Restrained Eating and Food Cues: Recent Findings and Conclusions

The Absence of Attentional Bias to Low-Calorie Food Stimuli in Restrictive Dieters: Differences in the Allocation of Attentional Resources to High-Calorie Foods

Restrictive dieters are those who expect to achieve body shape and weight control through dieting. However, they often have difficulty suppressing the desire to consume food when confronted with it. It has been shown that when high- and low-calorie foods are presented together, the attention of restrictive eaters is preferentially directed to high-calorie foods. However, whether attentional bias occurs when low-calorie foods are present alone and whether the allocation of attentional resources is consistent with that for high-calorie foods has yet to be explored. The present study focused on the effects of high-/low-calorie foods on attentional bias in restrictive dieters. Seventy-eight participants were recruited to participate in the experiment via the Dutch Eating Behavior Questionnaire (DEBQ) scale, which is administered in a rapid serial visual presentation (RSVP) task. The results revealed that failed restrictive dieters had the lowest percentage of correct answers at the lag2 level, indicating attentional bias. Failed restrictive dieters allocated more attentional resources to high-calorie foods than to low-calorie foods. Restrictive dieters showed no attentional bias when low-calorie foods were presented alone. The results suggest that low-calorie foods do not elicit an attentional bias in restrictive dieters and that the allocation of attentional resources is not consistent when compared to that for high-calorie foods.

Mendelian Randomization Analysis Identifies Inverse Causal Relationship between External Eating and Metabolic Phenotypes

Disordered eating contributes to weight gain, obesity, and type 2 diabetes (T2D), but the precise mechanisms underlying the development of different eating patterns and connecting them to specific metabolic phenotypes remain unclear. We aimed to identify genetic variants linked to eating behaviour and investigate its causal relationships with metabolic traits using Mendelian randomization (MR). We tested associations between 30 genetic variants and eating patterns in individuals with T2D from the Volga-Ural region and investigated causal relationships between variants associated with eating patterns and various metabolic and anthropometric traits using data from the Volga-Ural population and large international consortia. We detected associations between HTR1D and CDKAL1 and external eating; between HTR2A and emotional eating; between HTR2A, NPY2R, HTR1F, HTR3A, HTR2C, CXCR2, and T2D. Further analyses in a separate group revealed significant associations between metabolic syndrome (MetS) and the loci in CRP, ADCY3, GHRL, CDKAL1, BDNF, CHRM4, CHRM1, HTR3A, and AKT1 genes. MR results demonstrated an inverse causal relationship between external eating and glycated haemoglobin levels in the Volga-Ural sample. External eating influenced anthropometric traits such as body mass index, height, hip circumference, waist circumference, and weight in GWAS cohorts. Our findings suggest that eating patterns impact both anthropometric and metabolic traits.

A Mexican Spanish Adaptation of the Dutch Eating Behavior Questionnaire: Psychometric Properties and Influence of Sociodemographic Variables in Pregnant Women

Eating behaviors are complex phenomena, entangling physiological signals of hunger and satiety, food choices, emotional states, and social factors and expectations, as well as food availability and sensory appearance. Evaluating eating behaviors is challenging and must cover different motives. One instrument for such evaluation is the Dutch Eating Behavior Questionnaire (DEBQ), composed of three subscales for exploring emotional eating, external eating, and restrained eating. In this article, we aimed to (1) evaluate the psychometric properties of a Mexican Spanish adaptation of the DEBQ; and (2) explore the associations between the three adapted DEBQ scales and the influence of sociodemographic factors on each of the three eating behaviors in Mexican pregnant women. A sample of 514 pregnant women responded to our adapted version of the DEBQ and a questionnaire about sociodemographic information. We performed an exploratory factor analysis using a principal component analysis with varimax rotation; based on this analysis, we removed items that loaded on two factors and then performed a confirmatory factor analysis. The final version of the adapted DEBQ has 26 items, clearly divided into a three-factor structure and satisfactorily reliable (Cronbach's ⍺ = 0.903). We then performed Spearman bivariate correlations and multivariate linear regression with backward variable selection to test the associations and influence of sociodemographic factors on each of the three eating behaviors evaluated with the DEBQ. In pregnant women, emotional eating (EmoE) had a medium-high correlation with external eating (ExtE) and a low correlation with restrained eating (RestE), while ExtE and RestE showed no association. The three eating behaviors are associated with maternal sociodemographic and reproductive variables, which partly explain their variation, most notably maternal schooling. Our adapted version of the DEBQ is suitable for use with Mexican Spanish-speaking pregnant women. Maternal sociodemographic and reproductive factors have an influence on the variance of eating behaviors during pregnancy.

Anodal stimulation of inhibitory control and craving in satiated restrained eaters

OBJECTIVES

Eating and weight disorders are severe and complex clinical conditions which, among other behaviors, include (attempts at) restrained eating, food avoidance, following dietary rules, and overeating. Comparable to women with obesity, restrained eaters (RE) without formal eating disorder diagnosis are worse at inhibiting their motor responses than unrestrained eaters (URE). According to neuroimaging studies, the right inferior frontal gyrus (rIFG) is involved in inhibitory control which, in turn, could be improved by neuromodulation such as anodal transcranial direct current stimulation (tDCS) across rIFG.

