Chocolate versions of the Food Cravings Questionnaires. Associations with chocolate exposure-induced salivary flow and ad libitum chocolate consumption

Motor impulsivity and spicy food craving: A mediation analysis of insula-based resting state functional connectivity

In China, the rate of spicy food consumption is rising, and chili pepper is among the most popular spicy foods consumed nationwide. However, little effort has been made to understand the mechanism behind spicy food craving. This exploratory study aimed to investigate differences in insula-based resting state functional connectivity (rsFC) between spicy food cravers and non-cravers, and the association between rsFC, impulsivity and spicy food craving. A group of extreme cravers (n = 49) and a group of age- and sex-matched non-cravers (n = 46) completed a resting-state fMRI scan, during which participants were instructed to keep their eyes closed, to not think of anything in particular, and to remain awake. Participants completed the Spicy Food Craving Questionnaire, Barratt Impulsiveness Scale, Sensation Seeking Scale and Positive and Negative Affect Schedule, and rated the frequency of spicy food intake. Results revealed increased insula-occipital lobe resting-state functional connectivity in individuals with spicy food cravings, and the positive correlations between insula-middle occipital gyrus rsFC, impulsivity and spicy food craving. Specifically, the insula-middle occipital gyrus rsFC strength mediated the relationship between the motor impulsivity and spicy food craving. It is hoped that our exploratory findings may shed new insights into the neural mechanisms of spicy food craving and motivate further exploration of spicy food craving in diverse contexts and cultures.

Decoupling of desire and salivation over repeated chocolate consumption and the moderating role of food legalizing

This study aimed to investigate the responses in desire and salivation during repeated chocolate consumption, and examining how these responses are influenced by a relaxed relationship with food, or 'food legalizing'. Salivation is often used as a proxy for desire, though evidence for this correlation is mixed. We hypothesized that both desire and salivation would decrease with repeated chocolate intake. Additionally, research has suggested that eating styles may affect habituation rates. We proposed that individuals with the food legalizing trait would habituate more rapidly to chocolate, providing an alternative mechanism to reward sensitivity associated with restrained eating. Fifty healthy-weight individuals participated in the study, consuming five blocks of chocolate (each 4 g, 22 calories) over trials. After the trials, participants were allowed to eat as much chocolate as they desired. The results showed that salivation was not correlated with self-reported desire over repeated chocolate consumption. While desire decreased with repeated intake and predicted ad libitum consumption, salivation increased and did not predict ad libitum consumption. Furthermore, food legalizing moderated the rate of responding in terms of the desire to eat but did not affect salivary flow. These findings suggest that salivation is not a reliable physiological measure of desire when eating chocolate. Instead, salivation appears to reflect sensitization to the sensory characteristics of chocolate and is less predictive of subsequent ad libitum chocolate consumption than self-reported desire. Lastly, having a carefree relationship with chocolate may help regulate its consumption, highlighting the potential benefits of a relaxed attitude toward food.

Impact of a 6-week dietary and lifestyle modification intervention on food cravings and eating behaviors in women

Introduction

Introduction: the multifaceted nature of food craving mirrors the complexity underlying the development of eating disorders. Objectives: the study aimed to investigate the impact of a 6-week dietary and lifestyle intervention on food cravings, eating behaviors, and changes in physical and biochemical measures among women. Methods: this study constitutes a behavior modification investigation involving a cohort of 35 female participants who sought consultation at a private nutrition counseling facility. At first, anthropometric and biochemical data were recorded; Information Form, Food Craving Questionnaire-Trait Scale (FCQ-T), Three-Factor Eating Scale (TFEQ-R21) were applied and 3-Day Food Consumption Records were taken. After 6 weeks of dietitian follow-up, the data collection tools were repeated and the individuals were compared with the baseline. Results: after 6-week follow-up, according to the examination of the food consumption records, differences in daily energy, fat, monounsaturated fatty acid, fibre, vitamin E, potassium, magnesium, iron intake levels were found significant (p < 0.05). Differences in body weight, body mass index (BMI), waist/height ratio, fat mass, fat ratio and fasting glucose, HbA1c, total cholesterol, triglyceride, LDL, AST, TSH, free T3, free T4 levels were found significant (p < 0.05). According to the FCQ-T evaluation; differences in total and nine sub-dimension scores of the scale were found significant (p < 0.001). According to the TFEQ-R21 evaluation; differences in cognitive restraint, emotional eating and uncontrolled eating scores were found significant (p < 0.05). Conclusions: a successful 6-week dietary and lifestyle intervention with improvement in anthropometric measurements and biochemical parameters is effective in reducing food cravings and regulating eating behaviours.

Ecological momentary assessment of digital food and beverage marketing exposure and impact in young adults: A feasibility study

Unhealthy food marketing is contributing to the obesity epidemic, but real-time insights into the mechanisms of this relationship are under-studied. Digital marketing is growing and following food and beverage (F&B) brands on social media is common, but measurement of exposure and impact of such marketing presents novel challenges. Thus, this study aimed to evaluate the feasibility of collecting data on exposure and impact of digital F&B marketing (DFM) using a smartphone-based ecological momentary assessment (EMA) methodology. We hypothesized that DFM-induced food cravings would vary based on whether (or not) participants engaged with F&B brands online. Participants were Singapore residents (n = 95, 21-40 years), recruited via telephone from an existing cohort. Participants were asked to upload screenshots of all sightings of online F&B marketing messages for seven days, and answer in-app contextual questions about sightings including whether any cravings were induced. Participants provided a total of 1310 uploads (median 9 per participant, Q1-Q3: 4-21) of F&B marketing messages, 27% of which were provided on Day 1, significantly more than on other days (P < 0.001). Followers of food/beverage brands on social media encountered 25.6 percentage points (95% CI 11.4, 39.7) more marketing messages that induced cravings than participants who were not followers. University education was also associated with more (18.1 percentage points; 95% CI 3.1, 33.1) encounters with marketing messages that induced cravings. It was practical and acceptable to participants to gather insights into digital F&B marketing exposure and impact using EMA in young adults, although a shorter study period is recommended in future studies. Followers of food and beverage brands on social media appear to be more prone to experience cravings after exposure to digital F&B marketing.

