A nudge in a healthier direction: How environmental cues help restrained eaters pursue their weight-control goal

Effectiveness of visual nudges for encouraging healthier beverage choices from vending machines

ISSUES ADDRESSED

Research suggests visual nudging techniques can subtly encourage healthier consumption. Two experiments explored the effect of four visual primes for nudging drink choices from a vending machine display.

METHODS

Participants (17-25 years) were randomly assigned to view vending machine advertising posters containing pictorial nudges of water, soft drink, general health (runner), or a text-only control, for nudging vending machine choices. Participants then selected an item from a vending machine display containing drinks only (Experiment 1; n = 164), or both drinks and snack foods (Experiment 2, n = 684).

RESULTS

In both experiments, nudging condition predicted beverage choice. Specifically, the water image nudged healthier beverage choices in both experiments. However, there was no effect on food choice in Experiment 2. Furthermore, in both experiments, liking and habitual consumption of chosen items were also significant predictors of choice, but condition predicted beverage choice over and above these.

CONCLUSION

A water prime may be an effective means of encouraging healthier beverage choices in a vending machine environment. SO WHAT?: Findings have the potential to inform strategies for encouraging healthier beverage choices from vending machine environments.

The Impact of Modifiable Preoral Factors on Swallowing and Nutritional Outcomes in Healthy Adults: A Scoping Review

PURPOSE

Swallowing has previously been characterized as consisting of four phases; however, it has become apparent that these four phases are not truly discrete and may be influenced by factors occurring prior to bolus entrance into the oral cavity (i.e., preoral factors). Still, the relationship between these factors and swallowing remains poorly understood. The aim of this review was to synthesize and characterize the literature pertaining to the influence of preoral factors on swallowing and nutritional outcomes in healthy individuals.

METHOD

We performed a scoping review, searching the databases of PubMed, CINAHL, Cochrane, and Scopus. Search terms included those related to swallowing, experience of preoral factors, and exclusionary terminology to reduce animal and pediatric literature. Our initial search revealed 5,560 unique articles, of which 153 met our inclusionary criteria and were accepted into the review.

RESULTS

Of the accepted articles, 78% were focused exclusively on nutritional outcomes, 17% were focused on both swallowing and nutritional outcomes, and 5% were focused on solely swallowing outcomes. Of the preoral factors examined, 99% were exteroceptive in nature (17% olfactory, 44% visual, 21% auditory, 7% tactile, 11% other), while 1% were proprioceptive in nature.

CONCLUSIONS

This review supports the influence of preoral factors on swallowing and nutritional outcomes. However, there is a large emphasis on the visual modality and on nutritional outcomes. Nearly none of the literature found in this review directly measured swallowing safety, efficiency, or physiology. Future work will benefit from a larger focus on proprioceptive preoral factors as they relate to swallowing outcomes.

The effect of spatial separation on food and drink choices from an online menu

Emerging research suggests that modifying the presentation context of healthy food items can subtly 'nudge' individuals to make healthier choices. The present study aimed to investigate the effect of spatial separation between high and low nutritional value items on food and drink choices from an online fast-food menu. Participants (N = 210 women) were presented with one of three pictorial menus in which high nutritional value food and drink items were presented spatially mixed, grouped, or separate from low nutritional value items. Participants were asked to make one selection from each menu category (a main, drink, and dessert), and then completed a measure of dietary restraint. Overall, there was no main effect of menu condition. However, dietary restraint status moderated the effect of menu condition on healthy choices. In particular, women who scored low (but not those who scored high) on dietary restraint were positively influenced by the experimental manipulation, making approximately 14 % healthier selections when high nutritional value items were presented separately from low nutritional value items. This was principally the case for desserts, and to a lesser extent drinks. The findings have practical implications for the design of online fast-food menus to promote healthier food and drink selections.

Improving Knowledge, Engagement, and Self-Efficacy in the Creation of Healthy Home Environments for Mothers Using a Facebook Intervention (Design for Wellness): Randomized Controlled Trial

BACKGROUND

Designing the home environment can promote well-being. Social networks provide learning opportunities to improve health.

OBJECTIVE

This study aimed to develop and evaluate a Facebook intervention called Design for Wellness (DWELL). The program was created to improve knowledge, engagement, and self-efficacy in the creation of healthy home environments.

METHODS

A randomized controlled trial was conducted to assess the effects of the intervention program DWELL. Content was uploaded to the Facebook group and gave the participants practical solutions for how to design their home environment for wellness. The intervention addressed multiple components of health behaviors, such as healthy eating, physical activity, tobacco-free environment, hygiene, family conversations regarding wellness issues, and stress reduction. The main outcome was the participants' overall score on the DWELL index, which we developed to assess the elements of our intervention: knowledge, awareness, engagement, and self-efficacy regarding home design for wellness. The intervention was conducted in Israel and lasted 6 weeks during the third wave of the COVID-19 pandemic. The primary analysis included a multivariable model to assess the DWELL score at the end of the study while controlling for baseline characteristics. The waitlist control group did not receive an intervention between the 2 administrations of the questionnaire.