METHODS

This double-blind sham-controlled cross-over study was conducted after a standardized breakfast. Normal-weight female RE und URE performed a stop-signal task (SST) with food and non-food stimuli during sham or anodal tDCS. Food craving, hunger, and satiety were self-reported before and after tDCS. We employed a mixed between-subjects (group: RE vs. URE) and within-subjects factorial design (tDCS: anodal tDCS vs. sham; stimuli: food vs. control pictures).

RESULTS

Breakfast consumption was comparable for RE and URE, as well as craving, hunger, and thirst. Regarding inhibitory control, a significant two-way interaction between group and tDCS ermerged: RE had longer stop-signal reaction times (SSRTs) during sham tDCS, but they improved to the level of URE by application of anodal tDCS.

DISCUSSION

Results replicated an inhibitory control deficit in RE with longer SSRTs compared to URE without stimulation. During anodal tDCS to the rIFG, reduced SSRTs in RE indicated an improvement in inhibitory control. The findings suggest a specificity of rIFG stimulation in at-risk groups with regards to inhibitory control irrespective of craving.

The Power of Suggestion: Subjective Satiety Is Affected by Nutrient and Health-Focused Food Labelling with No Effect on Physiological Gut Hormone Release

Health claims on food labelling can influence peoples' perception of food without them actually eating it, for example driving a belief that a particular food will make them feel fuller. The aim of this study was to investigate whether nutrient and health claims on food labelling can influence self-reported, and physiological indicators of, satiation. A total of 50 participants attended two visits where they were asked to consume a 380 kcal breakfast (granola and yogurt) labelled as a 500 kcal 'indulgent' breakfast at one visit and as a 250 kcal 'sensible' breakfast at the other. The order of the breakfast descriptions was randomly allocated. Participants were unaware that the two breakfasts were the same product and that only the food labels differed. At each visit blood samples were collected to measure gut hormone levels (acylated ghrelin, peptide tyrosine-tyrosine and glucagon-like peptide-1) at three time points: 20 min after arrival (baseline), after 60 min (anticipatory, immediately prior to consumption) and after 90 min (post-consumption). Visual analogue scales measuring appetite (hunger, satiety, fullness, quantity and desire to eat) were completed prior to each sample. Between 60 and 90 min, participants consumed the breakfast and rated its sensory appeal. Participants reported a higher mean change in self-reported fullness for the 'indulgent' than the 'sensible' breakfast from anticipatory to post-consumption (mean difference: 7.19 [95% CI: 0.73, 13.6]; p = 0.030). This change was not observed for the other appetite measures at the other time points or gut hormone levels. This study suggests that nutrient and health claims on food labels may influence satiation as measured by self-reported fullness. It also suggests that the observed differences in satiety scores are not due to changes in the main appetite regulating gut hormones, but are more likely centrally mediated. More high-quality trials are required to confirm these findings.

Craving for carbs: food craving and disordered eating in low-carb dieters and its association with intermittent fasting

Studies point to positive outcomes in a diet with reduction of carbohydrates and that the associated practice of intermittent fasting (IF) might increase weight loss. Although dieting might be related to disordered eating, little evidence is available about the role of restrictive carbohydrates diets on disordered eating. This study aimed to explore if doing low-carb (LC) diets was related to disordered eating and if IF would increase these symptoms. The sample comprised university students (n = 682), with a mean age of 22 years old and average BMI of 23.6 kg/m2 (SD = 4.3). Twenty-seven percent (n = 188) of respondents reported doing LC diet in the last three months. Of those, 31% (n = 58) reported doing LC diet combined with periods of IF. Mean scores were compared using parametric tests, and effects size and correlations between variables were calculated. Dieters showed higher levels of binge eating, food cravings, cognitive restraint, cognitive restraint toward carbohydrates when compared to non-dieters. The association of LC and IF was related to an increase in disordered eating, especially binge eating and food cravings, specifically 'Lack of control', 'Thoughts or preoccupation with food,' and 'Guilt from cravings and/or for giving in to them'. These results provide evidence that restrictive carbohydrate diets and IF may increase cognitive restraint and, consequently, food cravings.Level III: Evidence obtained from cohort or case-control analytic studies.

Examining socio-cognitive factors and beliefs about mindful eating in healthy adults with differing practice experience: a cross-sectional study

Background

Mindful eating (ME), defined as a “non-judgmental awareness of bodily and emotional sensations regarding food consumption”, may be a promising strategy to promote healthy eating behaviors. However, little is known about the psychosocial factors and underlying beliefs that explain ME adoption.

Methods

Participants (N = 282; M_age = 43.2) responded to an online questionnaire based on the I-Change Model. Groups with different frequencies of prior engagement in ME, i.e., low (n = 82; LME), medium (n = 96), and high (n = 104), were compared via (M)ANOVAs on factors and individual beliefs regarding predisposing (i.e., habits, experience with mindfulness, emotional eating, facets of ME), pre-motivational (i.e., knowledge, behavioral cognizance, risk perception, cues to action), and motivational factors (i.e., attitudes, self-efficacy, social influence) as well as their intentions and action planning. Bivariate correlations and a forward-stepwise regression with ICM constructs were conducted to examine model fit.

Results

LME had a greater habit of mindless eating and significantly lower internal awareness, cognizance, cues, and less favorable attitudes, self-efficacy, engagement and support by their social environment, intention, and action plans about engaging in ME than the other two groups. Less habitual mindless eating, and greater experience, internal awareness, cognizance, susceptibility, support, and intention explained 54% of the variance in ME.