The effects of a retrieval cue on renewal of conditioned responses in human appetitive conditioning

Contextual renewal of reward anticipation may be one potential mechanism underlying relapse in eating and substance use disorders. We therefore tested retrieval cues, a method derived from an inhibitory retrieval-based model of extinction learning to attenuate contextual renewal using an appetitive conditioning paradigm. A pilot study was carried out in Experiment 1 to validate a differential chocolate conditioning paradigm, in which a specific tray was set up as a conditioned stimulus (CS) for eating chocolate (unconditioned stimulus, US). Using an ABA renewal design in Experiment 2, half of the participants were presented with a retrieval cue in the acquisition phase (group AC) and the other half in the extinction phase (group EC). Presentation of the retrieval cue in the EC was associated with reduced renewal of US-expectancy, while there was a clear renewal effect for US-expectancy in the AC. One limitation was the difference in cue presentations between both groups due to the number of trials in acquisition and extinction. Experiment 3 therefore aimed at replicating the results of Experiment 2, but with fewer cue presentations for the EC to match the AC. No significant group differences were observed indicating no effect of the retrieval cue. Theoretical and clinical implications in light of the differing results are discussed.

Imagine chocolate: The craving experience questionnaire in the food domain

Measurement of food craving has gained relevance in the current obesity epidemic. The Craving Experience Questionnaire (CEQ) considers not only craving intensity but also cognitive intrusiveness and imagery vividness as separate craving factors and could thus refine food craving assessment. It is available in two versions with ten items each. The CEQ-F assesses craving frequency across specific time periods and the CEQ-S time-point specific craving strength. Across three independent studies, N = 533 participants completed the German chocolate CEQ-F referenced at the past year to operationalise trait-like craving. Among them, N = 402 also completed the German chocolate CEQ-S referenced at the current moment to operationalise state-like craving. Four-week test-retest reliability was measured. For external validity, we assessed self-reported chocolate consumption, body-mass-index, trait approach motivation, general imagery vividness, and the most widely used food craving questionnaire, namely the Food Cravings Questionnaires in a trait (FCQ-T-r) and state version (FCQ-S), as well as behavioural approach bias (reaction time-based measurement). The three-factor structure was replicated with excellent internal consistency for both CEQ-F and CEQ-S. Test-retest reliability was moderate for both CEQ versions. CEQ-F scores were related to higher levels of chocolate consumption, approach motivation, and FCQ-T-r scores, but not to body-mass-index, imagery vividness, or approach bias. CEQ-S scores were associated with FCQ-S scores and partly with approach bias, but not with approach motivation and imagery vividness. The current results support the factor structure, validity and reliability of the German chocolate CEQ-S and CEQ-F with questions remaining regarding the ability of the CEQ-S to measure state craving. Thus, CEQ-F and CEQ-S usefully contribute to food craving assessment.

Sex-specific association between regional gray matter volume and spicy food craving or consumption

Both food cravings and long-term food consumption have been associated with brain changes. Sex differences in food craving are robust and substantial. The current study examined the potential sex-specific neuroanatomical correlates of spicy food craving and habitual spicy food consumption. One hundred and forty-nine participants completed the Spicy Food Consumption Questionnaire and the Spicy Food Craving Questionnaire while their structural brain images were acquired using a 3-T scanner. Multiple regression analysis was used to examine regional gray matter volume (GMV) in relation to questionnaire scores. GMV of the right supplementary motor area (SMA) and the dorsal superior frontal gyrus were significantly correlated with spicy food craving in women, whereas spicy food craving was associated with greater GMV of the inferior temporal gyrus and the occipital gyrus in men. In addition, habitual spicy food consumption was correlated with increased GMV of the bilateral putamen, left postcentral gyrus, and right paracentral lobule, which was more pronounced among female participants. These findings suggest distinct central neuroanatomical reflections of trait craving or habitual exposure to spicy flavors. The sex-specific correlation between spicy food craving and brain anatomical features may be related to food-related sensory imagery or cognitive control.

Temporal dynamics of mental imagery, craving and consumption of craved foods: an experience sampling study

Objective: According to the elaborated intrusion theory of desire, an initial thought about a wanted substance is elaborated with mental imagery, which increases craving and the probability of consuming the substance. We used an app-assisted experience sampling approach to test this theory in the context of food craving and eating.Design: Overall, 221 females (mean age = 21 years; mean body mass index = 22) reported craving, mental imagery, and food consumption six times per day (2 h intervals) for seven consecutive days. Additionally, two traits (general food craving and imagery ability) were assessed.Main outcome measures: craving intensity, food consumption.Results: The probability of eating a craved food increased if the vividness of the mental food image and craving intensity increased two hours before - independent of trait food craving and trait imagery ability. We also found evidence of controlled eating behavior, with participants consuming the food they craved in only 38% of the cases.Conclusion: Mental imagery vividness and craving intensity predict consumption of craved food. The association between craving and eating might be stronger in individuals who struggle with controlling their eating behavior. Therefore, future studies should examine these relationships in overweight/obese samples or patients with eating disorders.