RESULTS

In total, 643 participants began the program: 322 (50.1%) in the intervention group and 321 (49.9%) in the control group. Of the 643 participants, 476 (74%) completed the study. At the end of the study, there was a statistically significant benefit of the intervention as assessed using a one-way analysis of covariance: there was a mean difference of 8.631 (SD 1.408) points in the DWELL score in favor of the intervention group (intervention: mean 61.92, SD 14.30; control: mean 53.29, SD 16.374; P<.001). Qualitative feedback from participants in the intervention group strengthened the positive results as most of them found the group beneficial. The Facebook group was very active. Being more engaged in the group correlated with having a higher DWELL score, but this relationship was weak (r=0.37; P<.001). The mean significant difference of 26.281 (SD 19.24) points between the overall DWELL score and the overall engagement score indicated that participants who were not active in the group still followed the posts and benefited. We found no improvements in the secondary outcome regarding participants' well-being. The COVID-19 lockdown may have prevented this.

CONCLUSIONS

DWELL was found to be a beneficial intervention for improving perceptions of the design of home environments to foster wellness. Facebook was an effective platform to deliver this intervention. DWELL may become a prototype for other health promotion interventions.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03736525; https://clinicaltrials.gov/study/NCT03736525?term=DWELL&rank=1.

The effects of food anthropomorphism on consumer behavior: A systematic literature review with integrative framework and future research directions

Anthropomorphizing or humanizing food is a common marketing practice that has gained significant scholarly attention in the past few years. The present systematic review analyzes articles that examined the effects of anthropomorphizing various food and food ingredients on consumers' behavior to synthesize the existing body of work into an integrative framework, provide managerial recommendations, and identify avenues for future research. Using the Prisma 2020 statement for systematic reviews, a systematic search of four databases (EBSCO, PubMed, SCOPUS, and Web of Science) for peer-reviewed, quantitative articles published in English till the March 10, 2023 was undertaken, resulting in a final number of 21 articles meeting our selection criteria. The identified articles studied anthropomorphism of one of the three categories of food - regular food, misshapen/irregularly-shaped food, and meat animal. Analysis based on an integrative framework suggests that, in general, anthropomorphizing misshapen produce and regular food has a positive effect on behavior towards the food (e.g., purchase intention) and the restaurant/brand (e.g., restaurant visit intention) among adult consumers through elicitation of cognitive and affective responses. However, anthropomorphizing meat animals reduces consumers' intention to buy or eat meat by evoking negative emotions such as guilt. Similarly, anthropomorphizing regular food discourages consumption among children. The framework highlights several moderating variables of these effects. Based on the insights from this literature review, several recommendations for practitioners and researchers are suggested.

Exploring Whether Weight-Related Cues Affect Food Intake in Older Adults with Dementia

Purpose

Past research has shown that exposure to the image of a slim person reduces food consumption among young adults. However, it remains unknown whether this paradigm could be adapted and applied to increase food intake among older adults with dementia by exposing them to the image of a higher-weight person to mitigate weight loss and malnutrition. The present study explored whether weight-related visual cues affect the amount of food consumed by older adults with dementia.

Participants and Methods

In the experiment, twenty-one elderly people with dementia living in a nursing home were visually exposed to one of four conditions (a cartoon image of a normal-weight chef, a higher-weight chef, a flower or no image) during real-life daily lunch situations over the course of four weeks, during which each condition was presented for one week.

Results

Results demonstrate that participants finished their meals more frequently when they were exposed to the image of the higher-weight chef than when they were not exposed to any images.

Conclusion

These results suggest that exposure to a cartoon chef character representing a stereotyped social group related to body weight activates the stereotype and increases stereotype-consistent behavior in older adults with dementia. The present findings will contribute to understanding the effect of visual information on eating behavior and to designing eating environments which facilitate sufficient nutrition intake among older adults with dementia.