Discussion and conclusion

Results indicate that individuals need to be treated differently when promoting ME with respect to their psychosocial characteristics, rather than as a single group with homogenous baseline beliefs, abilities, support, and motivation. Future longitudinal research should examine which determinants are predictors of ME to better tailor program contents.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-022-00977-4.

Alias SR. Age and fasting blood sugar levels are associated factors for mindful eating among Type 2 diabetes mellitus patients during COVID-19 pandemic confinement

The COVID-19 pandemic has impacted the eating behaviours of many people, especially Type 2 Diabetes Mellitus (T2DM) patients. This study aimed to determine the level of mindful eating and its associated factors among T2DM patients at a primary care clinic near Kuala Lumpur. A cross-sectional study was conducted from 18th December 2020 to 5th March 2021 during the movement control order in Malaysia. Respondents were recruited using systematic random sampling via an electronic appointment system. They completed a questionnaire consisting of sociodemographic, clinical profiles, and a Malay-translated Mindful Eating Questionnaire (MEQ-M). Their blood pressure and body mass index were taken during the appointment day while the remaining clinical profiles such as fasting blood sugar (FBS) were obtained from the medical record. Two hundred respondents were recruited with a mean (SD) age of 57.0 (10.90) years. More than half of them were female (54%). Two-thirds of them had uncontrolled diabetes based on elevated FBS of >7 mmol/L (61.5%) and glycated haemoglobin (HbA1c) of >7% (67%), respectively. The mean (SD) score for mindful eating was 2.9 (0.25). Multiple logistic regression revealed that older respondents had a higher level of mindful eating [(AOR = 1.05, p-value 0.01, 95% CI = 1.01–1.09)]. In addition, elevated FBS level was also associated with a greater level of mindful eating [(AOR = 2.55, p-value 0.01, 95% CI = 1.28–5.07)]. Therefore, healthcare providers should promote mindful eating during the consultation, especially among younger patients. Blood glucose monitoring is also recommended to instil awareness of the importance of healthy eating habits.

Effects of Mindset and Dietary Restraint on Attention Bias for Food and Food Intake

Evidence for attention bias (AB) for food in restrained eaters is inconsistent. A person’s mindset related to food – that is, whether someone focuses on the hedonic or health aspects of food – might be an overlooked influence on AB for food, possibly explaining the inconsistency in the literature. Fluctuations between a hedonic versus a health mindset might be strongest in restrained eaters, who have a conflicted relationship with food. We investigated the effect of mindset and dietary restraint on AB for food and food intake. We hypothesized that AB for food, as reflected in eye-movement measures and manual response latencies, as well as food intake, would be larger in the hedonic than in the health mindset, most strongly in participants scoring high on dietary restraint. Moreover, we expected a positive correlation between AB for food and food intake, especially in the hedonic mindset. We used short video clips to induce either a health or hedonic mindset. Subsequently, participants (n = 122) performed a modified additional singleton task with pictures of high-caloric food vs neutral pictures as irrelevant distractors. Next, food intake was measured in a bogus taste test. We found no evidence for an AB towards food, nor any moderation by either mindset or dietary restraint. Food intake tended to be higher for participants scoring higher on dietary restraint, but effects were not moderated by mindset. Response-latency based AB for food tended to correlate positively with food intake in the hedonic mindset. Taken together, our hypotheses regarding AB for food were largely not confirmed. We provide suggestions on how to improve upon the specific implementations of our AB task and mindset manipulation, to strengthen future research in this field.

The role of associative learning in healthy and sustainable food evaluations: An event-related potential study

Individuals in industrialized societies frequently include processed foods in their diet. However, overconsumption of heavily processed foods leads to imbalanced calorie intakes as well as negative health consequences and environmental impacts. In the present study, normal-weight healthy individuals were recruited in order to test whether associative learning (Evaluative Conditioning, EC) could strengthen the association between food-types (minimally processed and heavily processed foods) and concepts (e.g., healthiness), and whether these changes would be reflected at the implicit associations, at the explicit ratings and in behavioral choices. A Semantic Congruency task (SC) during electroencephalography recordings was used to examine the neural signature of newly acquired associations between foods and concepts. The accuracy after EC towards minimally processed food (MP-food) in the SC task significantly increased, indicating strengthened associations between MP-food and the concept of healthiness through EC. At the neural level, a more negative amplitude of the N400 waveform, which reflects semantic incongruency, was shown in response to MP-foods paired with the concept of unhealthiness in proximity of the dorsal lateral prefrontal cortex (DLPFC). This implied the possible role of the left DLPFC in changing food representations by integrating stimuli's features with existing food-relevant information. Finally, the N400 effect was modulated by individuals' attentional impulsivity as well as restrained eating behavior.

Gender, Age, Hunger, and Body Mass Index as Factors Influencing Portion Size Estimation and Ideal Portion Sizes

Portion sizes of meals have been becoming progressively larger which contributes to the onset of obesity. So far, little research has been done on the influence of body weight on portion size preferences. Therefore, we assessed whether Body Mass Index (BMI), as well as other selected factors, contribute to the estimation of food portions weight and the subjective perception of portion sizes. Through online questionnaires, the participants were asked to estimate the weight of pictured foods in the first study. In the second study, the participants indicated how the depicted varying portion sizes of different meals relate to their actual consumed real-life portion sizes. A total of 725 and 436 individuals were included in the statistical analysis in the first and second study, respectively. BMI and gender had a small effect on the capacity to estimate the weight of foods. The main predictor for portion size choices was the factor gender with men estimating ideal portion sizes as larger than women. Further, age and hunger together with external and restrictive eating behaviors were among the deciding factors for portion size choices. As expected, externally motivated eaters chose bigger portions while restrictive individual smaller ones. Gender- and age-related differences in portion size preferences likely reflect distinct energy requirements. The individuals with a higher BMI do not differ strongly from other BMI groups in their portion-related preferences. Therefore, other factors such as meal frequency, snacking, or a lifestyle, may contribute more to the onset, development, and maintenance of overweight.