Reactivity to food cues in spicy food cravers: Physiological and behavioral responses

In China, the rate of spicy food consumption is rising, and chili pepper is among the most popular spicy foods consumed nationwide. According to the 'cued overeating' model, visual and olfactory cues of food can lead to changes in physiological responses and increase the likelihood and amount of food intake. However, no studies have explored the role of spicy food cues in cue reactivity among spicy food cravers. The exploratory study aimed to investigate cue-induced physiological responses, subjective cravings, eating behaviors and their associations in spicy food cravers. A group of spicy cravers (n = 59) and a group of age- and sex-matched non-cravers (n = 60) were exposed to food cues that contained or did not contain chili, during which physiological responses and food consumption were measured. The results revealed that spicy food cravers showed increased salivation and heart rate in response to food cues that contained chili compared to cues without chili and consumed significantly more chili oil after chili exposure. For cravers, heart rate during chili exposure was positively correlated with changes in subjective spicy food craving, and increases in subjective spicy food craving during chili exposure positively predicted subsequent chili oil consumption. The current exploratory study confirms the 'cued overeating' model and extends previous findings on food cravings, showing that even though chili peppers can elicit aversive oral burns and pain, they share the same physiological mechanism underlying cue reactivity as other kinds of cravings.

Playing with temptation: Stopping abilities to chocolate are superior, but also more extensive

Cue-specific inhibitory control is assumed to support balanced food intake, but previous studies with established measures showed inconsistent results. We developed a novel kinematic stop task in virtual reality (VR) and report results from trajectory recordings. The primary objective of this explorative study was to assess the interrelationships between validated measures of food-related inhibitory control and novel measures from the VR task. We hypothesized that healthy female participants show worse inhibitory control when grasping attractive virtual chocolate, compared to non-edible color-and-shape matched objects. We further aimed to quantify the construct validity of kinematic measures (e.g., reaching extent/spatial displacement, movement time after stop-signal, velocity) with established measures of inhibitory control in a keyboard-based adaptive stop-signal task (SST). In total, 79 females with varying levels of chocolate craving participated in an experimental study consisting of self-report questionnaires, subjective chocolate craving, the conventional SST and the kinematic task in VR. Results showed superior stopping ability to chocolate in both tasks. In VR, participants successfully interrupted an initiated approach trajectory but terminated slightly closer to chocolate targets. Stop-signal delay (SSD) was adapted relative to movement onset and appeared later in chocolate trials, during which participants still stopped faster, as was also confirmed by shorter stop-signal reaction time (SSRT) in the conventional task. Yet, SSRT did not correlate with stopping in VR. Moreover, SSRT was related to depressive symptoms whereas measures from VR were related to chocolate craving and subjective hunger. Thus, VR stopping can provide deeper insights into healthy weight individuals' capacity to inhibit cue-specific approach behavior towards appetitive stimuli in simulated interactions. Furthermore, the results support a multi-faceted view of food-specific inhibitory control and behavioral impulsivity.

On the measurement and correlates of plate clearing: examining a German version of the Plate Clearing Tendency Scale

PURPOSE

Plate clearing-eating a meal in its entirety-is common and may be a factor contributing to obesity. For the assessment of individual differences in plate clearing tendencies, Robinson et al. (Obesity 23:301-304, 2015) developed the Plate Clearing Tendency Scale (PCTS). However, little is known about the psychometric properties of this scale and its correlates.

METHODS

In the current study, participants (N = 207, 76% female) completed a German translation of the PCTS and other questionnaires online.

RESULTS

A one-factor structure had good model fit and the PCTS had acceptable internal reliability and good test-retest reliability across an average of four and a half weeks. Higher plate clearing tendencies related to more frequent parental encouragement to clear one's plate in childhood and to stronger food waste concerns but were unrelated to sex, body weight, self-control, and eating behaviors. However, higher plate clearing tendencies related to higher body weight in unsuccessful dieters.

CONCLUSION

The current study shows that the PCTS has sound psychometric properties and that plate clearing tendencies appear to be largely driven by food waste concerns and not by automatic eating habits or low eating-related self-control. In dieters, however, high plate clearing tendencies may contribute to low dieting success and hinder weight loss.

LEVEL OF EVIDENCE

No level of evidence, basic science.

Can sweet food-specific inhibitory control training via a mobile application improve eating behavior in children with obesity?

OBJECTIVES

Consumption of excess sugar, a common energy-dense nutrient-poor food, is a risk factor for obesity in school-aged children. Food-specific inhibition training, where responses to palatable food stimuli, such as sweet foods, are consistently and repeatedly inhibited, reduces sweet food intake in adults. However, no studies have yet examined the effectiveness of inhibitory control training specifically targeting sweet foods among children with high sugar cravings. We examined whether sweet food-specific inhibitory control training (SF-ICT), administered via a mobile app, reduced choice and consumption of sweet foods, and weight in a sample of children aged 7-11 with overweight or obesity and who had high sugar cravings (N = 46).

DESIGN

This study was designed as a 2 × 3 between-within design.

METHODS

Participants were randomly allocated to a single-blind design with two conditions: they either received 7 sessions of active or control go/no-go training in which either sweet foods or non-food cues were paired with no-go signals. Participants' weight, sweet food choice, and consumption were measured pre and post-training, and at three-month follow-up.

RESULTS

The results revealed that participants in the active group showed a significant reduction in sweet food choice and intake from pre to post-training relative to the control group. The effects of the training on reducing sweet food intake persisted over the 3-month follow-up No significant changes in weight loss were observed.

CONCLUSIONS

These results provide preliminary evidence that sweet food-specific inhibitory control training (SF-ICT) via a mobile app is effective in modifying eating behavior among children with excessive consumption of sugary foods. Further research is required to clarify under what conditions the benefits of training would expand to weight loss.