Effects of a Nudging Cue Targeting Food Choice in a University Cafeteria: A Field Study

Many students approaching adulthood often choose high-calorie food products. Concurrently, health interventions applied during this life phase can potentially lead to a healthier lifestyle. Nudge health interventions in experimental cafeteria settings have been found to improve eating behavior effectively, yet research in real-world settings is lacking. Accepting nudges as health interventions impacts nudge effectiveness. The present study applies a pretest-posttest design for a period of three consecutive weeks (no nudge, nudge, no nudge), testing the effectiveness of the so-called Giacometti cue on the number of calories purchased in a real-world cafeteria. Students were exposed to the nudge during the intervention week when entering the cafeteria and when choosing their meals. After purchasing a meal, their choice was recorded, and they completed a questionnaire. The Giacometti cue immediately reduced the number of calories purchased (comparing weeks one and two). After nudge removal, an effect was identified, increasing the number of calories purchased (comparing weeks two and three). Contrary to expectations, higher nudge acceptance resulted in more calories purchased. Neither awareness of the nudge's presence when buying food nor the interaction between acceptance and awareness played a role. We explore potential explanations for the Giacometti cue's effects.

DWELL: Design for WELLness. A pilot study of an online Facebook intervention to improve perceptions of knowledge, engagement, and self-efficacy in the creation of healthy home environments

Background

Many factors in the environment influence healthy behaviors. Designing user-friendly environments, by changing the way choices are presented in the environment, may result in behavioral changes and promote the well-being.

Objectives

To run a pilot study to evaluate the feasibility and acceptability of DWELL (Design for WELLness), which is an online Facebook intervention to improve perceptions of knowledge, engagement, and self-efficacy in the creation of healthy home environments.

Methods

Both quantitative and qualitative methods were used to evaluate this 7.5-week pilot study. The intervention was conducted during the first wave of COVID-19 lockdown in Israel. Participants answered an online questionnaire at the beginning and end of the pilot. Afterwards, eleven semi-structured telephone interviews were conducted with some of the participants.

Results

There were 36 mothers who participated in the study. The overall DWELL index increased by 15.43 points (p < 0.001) from the beginning of the pilot [Mean(SD) = 48.14(17.91)] to the end [Mean(SD) = 63.57(11.98]. There were significant increases in all 5 items of DWELL (p < 0.05). Positive feedback was obtained from interviewees about their experience with the program, including being interested with the posts and having a mutual learning experience with other members. The intervention was found to be beneficial to most families during COVID-19 lockdown time.

Conclusions

DWELL was found to be a promising intervention for improving perceptions regarding designing home environments for wellness. These results justified the continuation of the program toward its next phase of the RCT.

Nudging food service users to choose fruit- and vegetable-rich items: Five field studies

Although nudging has been found to promote the choice of healthy foods in lab studies and ad-hoc field studies, relatively little research is available regarding effectiveness in real food venues that operate for profit. The paucity of empirical studies providing "proof of implementation" reveals the difficulty of applying previous empirical findings on nudging to mass-eating food services contexts, which serve meals to a lot of individuals daily. Based on the typology of choice architecture in food choice contexts, we closely collaborated with the in-house food service operator to devise and implement five nudge interventions to promote fruits and vegetables (FV) in university cafeterias. Each study was conducted for one 12-week semester or more over a three-year period. In the first two studies, non-verbal point-of-purchase prompting increased the choice of kale/spinach supplemented smoothies and whole fruits from baskets. In Study 3, the combination of sizing and point-of-purchase non-verbal prompting increased the sale of large size vegetable-rich bowls from a stir-fry grill. In Study 4, the proximity type of nudging by altering the position of the healthier option in a sandwich bar in combination with non-verbal prompting increased the sale of sandwiches containing spinach. In Study 5, the combination of sizing and proximity of large vs. small sized plates and serving spoons had no effect on sale of self-serve items in a salad bar. All the interventions except for Study 5 produced a moderate effect in increasing the choice of FV-rich items. We recommend that hospitality and food service operators consider operational parameters and simultaneously adopt more than one nudging components to achieve a sizable effect. Future randomized controlled trials are needed to implement choice architecture techniques in collaboration with food service companies.

A Consumer Segmentation Study of Nutrition Information Seeking and Its Relation to Food Consumption in Beijing, China

The aim of this study is to identify consumer groups based on nutrition information-seeking behavior and how it relates to food consumption. Although the Chinese public can now access nutrition information through different channels, research on the segmentation of homogeneous consumer groups seeking nutrition information is lacking. This study closes this research gap and, in doing so, also shows how information seeking is related to dietary behavior. A questionnaire was sent out to a stratified random sample in Beijing, resulting in 448 responses. A cluster analysis using hierarchical methods was conducted, identifying four distinct consumer groups: Multi-Channel (27.43%), Mass Media (20.57%), Moderate (27.88%), and Uninterested (24.12%). The four segments differed significantly concerning food consumption frequencies, food literacy, and sociodemographic characteristics. Consumers who were more involved in nutrition information tended to eat healthier. Our findings indicate that nutrition information is worth promoting, but this kind of intervention is not a cure-all. Targeted interventions should focus on uninterested populations by providing non-informational nudging strategies to promote healthy eating behaviors. This study contributes to the identification of meaningful profiles for targeted interventions, particularly as regards uninterested or unreached consumers.