Correlation between Eating Behavior and Use of Social Media with Energy-Dense Food Intake Based on Gender among Students in Semarang, Indonesia

BACKGROUND: Eating behavior and the use of social media are believed to affect the intake of energy-dense foods. This study aimed to determine the relationship between eating behavior and use of social media with energy-dense food intake in students by gender. METHODS: This study used a cross-sectional method. The subjects were 123 peoples from one of university in Semarang, Indonesia aged 18-24 years, taken using the consecutive sampling method. Energy-dense food intake was taken using the Semi-Quantitative Food Frequency Questionnaire, eating behavior was using the Dutch Eating Behavior Questionnaire and social media use was using the Scale of Effects of Social Media on Eating Behavior and self-identity questionnaire. Data were analyzed using Pearson's test, Spearman's rank test, and multiple linear regression. RESULTS: The intake of energy-dense foods was higher in men than women. This study showed that there was a relationship between emotional eating (p = 0.001; r = 0.408), external eating (p = 0.008; r = 0.338), and eating behavior due to social media (p = 0.001; r = 0.415) and energy-dense food intake. in women, and duration of social media use (p = 0.003; r = 0.377) with energy-dense food intake in men. Gender and eating behavior due to social media had an effect of 24.9% on energy-dense food intake. CONCLUSION: In women, emotional eating, external eating, and eating behavior due to social media were related to the intake of energy-dense foods. In men, the duration of social media use was related to the intake of energy-dense foods. Gender and eating behavior due to social media were the most influential variables on energy-dense food intake.

Front-of-pack health imagery on both 'healthy' and 'unhealthy' foods leads people to misremember seeing health claims: Two memory experiments

Front-of-pack health imagery can shape people's inferences about food products' health benefits, even leading people to falsely remember reading health claims they never saw. However, research has typically examined these effects in situations where participants have little contextual information to guide their inferences about a product. The present research aimed to replicate the finding that front-of-pack health imagery leads participants to falsely remember reading health claims. It also extends that finding, by exploring whether this effect is moderated by the presence of contextual information signaling the product's actual 'healthiness'. In two pre-registered experiments, participants saw images of fictitious food products accompanied by written nutrition claims. Some of the products contained a health-related image whereas others did not. The supposed 'healthiness' of each product was manipulated by altering the color of the products' multiple traffic light (MTL) label (Experiment 1), or with an explicit healthiness statement (Experiment 2). Participants then attempted to remember the written claims that had appeared on each product's packaging. Health-related images increased participants' tendency to falsely remember reading health claims. But this was true regardless of whether or not participants saw contextual cues about the products' healthiness, either indirectly (Experiment 1) or directly (Experiment 2). These findings suggest that the presence of health imagery on a food product's package can lead consumers to infer health benefits, even when other, more direct cues indicate that the product is unhealthy. This research informs debates on safeguarding consumers from potentially misleading health claims, through the regulation of imagery in food marketing.

Translation and validation of the Child Three-Factor Eating Questionnaire (CTFEQr17) in French-speaking Canadian children and adolescents

OBJECTIVE

To translate and validate the Child Three-Factor Eating Questionnaire (CTFEQr17), assessing cognitive restraint (CR), uncontrolled eating (UE) and emotional eating (EE), among French-speaking Canadian young individuals.

DESIGN

Phase 1 comprised a translation and the evaluation of the comprehension of the questionnaire. Phase 2 comprised a confirmatory factor analysis (CFA), the evaluation of internal consistency (Cronbach's α), test-retest reliability (intra-class correlation coefficients (ICC)) and construct validity, including correlations among the CTFEQr17 and Eating Attitudes Test (EAT-26), anthropometrics, dietary intake and diet quality.

SETTING

Primary and secondary schools, Québec City, Canada.

PARTICIPANTS

Phases 1 and 2 included 20 (40 % boys, mean age 11·5 (sd 2·4) years) and 145 (48 % boys, mean age 11·0 (sd 1·9) years) participants, respectively.

RESULTS

Phase 1 resulted in the questionnaire to be used in Phase 2. In Phase 2, the CFA revealed that the seventeen item, three-factor model (CTFEQr17) provided an excellent fit. Internal consistency was good (Cronbach's α: 0·81-0·90). Test-retest reliability was moderate to good (ICC = 0·59, (95 % CI 0·48, 0·70), ICC = 0·78, (95 % CI 0·70, 0·84), ICC = 0·50, (95 % CI 0·38, 0·62) for CR, UE and EE, respectively). CR correlated with EAT-26 score (r = 0·43, P < 0·0001). UE and EE correlated negatively with BMI Z-scores (r = -0;·26, P = 0·003; r = -0;·19, P = 0·03, respectively). CR correlated with the proportion of energy intake from protein and diet quality (r = 0·18, P = 0·04; r = 0·20, P = 0·02, respectively).