Comparison of different response devices to assess behavioral tendencies towards chocolate in the approach-avoidance task

Behavioral tendencies in the Approach-Avoidance Task (AAT) have mostly been assessed using a joystick as a response device. In recent years, other hardware devices such as tablets, smartphones, and computer mice have also been used. However, it remains unclear whether different response devices yield similar results and show comparable psychometric properties. The aim of the present study was to assess approach biases towards chocolate with different response devices and to compare their reliability and validity. Forty-five individuals with regular chocolate consumption completed three different AATs (joystick, computer mouse, touchscreen), each comprised of two blocks. In the compatible block of trials, chocolate-related pictures had to be pulled near while object-related pictures had to be pushed away. In the incompatible block of trials, instructions were reversed. Preregistered analyses revealed that participants were faster to pull than to push chocolate-related pictures relative to object-related pictures, indicating an approach bias for chocolate with no significant differences between response devices. Correlations among the three response devices were low to medium. Exploratory analyses revealed that approach biases were moderated by block order such that biases were only present and associated with craving (joystick AAT only) when the incongruent block was completed first. Internal consistencies of the bias score ranged between r_SB = 0.67-0.76. Results of the present study point to the existence of an approach bias to chocolate regardless of response device, albeit each task seems to measure a different aspect of it. Order effects point to specific temporal dynamics in the acquisition of stimulus response (e.g., chocolate-pull) mappings that require further study.

Reduced Olfactory Bulb Volume in Obesity and Its Relation to Metabolic Health Status

Smell perception plays an important role in eating behavior and might be involved in body weight gain. Since a body of literature implies that olfactory perception and function is hampered in obesity, we here investigate neuroanatomical correlates of this phenomenon. We assessed olfactory bulb (OB) volume with magnetic resonance imaging in 67 healthy participants with a body mass index (BMI) from 18.9 to 45.4 kg/m2 (mean = 28.58 ± 6.64). Moreover, we obtained psychophysiological data on olfactory ability (Sniffin' Sticks, Food associated odor test) and self-report measurements on eating behavior. Additionally, we collected parameters associated with metabolic health in obesity (waist-hip ratio, waist-height ratio, leptin levels, body fat percentage, fat mass index, insulin resistance) to investigate recently proposed mechanistic explanatory models of why olfaction may be altered in obesity. We showed that OB volume was significantly lower in participants with obesity when compared to those of normal weight. Moreover, we found weak to moderate negative correlations between OB volume and BMI and related measures of metabolic health, especially leptin, body fat percentage, waist-height ratio and insulin resistance. However, neither OB volume nor BMI were related to olfactory function in our young and healthy sample. Nevertheless, our results provide first indications that obesity is associated with brain anatomical changes in the OBs.

Love at first taste: Activation in reward-related brain regions during single-trial naturalistic appetitive conditioning in humans

Palatable food can trigger appetitive responses, such as salivation and approach tendencies. Though evolutionarily functional, these conditioned responses can encourage overeating and obesity when food is abundant. The current study examines the neural correlates of 'denovo' Pavlovian appetitive conditioning, pairing one class of unknown objects (conditioned stimuli, CS) with their sweet taste (unconditioned stimulus, US) during a single trial. To do so, 23 participants consumed unknown (marzipan) objects of one particular color (CS+) while only interacting with control stimuli of different color and shape (CS-). After this single-trial conditioning procedure, participants viewed and rated images of the marzipan figures and the control objects during functional magnetic resonance imaging (fMRI). Relative to the CS-, the CS+ elicited stronger activation in the dorsal striatum, a brain region associated with cue-reward coupling. Furthermore, conditioning effects in subjective 'craving', defined as increased palatability and desire to eat, were observed, and these were positively related to conditioning effects in the amygdala, a brain region associated with the need-dependent value of a reward. Thus, the study identified reward-related brain regions involved in single-trial appetitive learning, thereby providing a potential mechanism that contributes to the etiology of food craving. These findings might help to understand clinically relevant food cravings in individuals with eating or weight related concerns and might support the development of extinction based treatments.

The Psychology of Food Cravings: the Role of Food Deprivation

PURPOSE OF REVIEW

Dieting is often blamed for causing food cravings. Such diet-induced cravings may be mediated by physiological (e.g., nutritional deprivation) or psychological (e.g., ironic effects of food thought suppression) mechanisms. However, this notion is often based on cross-sectional findings and, thus, the causal role of food deprivation on food cravings is unclear.

RECENT FINDINGS

Experimental studies suggest that a short-term, selective food deprivation seems to indeed increase cravings for the avoided foods. However, experimental studies also show that food craving can be understood as a conditioned response that, therefore, can also be unlearned. This is supported by intervention studies which indicate that long-term energy restriction results in a reduction of food cravings in overweight adults. Dieting's bad reputation for increasing food cravings is only partially true as the relationship between food restriction and craving is more complex. While short-term, selective food deprivation may indeed increase food cravings, long-term energy restriction seems to decrease food cravings, suggesting that food deprivation can also facilitate extinction of conditioned food craving responses.

Cognitive Restructuring vs. Defusion: Impact on craving, healthy and unhealthy food intake

Coping with food cravings is crucial for weight management. Individuals tend to use avoidance strategies to resist food cravings and prevent overeating, but such strategies may not result in the benefits sought. This study compared the effects of two cognitive techniques (Restructuring vs. Defusion) for dealing with food cravings in terms of their impact on healthy vs. unhealthy eating behavior (i.e., consumption of chocolate and/or carrots following the intervention). Sixty-five participants (M_age = 19.65 years) received either a 30-minute face-to-face instruction on cognitive restructuring (CR) or cognitive defusion (CD) along with 15 min of practice, or 45 min of obesity education and discussion (control). To examine craving and eating choices following the intervention, participants received bags of chocolate and carrots and were asked to carry these with them at all times over the next week, exchanging the bags every 2 days. Participants in the CD group ate fewer chocolates (M = 11.74) compared to CR (M = 17.06) and Control groups (M = 29.18) during the experimental week. The groups did not differ in number of carrot pieces eaten, though the CD group ate more carrots than chocolates. CD resulted in fewer self-reported cravings compared to CR and CO groups. At a final taste test, both CD and CR groups ate significantly fewer chocolates compared to the CO group. CD appears to be an effective technique in managing food craving and to present some advantages over CR.

