high prevalence and widespread distribution (consistent with a common underlying etiology), clinical psychologists and primary care physicians routinely approach the problem with individualized but often ineffective treatments like psychotherapy and pharmacotherapy, or propose alterations to specific components of the 'toxic environment', cultural influences, and psychosocial factors purported to cause overeating. This paper presents an alternative perspective and proposes a potential framework for assisting health professionals in developing rational approaches to education about and preventive treatment of obesity based on the role of factors in early life that contribute to personality and behavior and which over time lead to obesity and its maintenance.

State craving, food availability, and reactivity to preferred snack foods

The startle response has been shown to be useful in studying reactivity to food cues. Following 6h of food deprivation and exposure to neutral and food cues, we examined the role of state craving combined with both a short and long delay of consumption on affect and startle reflex. Participants completed the PANAS, consumed a controlled early morning meal, and experienced 6h of food deprivation. They then reported back to the laboratory, completed a second baseline PANAS, and had their baseline eyeblink EMG startle responses to 100 dB(A) startle probe assessed. Prior to and following the presentation of cues, startle probes were presented and responses were recorded. The PANAS and state craving were also assessed after each cue. Food cues provoked higher levels of state craving than neutral cues and startle responses failed to habituate as quickly to food cues as they did to neutral cues. In addition, cue exposure created the highest NA among high state cravers in the long delay of consumption group. Startle responses differed from NA in that with long delay startle was high irrespective of state craving scores; in the short delay of consumption condition, startle increased linearly with state craving. These results illustrate that state craving and expectations of food availability are important variables in understanding food-related cue reactivity.