CONCLUSION

The CTFEQr17 is suitable to use among French-speaking Canadian young individuals.

Enhanced capacity to switch but not to maintain: The basis of attentional bias to high calorie foods in restrained eaters

It has been argued that high restrained eaters (i.e., people who fluctuate between restrictive food intake and overeating) are characterised by a heightened attentional bias to high calorie foods. However, the validity of this hypothesis has not yet been convincingly established. The current study sought to empirically evaluate this hypothesis using two directional measures of attentional bias: the well-established dot probe bias assessment task and the more novel Chase the Food bias assessment task. The latter attentional assessment approach has the capacity to differentiate between attentional switching and attentional maintenance within a complex and dynamic food environment. Participants (61 high restrained eaters and 38 low restrained eaters) completed the dot probe task and the Chase the Food task. Findings obtained on the dot probe task did not reveal a group difference in terms of biased attentional responding towards high calorie vs. low calorie food. Conversely, the two groups were found to differ on one of the measures obtained on the Chase the Food task. Specifically, high restrained eaters, as compared to low restrained eaters, demonstrated speeded attentional switching to high calorie foods, rather than a greater ability to maintain attention on high calorie foods when required to do so. These novel findings imply that high restrained eaters are potentially characterised by facilitated attentional switching towards high calorie foods. Implications are discussed including the possibility of targeting biased attentional switching using training variants of the Chase the Food task in interventions designed to reduce maladaptive eating behaviours.

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.

The Effect of Downsizing Packages of Energy-Dense, Nutrient-Poor Snacks and Drinks on Consumption, Intentions, and Perceptions-A Scoping Review

The single-serve packaging of discretionary foods is becoming increasingly popular, but evidence is limited on whether smaller package sizes can reduce food intake. The aim of this scoping review is to assess the effect of reducing the package size of energy-dense, nutrient-poor (EDNP) snacks and drinks on consumption, intentions, and perception, and to examine the effects of potential moderators or mediators. The search was conducted in six selected databases and grey literature sources, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for the scoping review process (PRISMA-ScR) guidelines. After screening 5562 articles, 30 articles comprising 47 intervention studies were included. Twelve of 15 studies found a significant effect in lowering the actual or intended consumption when a single smaller package was offered compared with a single larger package. When the total serving size was held constant between varying package conditions, such as a multipack, single package, or unpackaged, the results on the actual and intended consumption were inconsistent and varied according to the presence of moderators. Overall, these findings suggest that an overall reduction in the size of a single package is a more promising strategy than providing multipacks to reduce consumption. Changes to the current food environment to promote single smaller packages of EDNP snacks and drinks are necessary to support the better selection of appropriate portion sizes and reduce consumption.

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.

A systematic review and meta-analysis of animal models of binge eating - Part 1: Definitions and food/drink intake outcomes

Binge eating involves consuming excessive amounts of food within a discrete period of time and is associated with significant impairments in binge-eating disorder and bulimia nervosa. While research on clinical binge eating has provided valuable aetiological insights, animal models allow for closer examination of environmental, biological, and developmental risk factors. Numerous animal models of binge eating exist and differ widely in operational definitions of bingeing, animal characteristics and methodological parameters. The current review aimed to synthesise the available published evidence on these models. A systematic review of binge definitions in 170 articles found most studies displayed good face validity. Meta-analyses on 150 articles confirmed that the amount of food or drink consumed by animals under binge conditions was larger than that of non-binge conditions across many protocols. The meta-regression revealed species, strain, and sex moderated binge effect size, with the largest effect observed in studies with female animals and mice. Risk of bias assessment identified that improved reporting of allocation, baseline characteristics and outcome assessment is required in future studies.

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.

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.

See the cake and have it too? Investigating the effect of watching a TV cooking show on unhealthy food choices

This study tested whether exposure to food-related (vs. non-food related) TV content would increase unhealthy food choices in unsuccessful restrained eaters (i.e., chronic dieters with low perceived self-regulatory success; PSRS), decrease unhealthy food choices in successful restrained eaters (i.e., chronic dieters with high PSRS), and would not affect food choices in unrestrained eaters (i.e., non-dieters). As such, we attempted to (1) explain previous mixed findings on behavioral effects of exposure to food-related TV content, and (2) generalize previous findings on successful and unsuccessful restrained and unrestrained eaters' differential reactivity to isolated food cues (e.g., food words) to food cues embedded in TV content. In a one-factorial between-subjects experiment, participants viewed a cooking segment in which high-calorie cakes were prepared (n = 50) or a non-food segment (n = 62) of a TV show. The percentage of unhealthy (vs. healthy) food choices in a computerized choice task served as dependent variable. Eating restraint and PSRS were measured afterwards. In contrast to the hypothesis, no three-way interaction between TV content, eating restraint, and PSRS on the percentage of unhealthy food choices was found. However, it was found that overall, people with lower levels of PSRS made a higher percentage of unhealthy food choices compared to people with higher levels of PSRS. Contrasting findings from previous research using isolated food cues, this study showed no evidence of unsuccessful restrained eaters' heightened susceptibility to food cues in TV content, possibly explained by a lower salience of or attention to food cues.