Twenty Years of the Food Cravings Questionnaires: a Comprehensive Review

Purpose of Review

The Food Cravings Questionnaires (FCQs; Cepeda-Benito, Gleaves, Williams, & Erath, 2000) are among the most widely used instruments for measuring food cravings. In addition to the Food Cravings Questionnaire–Trait (FCQ–T) and the Food Cravings Questionnaire–State (FCQ–S), several modified versions have been developed as well. For their 20th anniversary, this article provides a comprehensive description of the FCQs and reviews studies on their psychometric properties and correlates.

Recent Findings

The FCQs and their modified versions have excellent internal reliability. Expectedly, the FCQ–T (and its derivatives) has higher retest-reliability than the FCQ–S as the FCQ–S is sensitive to situational changes such as food deprivation and food intake. However, while the FCQ–T is largely unaffected by such momentary states, it is also sensitive to change during weight-loss treatments and other interventions. Factor structure of the FCQ–T and FCQ–S has only partially been replicated. Construct validity of the FCQs is supported by experimental and longitudinal studies that measured food craving and food consumption in the laboratory and with ecological momentary assessment.

Summary

Numerous studies support reliability and validity of the FCQs and their modified versions, yet findings about their factor structures are inconsistent. Thus, using total scores or the short versions of the FCQs may be preferable.

Does acute stress influence the Pavlovian-to-instrumental transfer effect? Implications for substance use disorders

RATIONAL

The ability of conditioned stimuli to affect instrumental responding is a robust finding from animal as well as human research and is assumed as a key factor regarding the development and maintenance of addictive behaviour.

OBJECTIVES

While it is well known that stress is an important factor for relapse after treatment, little is known about the impact of stress on conditioned substance-associated stimuli and their influence on instrumental responding.

METHODS

We administered in the present study a Pavlovian-to-instrumental transfer (PIT) paradigm with stimuli associated with smoking- and chocolate-related rewards using points in a token economy to light to moderate smokers who also indicated to like eating chocolate. After completion of the first two phases of the PIT paradigm (i.e. Pavlovian training and instrumental trainings), participants were randomly allocated to the socially evaluated cold pressor test or a control condition before the final phase of the PIT paradigm, the transfer phase, was administered.

RESULTS

The presentation of a smoking-related stimulus enhanced instrumental responding for a smoking-related reward (i.e. 'smoking-PIT' effect) and presentation of a chocolate-related stimulus for a chocolate-related reward (i.e. 'chocolate-PIT' effect) in participants aware of the experimental contingencies as indicated by expectancy ratings. However, acute stress did not change (i.e. neither enhanced nor attenuated) the 'smoking-PIT' effect or the 'chocolate-PIT' effect, and no overall effect of acute stress on tobacco choice was observed in aware participants.

CONCLUSIONS

The established role of stress in addiction appears not to be driven by an augmenting effect on the ability of drug stimuli to promote drug-seeking.

Effects of a Smartphone-Based Approach-Avoidance Intervention on Chocolate Craving and Consumption: Randomized Controlled Trial

BACKGROUND

Repeatedly pushing high-calorie food stimuli away based on joystick movements has been found to reduce approach biases toward these stimuli. Some studies also found that such avoidance training reduced consumption of high-calorie foods.

OBJECTIVE

This study aimed to test effects of a smartphone-based approach-avoidance intervention on chocolate craving and consumption, to make such interventions suitable for daily use.

METHODS

Within a 10-day period, regular chocolate eaters (n=105, 86% female) performed five sessions during which they continuously avoided (ie, swiped upward) chocolate stimuli (experimental group, n=35), performed five sessions during which they approached and avoided chocolate stimuli equally often (placebo control group, n=35), or did not perform any training sessions (inactive control group, n=35). Training effects were measured during laboratory sessions before and after the intervention period and further continuously through daily ecological momentary assessment.

RESULTS

Self-reported chocolate craving and consumption as well as body fat mass significantly decreased from pre- to postmeasurement across all groups. Ecological momentary assessment reports evidenced no differences in chocolate craving and consumption between intervention days and rest days as a function of the group.

CONCLUSIONS

A smartphone-based approach-avoidance training did not affect eating-related and anthropometric measures over and above measurement-based changes in this study. Future controlled studies need to examine whether other techniques of modifying food approach tendencies show an add-on benefit over conventional, monitoring-based intervention effects.

TRIAL REGISTRATION

AsPredicted 8203; https://aspredicted.org/pt9df.pdf.

Do children with a high level of eating motivation consume less when foods are partitioned?

Eating behaviors, especially the control of intake, are modulated by both internal and external factors. The objective of our study was to examine the effect of the interaction between eating motivation (as an internal factor) and food partition (as an external factor) on chocolate intake in children, with the hypothesis, based on the paradigm of motivated perception, that the effect of partition, i.e. reduced intake, is higher for children with a high level of eating motivation than for other children. A mixed model design was used in which 80 children aged 8-11 yrs. were offered, in their natural setting, two standardized afternoon snacks that included, among other things, 100 g of chocolate presented once as a whole (one bar) and once segmented (six pieces). The amount of chocolate eaten was weighed and compared between conditions (Bar vs Pieces). Children completed questionnaires in order to assess two of their eating motivational features (appetite arousal, chocolate specific appetite). Results indicated no effect of Partition: children ate the same quantity of chocolate in the two conditions (Bar or Pieces). Only chocolate specific appetite was associated with the amount of chocolate eaten, with children with a higher level eating more than other children (+13 g). Contrary to adults, children are not influenced by the "many is more effect". Methodological and developmental interpretations were suggested, linked to the size of the portion, the network of attention and the sensibility to the external cues underlying the control of intake.