Actigraphy-Derived Sleep Is Associated with Eating Behavior Characteristics

Poor sleep is a determinant of obesity, with overconsumption of energy contributing to this relationship. Eating behavior characteristics are predictive of energy intake and weight change and may underlie observed associations of sleep with weight status and obesity risk factors. However, relationships between sleep and dimensions of eating behavior, as well as possible individual differences in these relations, are not well characterized. Therefore, the aim of this study was to evaluate whether sleep behaviors, including duration, timing, quality, and regularity relate to dietary restraint, disinhibition, and tendency towards hunger and to explore whether these associations differ by sex. This cross-sectional study included 179 adults aged 20–73 years (68.7% women, 64.8% with BMI ≥ 25 kg/m²). Sleep was evaluated by accelerometry over 2 weeks. Eating behavior dimensions were measured with the Three-Factor Eating Questionnaire. Prolonged wake after sleep onset (WASO) (0.029 ± 0.011, p = 0.007), greater sleep fragmentation index (0.074 ± 0.036, p = 0.041), and lower sleep efficiency (−0.133 ± 0.051, p = 0.010) were associated with higher dietary restraint. However, higher restraint attenuated associations of higher WASO and sleep fragmentation with higher BMI (p-interactions < 0.10). In terms of individual differences, sex influenced associations of sleep quality measures with tendency towards hunger (p-interactions < 0.10). Stratified analyses showed that, in men only, higher sleep fragmentation index, longer sleep onset latency, and lower sleep efficiency were associated with greater tendency towards hunger (β = 0.115 ± 0.037, p = 0.003, β = 0.169 ± 0.072, p = 0.023, β = −0.150 ± 0.055, p = 0.009, respectively). Results of this analysis suggest that the association of poor sleep on food intake could be exacerbated in those with eating behavior traits that predispose to overeating, and this sleep-eating behavior relation may be sex-dependent. Strategies to counter overconsumption in the context of poor quality sleep should be evaluated in light of eating behavior traits.

The association between pre-conception intuitive eating and gestational weight gain

PURPOSE

To determine if pre-conception intuitive eating, an adaptive eating behavior, was related to gestational weight gain (GWG) and the likelihood of exceeding GWG recommendations.

METHODS

This prospective survey study took place in an outpatient obstetric clinic. Participants completed the pre-conception Intuitive Eating Scale for Pregnancy during a prenatal check-up appointment and total GWG was collected from the medical record. The pre-conception Intuitive Eating Scale for Pregnancy assesses unconditional permission to eat, eating for physical rather than emotional reasons, and reliance on hunger and satiety to inform what, when, and how much to eat. Hierarchical linear multiple regression and logistic multiple regression analyses determined associations between pre-conception intuitive eating and GWG on the total sample and stratified by weight status (normal/underweight, overweight, and obese).

RESULTS

The majority of the sample (n = 253) was white, married, employed, had annual household income > $50,000, and had a college degree. No aspects of pre-conception intuitive eating predicted the likelihood of excess GWG. However, in the total sample, unconditional permission to eat (subscale) was inversely related to total GWG (B = -0.16, p < 0.05). Among women with obesity (n = 36), eating for physical rather than emotional reasons (subscale) was inversely related to total GWG (B = -0.47, p < 0.05).

DISCUSSION

Some aspects of intuitive eating during the pre-conception period were related to total GWG, particularly for women with obesity. However, intuitive eating scores did not increase or decrease the likelihood of excess GWG. More research is needed to understand the mechanisms for this association before clinical recommendations can be made.

LEVEL OF EVIDENCE

Level III (Evidence obtained from well-designed cohort or case-control analytic studies).

A systematic review of neural correlates of dysregulated eating associated with obesity risk in youth

Dysregulated eating among children and adolescents is associated with a wide range of negative mental and physical health outcomes, including obesity. However, less is known regarding underlying neural mechanisms underlying such behaviors. Therefore, the present manuscript systematically reviewed neuroimaging research examining dysregulated eating behavior linked to excess weight in children and adolescents. A systematic literature search identified 23 eligible studies, the majority of which were cross-sectional functional magnetic resonance imaging (fMRI) studies and excluded participants with psychiatric disorders. Dysregulated eating was captured by measures of eating styles and eating self-regulation, eating disorder behaviors, food addiction, objective measures of non-homeostatic eating and caloric restriction. While preliminary, findings suggested eating dysregulation was related to aberrant functioning within the frontostriatal and frontoparietal regions involved in self-regulatory processes, as well as regions involved in satiety signaling and interoception. This heterogeneous body of research is continually growing and may have potential to inform future prevention and intervention approaches. Results also identified several important limitations to consider and highlight key areas for future research.

A Dieting Facilitator on the Fridge Door: Can Dieters Deliberately Apply Environmental Dieting Cues to Lose Weight?

Individuals exposed to dieting-related environmental cues have been repeatedly shown to be better able to resist tempting food. This especially applies to restrained eaters who hold a chronic dieting goal. Thus far, mainly short-term effects of environmental dieting cues have been examined and the individuals were typically unaware of being influenced. Yet, it is unclear whether individuals can deliberately apply environmental dieting cues for themselves to facilitate the pursuit of the longer-term goal of losing weight. The present longitudinal study applied a 2 (cue: visually dieting-related vs. visually neutral cue) × 2 (awareness: being aware vs. not being aware of the cue’s facilitating influence) between-subjects design for 6 months (N = 166 participants who started the study; M_age = 47.85 years; 69.9% female; M_BMI = 29.07 kg/m²). Our results provide preliminary indications that cue, awareness, and restrained eating interact. The results suggest that high (vs. low) restrained eaters could deliberately apply environmental dieting cues for themselves to facilitate losing weight. However, further studies are needed to explore the effects of environmental dieting cues over a longer period of time.