Measuring approach-avoidance tendencies towards food with touchscreen-based arm movements

Most tasks for measuring automatic approach-avoidance tendencies do not resemble naturalistic approach-avoidance behaviors. Therefore, we developed a paradigm for the assessment of approach-avoidance tendencies towards palatable food, which is based on arm and hand movements on a touchscreen, thereby mimicking real-life grasping or warding movements. In Study 1 (n = 85), an approach bias towards chocolate-containing foods was found when participants reached towards the stimuli, but not when these stimuli had to be moved on the touchscreen. This approach bias towards food observed in grab movements was replicated in Study 2 (n = 60) and Study 3 (n = 94). Adding task features to disambiguate distance change through either corresponding image zooming (Study 2) or emphasized self-reference (Study 3) did not moderate this effect. Associations between approach bias scores and trait and state chocolate craving were inconsistent across studies. Future studies need to examine whether touchscreen-based approach-avoidance tasks reveal biases towards other stimuli in the appetitive or aversive valence domain and relate to relevant interindividual difference variables.

Implicit evaluation of chocolate and motivational need states interact in predicting chocolate intake in everyday life

Snack food consumption has a high relevance for health and is partially controlled by implicit, motivational processes that make self-control difficult at certain times. Specifically, research suggests that individuals with a more positive implicit food evaluation consume more snack foods in the laboratory under conditions of high motivational needs (e.g., hunger and food craving). Yet, no study investigated if and under which circumstances implicit evaluation of food predicts snack food intake in real life. In the present study, 60 female undergraduate students (mean age: 22.3 ± 2.34 years) at the University of Salzburg, Austria, completed a chocolate-related Single Category Implicit Association Test in the laboratory and then reported snack food intake during seven days of signal-contingent Ecological Momentary Assessment. Results showed that a more positive implicit evaluation of chocolate was associated with a higher likelihood of consuming chocolate in states of high hunger and high momentary chocolate craving, whereas no such modulatory pattern was found in states of low hunger or low chocolate craving. Therefore, interventions targeting daily chocolate craving and consumption may be particularly beneficial in specific situations (i.e., in states of high hunger and craving) and also in vulnerable populations (e.g., those with a more positive implicit food evaluation).

Polarity Specific Effects of Cross-Hemispheric tDCS Coupled With Approach-Avoidance Training on Chocolate Craving

Transcranial Direct Current Stimulation (tDCS) over the Dorsolateral Prefrontal Cortex (DLPFC) has already been shown to decrease craving for food. However, it remains unclear whether a single session of tDCS combined with a cognitive bias modification (CBM) task may affect explicit and implicit measures of craving for chocolate. Fifty-one healthy volunteers (38 females; mean age: 22.12 ± 3.38) were randomly allocated to CBM training based on the Approach Avoidance task and either Sham, Right anodal-Left cathodal (RALC), or Left anodal-Right cathodal (LARC) tDCS. Results show that there was an increase in the explicit craving for chocolate, as assessed by the Visual Analog Scale [F(2, 46) = 3.239, p = 0.048], from the baseline to post-intervention. Participants which received LARC tDCS were explicitly self-reporting more craving for chocolate than those that received RALC tDCS (p = 0.023). Moreover, this effect was also observed on the implicit measure [F(2, 46) = 4.168, p = 0.022]. LARC tDCS significantly increased the implicit preference for chocolate when comparing to both RALC (p = 0.009) and Sham tDCS (p = 0.034). Previous studies have shown that RALC tDCS over the PFC is able to effectively decrease craving for food. Interestingly, the present data not only does not reproduce such result, but instead it suggests that LARC tDCS can actually increase the preference for chocolate. This result is compatible with recent models of brain laterality, in which cue craving seems to be more dependent on the left hemisphere. Thus, shifting the activity to the left hemisphere (while simultaneously reducing the activity over the homotopic region) may have led to this increased implicit as well as explicit preference for chocolate.

A review of food craving measures

OBJECTIVE

Summarize and evaluate self-report measures of food craving, provide suggestions on future directions for the field of food craving measurement, and deliver guidance on how to select a food craving measure.

METHODS

Online bibliographical databases (PsycINFO and PubMed) were searched for peer-reviewed literature on self-report measures of food craving.

RESULTS

There is a wide selection of food craving measures that researchers and clinicians can use to assess state, past, and trait food cravings. Most questionnaires were tested on homogenous samples and their psychometric properties in older, male, and socioeconomically, racially, and ethnically diverse samples is largely unknown. Few questionnaires were tested in samples with overweight/obesity or eating disorders. Relatively few questionnaires adequately evaluate contextual factors that can trigger craving. There appears to be limited data on the predictive validity of food craving measures in regards to response to eating disorder treatment. A decision tree was provided to help researchers and clinicians select a food craving measure that is best suited to a particular clinical or research purpose.

CONCLUSIONS

It is recommended that researchers adequately assess the contextual factors that may trigger craving and the multi-sensory nature of craving for food. It would be beneficial for researchers to evaluate the psychometrics of food craving measures in more diverse samples (in terms of sex, race, ethnicity, socioeconomic status, weight status, and eating disorder psychopathology). More longitudinal studies should be conducted to provide information on the predictive validity of food craving measures regarding response to eating disorder treatment. Furthermore, it is suggested that researchers assess which tactics people use to reduce the frequency and strength of food cravings and restrain their consumption of craved foods.