Eating restraint is associated with reduced attentional capture by signals of valuable food reward

Previous paradigms used to examine attentional distraction by task-irrelevant food words and food images were not suited for the investigation of involuntary and automatic attentional capture. In the current experiments we adapted a well-established visual-search paradigm (with eye tracking) to investigate involuntary attentional capture by food and drink rewards. We first used a satiety procedure to manipulate relative preference for different food and drink outcomes (potato chips and water in Experiment 1 and popcorn and chocolate Smarties in Experiment 2). Participants then performed the visual-search task where a coloured distractor signalled on each trial which of the two food and drink rewards was available for successful identification of the target. The signalled reward was cancelled, however, if any eye gaze was registered on the distractor. Participants were therefore motivated to try and control the automatic orienting of attention towards cues signalling valuable outcomes, in order to earn those outcomes. In both experiments we found that attention was more often captured by the distractor signalling the valuable (non-sated) outcome, replicating previous studies using this paradigm with monetary rewards. We also found that those scoring high on eating restraint (as measured with the Dutch Eating Behavior Questionnaire) were better at controlling reflexive orienting of attention to desirable food rewards. This paradigm offers a novel approach for understanding how reflexive attention and control relate to conflicts in everyday life around distracting food cues, and the moderating role of dietary restraint.

The Influence of Response Inhibition Training on Food Consumption and Implicit Attitudes toward Food among Female Restrained Eaters

Restrained eaters display difficulties engaging in self-control in the presence of food. Undergoing cognitive training to form associations between palatable food and response inhibition was found to improve self-control and influence eating behaviors. The present study assessed the impact of two such response inhibition trainings on food consumption, food-related anxiety, and implicit attitudes toward food among female restrained eaters (Dutch Eating Behavior Questionnaire-restrained eating subscale ≥ 2.5). In Experiment 1, 64 restrained eaters completed either one of two training procedures in which they were asked to classify food vs. non-food images: a food-response training, in which stop cues were always associated with non-food images, or a balanced food-response/inhibition training, in which participants inhibited motor actions to food and non-food stimuli equally. The results revealed reduced snack consumption following the food-response/inhibition training compared to the food-response training. The food-response training was associated with increased levels of food-related anxiety. In Experiment 2, the same training procedures were administered to 47 restrained eaters, and implicit attitudes toward palatable foods were assessed. The results revealed an increase in positive implicit attitudes toward palatable foods in the food-response/inhibition group but not in the food-response training group. The results suggest that balancing response inhibition and execution across food and non-food stimuli may reduce overeating while retaining positive attitudes toward food among female restrained eaters.

Predicting Weight Loss Using Psychological and Behavioral Factors: The POUNDS LOST Trial

CONTEXT

Eating habits and food craving are strongly correlated with weight status. It is currently not well understood how psychological and behavioral factors influence both weight loss and weight regain.

OBJECTIVE

To examine the associations between psychological and behavioral predictors with weight changes and energy intake in a randomized controlled trial on weight loss.

DESIGN AND SETTING

The Prevention of Obesity Using Novel Dietary Strategies is a dietary intervention trial that examined the efficacy of 4 diets on weight loss over 2 years. Participants were 811 overweight (body mass index, 25-40.9 kg/m2; age, 30-70 years) otherwise healthy adults.

RESULTS

Every 1-point increase in craving score for high-fat foods at baseline was associated with greater weight loss (-1.62 kg, P = .0004) and a decrease in energy intake (r = -0.10, P = .01) and fat intake (r = -0.16, P < .0001) during the weight loss period. In contrast, craving for carbohydrates/starches was associated with both less weight loss (P < .0001) and more weight regain (P = .04). Greater cognitive restraint of eating at baseline was associated with both less weight loss (0.23 kg, P < .0001) and more weight regain (0.14 kg, P = .0027), whereas greater disinhibition of eating was only associated with more weight regain (0.12 kg, P = .01).

CONCLUSIONS

Craving for high-fat foods is predictive of greater weight loss, whereas craving for carbohydrates is predictive of less weight loss. Cognitive restraint is predictive of less weight loss and more weight regain. Interventions targeting different psychological and behavioral factors can lead to greater success in weight loss.

Increases in Cigarette Consumption and Decreases in Smoking Intensity When Nondaily Smokers Are Provided With Free Cigarettes

Introduction

Studies testing novel tobacco products often provide participants with free product and assess consumption. Some, but not all, studies find that providing free cigarettes increases smoking. We tested changes in smoking when free cigarettes were provided to nondaily, intermittent smokers, who constitute one-third of US adult smokers.

Methods

Cigarette consumption was assessed by Time-Line Follow-Back in 235 intermittent smokers for two 2-week periods: when providing their own cigarettes and when provided own-brand cigarettes for free. Smoking topography and carbon monoxide boost were assessed for one cigarette at the end of each period.

Results

Cigarette consumption increased significantly, by 66% (from 1.98 to 3.28 cigarettes per day), when cigarettes were available for free; both the number of days the subjects smoked and the number of cigarettes on those days increased. The increases were significantly greater among African Americans, those Fagerström Tobacco Nicotine Dependence scores >0, those with incomes less than US $25,000 per year, those who engaged in greater conscious restraint of smoking, and for smokers of menthol cigarettes, or "longs." Smoking intensity (smoke volume, by topography) and carbon monoxide boost decreased significantly when cigarettes were provided for free.

Conclusions

Providing intermittent smokers with free cigarettes substantially increased their smoking while decreasing smoking intensity. The increases in smoking varied according to multiple individual and cigarette-type differences. These phenomena may complicate interpretation of studies that compare consumption of a free test product with cigarette consumption or constituent exposure when smokers are providing their own cigarettes. They also suggest that cigarette cost and variations in low-level dependence and in smoking restraint are factors in nondaily smoking.

Implications

The study shows that providing nondaily smokers with free cigarettes increases cigarette consumption, but does differentially for different subgroups and cigarette types, while also decreasing smoking intensity. This suggests the value of using free-cigarette baseline data in studies where interventions provide free cigarettes.

Moderate eating with pleasure and without effort: Toward understanding the underlying psychological mechanisms

Integrating research on elementary eating behaviors, savoring, mental imagery, mindfulness, cooking, and dinner rituals, a psychological theory of moderate eating is formulated that does not require effortful self-control and giving up on the pleasures of eating. The theory proposes that taste and pleasure can be combined with a relatively objective attitude toward food, resulting in a relatively slow, gentle, and thoughtful manner of eating that enhances satiation. The objective food attitude is thought to result from (a) the accumulation of multiple sensorimotor expectancies and perspectives and (b) a motivational mechanism underlying prosocial behavior, food sharing, and aggression-inhibiting dinner rituals.

Attentional Bias, "Cool" and "Hot" Executive Functions in Obese Patients: Roles of Body Mass Index, Binge Eating, and Eating Style

PURPOSE/BACKGROUND

Obesity is recognized as an important risk factor for many chronic diseases and is a major health issue. The current study examined attentional bias to food and the "cool" (inhibitory control and mental flexibility) and "hot" (affective decision making) executive functions (EFs) in obese patients preparing for bariatric surgery. In addition to body mass index (BMI), this study examined the impact of the binge-eating tendency and eating styles.

METHODS

The study population comprised 21 morbidly obese patients preparing to undergo bariatric surgery (BMI ≥30 kg/m) and 21 normal-weight controls (24 kg/m > BMI ≥ 18.5 kg/m). The Visual Probe Task was adopted to examine attentional bias toward food-related cues. The Stop-Signal Task and the Color Trails Test were used to assess inhibitory control and mental flexibility, respectively. The Iowa Gambling Task was administered to assess the affective decision making.

RESULTS

(1) The obese patients showed poorer performances on cool EFs (for Color Trails Test, P = 0.016, ηp = 0.136; for Stop-Signal Task, P = 0.049, ηp = 0.093) and hot EF (for Iowa Gambling Task, normal controls showed progressed performance, P = 0.012, ηp = 0.077, but obese patients did not show this progress, P = 0.111, ηp = 0.089) compared with the normal controls; (2) participants with low binge-eating tendency had larger attentional biases at 2000 milliseconds than at 200 milliseconds on food-related cues (P = 0.003, ηp = 0.363); and (3) low-restrained participants exhibited attentional bias toward the low-calorie food cues, compared with the high-restrained group (P = 0.009, ηp = 0.158).

CONCLUSIONS

The current study contributes to the development of a different therapeutic focus on obese patients and binge eaters.

Can Mindfulness Address Maladaptive Eating Behaviors? Why Traditional Diet Plans Fail and How New Mechanistic Insights May Lead to Novel Interventions

Emotional and other maladaptive eating behaviors develop in response to a diversity of triggers, from psychological stress to the endless external cues in our modern food environment. While the standard approach to food- and weight-related concerns has been weight-loss through dietary restriction, these interventions have produced little long-term benefit, and may be counterproductive. A growing understanding of the behavioral and neurobiological mechanisms that underpin habit formation may explain why this approach has largely failed, and pave the way for a new generation of non-pharmacologic interventions. Here, we first review how modern food environments interact with human biology to promote reward-related eating through associative learning, i.e., operant conditioning. We also review how operant conditioning (positive and negative reinforcement) cultivates habit-based reward-related eating, and how current diet paradigms may not directly target such eating. Further, we describe how mindfulness training that targets reward-based learning may constitute an appropriate intervention to rewire the learning process around eating. We conclude with examples that illustrate how teaching patients to tap into and act on intrinsic (e.g., enjoying healthy eating, not overeating, and self-compassion) rather than extrinsic reward mechanisms (e.g., weighing oneself), is a promising new direction in improving individuals' relationship with food.

Functional and structural plasticity contributing to obesity: roles for sex, diet, and individual susceptibility

The role of cortico-striatal pathways in cue-triggered motivational processes have been extensively studied. However, recent work has begun to examine the potential contribution of plasticity in these circuits to obesity. Despite the inclusion of women in human obesity studies examining neurobehavioral alterations in cue-triggered motivation, preclinical studies have focused mainly on male subjects. This lack of female subjects in preclinical research had led to a gap in the basic understanding of the neural mechanisms underlying over-eating in females. In this review, we highlight recent work from our lab and others that has begun to elucidate how diet, obesity, and individual susceptibility to weight gain influence functional and structural plasticity within the nucleus accumbens and prefrontal cortex in adult rats. As is the case throughout neuroscience, studies of females or sex differences are largely lacking in this area. Thus, below we describe preliminary neurobehavioral results from female studies in our labs and point out areas for future investigation.