Got chocolate? Bilateral prefrontal cortex stimulation augments chocolate consumption

BACKGROUND

Understanding the mechanisms behind exerting self-control may reveal why health behaviors are resistant to change. Activity in the right inferior frontal gyrus (rIFG) plays a role in self-control processes and may be modulated using transcranial direct current stimulation (tDCS).

OBJECTIVE

In this early phase behavioral research study, we investigated whether anodal stimulation over the rIFG with cathodal stimulation over the left IFG (versus sham) reduced chocolate consumption.

METHODS

Twenty-three healthy females (ages 18-35) completed two tDCS sessions (2.0 mA vs. sham; order counterbalanced) in a within-subject, double-blind, randomized design with a 4-week washout. Participants were self-reported "chocolate cravers" and restrained eaters. Self-report assessments on disinhibited eating were completed at intake. Delay discounting and inhibitory control were assessed at the remaining visits. During stimulation, participants completed an inhibitory control training task (chocolate go/no-go task) and were randomized to the chocolate no-go condition (inhibit all responses to chocolate cues) or the control condition (inhibit responses to chocolate cues on half the trials). Following stimulation, participants completed a 15-min chocolate "taste test" with chocolate rating forms. Afterwards, staff measured the remaining chocolate to determine total consumption.

RESULTS

Contrary to our hypotheses, active tDCS significantly increased chocolate consumption vs. sham (mean = 43.2 vs. 32.2, p=0.005) in both task conditions, but had no effect on chocolate ratings (ps > 0.05). Higher delay discounting and self-reported disinhibited eating predicted greater consumption (ps < 0.05).

CONCLUSIONS

The results suggest widespread activation of the prefrontal cortex may reduce the ability to resist chocolate. Our data highlights important methodological considerations for conducting tDCS studies to target health behaviors.

Suppressing images of desire: Neural correlates of chocolate-related thoughts in high and low trait chocolate cravers

Chocolate is the most often craved food in Western societies and many individuals try to resist its temptation due to weight concerns. Suppressing chocolate-related thoughts might, however, lead to paradoxical enhancements of these thoughts and this effect might be more pronounced in individuals with frequent chocolate cravings. In the current study, neural and cognitive correlates of chocolate thought suppression were investigated as a function of trait chocolate craving. Specifically, 20 high and 20 low trait chocolate cravers followed suppression vs. free thinking instructions after being exposed to chocolate and neutral images. Enhanced cue reactivity was evident in high trait chocolate cravers in that they reported more chocolate-related thoughts selectively after chocolate images compared to their low trait craving counterparts. This cue reactivity was mirrored neurally by higher activation in the ventral and dorsal striatum, demonstrating enhanced reward system activity. Unexpectedly, high trait chocolate cravers successfully reduced their elevated chocolate thoughts in the suppression condition. This lends support for the use of thought suppression as a means of regulating unwanted thoughts, cravings and imagery. Whether this thought manipulation is able to curb the elevated cue reactivity and the underlying reward sensitivity in chocolate cravers in applied settings remains to be shown.

Food cravings in food addiction: exploring a potential cut-off value of the Food Cravings Questionnaire-Trait-reduced

PURPOSE

The Food Cravings Questionnaires are among the most often used measures for assessing the frequency and intensity of food craving experiences. However, there is a lack of studies that have examined specific cut-off scores that may indicate pathologically elevated levels of food cravings.

METHODS

Receiver-Operating-Characteristic analysis was used to determine sensitivity and specificity of scores on the Food Cravings Questionnaire-Trait-reduced (FCQ-T-r) for discriminating between individuals with (n = 43) and without (n = 389) "food addiction" as assessed with the Yale Food Addiction Scale 2.0.

RESULTS

A cut-off score of 50 on the FCQ-T-r discriminated between individuals with and without "food addiction" with high sensitivity (85%) and specificity (93%).

CONCLUSIONS

FCQ-T-r scores of 50 and higher may indicate clinically relevant levels of trait food craving.

LEVEL OF EVIDENCE

Level V, descriptive study.

Effects of Chocolate Deprivation on Implicit and Explicit Evaluation of Chocolate in High and Low Trait Chocolate Cravers

Diet failures are often attributed to an increase in cravings for attractive foods. However, accumulating evidence shows that food cravings actually decrease during energy-restricting weight-loss interventions. The current study aimed at elucidating possible mechanisms that may explain how and under which circumstances food cravings in- or decrease during dieting. Specifically, decreases in food cravings during weight-loss diets may be due to effects of energy restriction (homeostatic changes) and to effects of avoiding specific foods (hedonic changes). Thus, we used a selective, hedonic deprivation (i.e., restricting intake of a specific food in the absence of an energy deficit) that precludes homeostatic changes due to energy restriction. Furthermore, interindividual differences in food craving experiences might affect why some individuals are more prone to experience cravings during dieting than others. Thus, we investigated whether a selective deprivation of chocolate would in- or decrease craving and implicit preference for chocolate as a function of trait-level differences in chocolate craving. Participants with high and low trait chocolate craving (HC, LC) refrained from consuming chocolate for 2 weeks but otherwise maintained their usual food intake. Both groups underwent laboratory assessments before and after deprivation, each including explicit (i.e., state chocolate craving) and implicit measures (i.e., Single Category Implicit Association Test, SC-IAT; Affect Misattribution Procedure, AMP). Results showed that hedonic deprivation increased state chocolate craving in HCs only. HCs also showed more positive implicit attitudes toward chocolate than LCs on the SC-IAT and the AMP irrespective of deprivation. Results help to disambiguate previous studies on the effects of dieting on food cravings. Specifically, while previous studies showed that energy-restricting diets appear to decrease food cravings, the current study showed that a selective, hedonic deprivation in the absence of an energy deficit increases food cravings. However, this effect can only be observed for individuals with high trait craving levels. Thus, if attractive foods are strictly avoided through a selective deprivation, HCs are at risk to experience craving bouts in the absence of an energy deficit. As implicit preference was unaffected by chocolate deprivation, strong implicit preference for chocolate likely characterize a stable mechanism that drives consumption in HCs.

Salivary secretion and disgust: A pilot study

Although a direct link has been established between self-experienced disgust and salivary secretion, it is unclear whether this physiological index is modulated by the social experience of disgust (i.e., exposure to the facial expression of disgust). We tested this issue in a pilot study by collecting salivary samples in a group of 20 healthy humans watching pictures of faces expressing disgust. Moreover, we tried to replicate previous evidence by testing saliva secretion in response to pictures of unpalatable (i.e., rotten) food and non-gustatory disgusting stimuli (i.e., disgusting insects). Overall, our analysis shows a general reduction of saliva secretion in response to disgust stimuli, compared to their positive counterparts, although further analyses for specific stimulus categories indicated that this difference was statistically significant only for food pictures. The non-significance of the face and insect categories might be due to insufficient power of our small sample. Overall, a general reduction of saliva secretion for different disgust-related stimuli suggests a shared mechanism of encoding, in line with theories of neural reuse.

Food cravings in everyday life: An EMA study on snack-related thoughts, cravings, and consumption

Food craving refers to an intense desire to consume a specific food and is regularly experienced by the majority of individuals. Yet, there are interindividual differences in the frequency and intensity of food craving experiences, which is often referred to as trait food craving. The characteristics and consequences of trait and state food craving have mainly been investigated in questionnaire-based and laboratory studies, which may not reflect individuals' behavior in daily life. In the present study, sixty-one participants completed the Food Cravings Questionnaire-Trait-reduced (FCQ-T-r) as measure of trait food craving, followed by seven days of Ecological Momentary Assessment (EMA), during which they reported snack-related thoughts, craving intensity, and snack consumption at five times per day. Results showed that 86 percent of reported snacks were high-caloric, with chocolate-containing foods being the most often reported snacks. Individuals with high FCQ-T-r scores (high trait food cravers, HCs) thought more often about high-calorie than low-calorie snacks whereas no differences were found in individuals with low FCQ-T-r scores (low trait food cravers, LCs). Further, the relationship between craving intensity and snack-related thoughts was stronger in HCs than in LCs. Higher craving intensity was associated with more consumption of snacks and again this relationship was stronger in HCs than in LCs. Finally, more snack-related thoughts were related to more frequent consumption of snacks, independent of trait food craving. Thus, HCs are more prone to think about high-calorie snacks in their daily lives and to consume more snack foods when they experience intense cravings, which might be indicative of a heightened responding towards high-calorie foods. Thus, trait-level differences as well as snack-related thoughts should be targeted in dietary interventions.

Subjective craving and event-related brain response to olfactory and visual chocolate cues in binge-eating and healthy individuals

High-sugar/high-fat foods are related to binge-eating behaviour and especially people with low inhibitory control may encounter elevated difficulties to resist their intake. Incentive sensitization to food-related cues might lead to increased motivated attention towards these stimuli and to cue-induced craving. To investigate the combined influence of olfactory and visual stimuli on craving, inhibitory control and motivated attention, 20 healthy controls and 19 individuals with binge-eating viewed chocolate and neutral pictures, primed by chocolate or neutral odours. Subjective craving and electroencephalogram activity were recorded during the task. N2 and Late Positive Potential (LPP) amplitudes were analysed. Patients reported higher craving than controls. Subjective craving, N2 and LPP amplitudes were higher for chocolate versus neutral pictures. Patients showed a higher relative increase in N2 amplitudes to chocolate versus neutral pictures than controls. Chocolate images induced significant increases in craving, motivated attention and measures of cognitive control. Chocolate odour might potentiate the craving response to visual stimuli, especially in patients with binge-eating.

Psychometric properties of the English Food Cravings Questionnaire-Trait-reduced (FCQ-T-r)

Food cravings have been implicated in the development and maintenance of a range of eating- and weight-related pathology. The rapid and accurate assessment of food cravings is thus critical in clinical and research settings. Existing measures of specific food cravings are often not suitable for capturing the multiple facets of the craving experience. A short version of the Food Cravings Questionnaire-Trait (FCQ-T), the most widely used measure of general food cravings, was recently developed in German and shown to be a one-factorial, internally reliable measure. Other recent studies validated an Italian and Spanish version of the FCQ-T-reduced (FCQ-T-r) and successfully replicated its basic psychometrics. This study sought to examine the psychometric properties of the English version of the FCQ-T-r. Undergraduate students (n=610, 51.0% female, 53.9% white/Caucasian) completed a battery of questionnaires containing the FCQ-T-r and measures of specific food cravings, eating style, eating disorder symptoms, weight dissatisfaction, and impulsivity. Even though results of a confirmatory factor analysis suggested poor fit with a one-factorial model, the FCQ-T-r was found to be a one-factorial measure in both principal component and parallel analysis. The FCQ-T-r demonstrated excellent internal consistency reliability (Cronbach's α=.94), and scores were significantly and positively correlated with measures of specific food cravings, restrained eating, eating disorder symptoms, and impulsivity. More work is needed to confirm the factor structure of the English FCQ-T-r, but preliminary findings suggest that it constitutes a valid and reliable alternative to lengthier measures of general food cravings.