Cafeteria Online: Nudges for Healthier Food Choices in a University Cafeteria-A Randomized Online Experiment

Many people do not consume as much healthy food as recommended. Nudging has been identified as a promising intervention strategy to increase the consumption of healthy food. The present study analyzed the effects of three body shape nudges (thin, thick, or Giacometti artwork) on food ordering and assessed the mediating role of being aware of the nudge. Students (686) and employees (218) of a German university participated in an online experimental study. After randomization, participants visited a realistic online cafeteria and composed a meal for themselves. Under experimental conditions, participants were exposed to one out of three nudges while choosing dishes: (1) thin body shape, (2) thick body shape, and (3) the Giacometti artwork nudge. The Giacometti nudge resulted in more orders for salad among employees. The thin and thick body shape nudges did not change dish orders. Awareness of the nudge mediated the numbers of calories ordered when using the Giacometti or thin body shape nudges. These findings provide useful insights for health interventions in occupational and public health sectors using nudges. Our study contributes to the research on the Giacometti nudge by showing its effectiveness when participants are aware (it is effective under conditions where it is consciously perceived).

What Nudge Techniques Work for Food Waste Behaviour Change at the Consumer Level? A Systematic Review

In European countries over 40% of food loss and waste occurs at the retail and consumer stages; this situation cannot be sustained and remediation is urgently needed; opportunities for change must be created. “Nudge” techniques have been shown to be effective in changing behaviour in areas related to food consumption (e.g., healthy diet), but the effectiveness of interventions using nudge techniques to change food waste behaviours remains unclear, despite a growing body of research. The aim of this review is to elucidate means to change household food waste behaviour using nudge approaches and identify priority needs for further research. Four databases, grey literature and reference lists were searched systematically to identify relevant research on nudges to change food waste behaviours. This search identified sixteen peer-reviewed research articles and two grey literature reports that were critically appraised using a critical appraisal checklist framework for descriptive/case series. Four studies deemed reliable show interventions using nudges of social norms, reminders or social norms with disclosure were effective in changing food waste behaviours at the household level, while disclosure alone, i.e., revealing environmental costs of food waste, was not. This review, unique in the application of a critical appraisal, suggests there is reliable information on the effectiveness of nudge for food waste recycling interventions when incorporating nudges of social norms, reminders or disclosure alongside use of social norms. If food waste recycling behaviour is considered an upstream measure to raise consumers’ consciousness on the amount of food waste they produce, this may have a positive impact on food waste reduction and therefore has important policy implications for food waste behaviour change at the household level.

Targeting automatic processes to reduce unhealthy behaviours: a process framework

While previous frameworks to address health behaviours through targeting underlying automatic processes have stimulated an improved understanding of related interventions, deciding between intervention strategies often remains essentially arbitrary and atheoretical. Making considered decisions has likely been hampered by the lack of a framework that guides the selection of different intervention strategies targeting automatic processes to reduce unhealthy behaviours. We propose a process framework to fulfil this need, building upon the process model of emotion regulation. This framework differentiates types of intervention strategies along the timeline of the unfolding automatic response, distinguishing between three broad classes of intervention strategies - direct antecedent, indirect antecedent, and response-focused. Antecedent-focused strategies aim to prevent the exposure to or activation of automatic responses directly through the avoidance of unwanted stimulus-response associations (i.e., situation modification or situation-specific response selection), or indirectly through automatising self-control (i.e., attentional deployment or cognitive change). Response-focused strategies aim to directly downregulate automatic unwanted responses (i.e., response modulation). Three main working hypotheses derived from this process framework provide practical guidance for selecting interventions, but await direct testing in future studies.

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.

Novel Methodological Considerations Regarding the Use of Visual Analog Scale (VAS) Appetite Questionnaires in Tightly Controlled Feeding Trials

Visual analog scale (VAS) questionnaires are widely used in nutrition research to assess appetite and subsequent food intake. However, a number of methodological considerations exist. The study aims were to test whether 1) appetite VASs alter subsequent food intake and 2) viewing previous appetite responses influences subsequent responses. Twelve healthy adults (age: 22 ± 3 y; BMI: 22.0 ± 3.1 kg/m2) completed the randomized crossover study. On separate days, participants were provided breakfast preloads and completed appetite VASs every 30 min for 4 h or did not complete the questionnaires. When completing VASs, the participants were shown their previous responses (PR) or were not (No-PR). After 4 h, an ad libitum lunch was provided. Hunger, fullness, desire to eat, and prospective food consumption were not different between PR and No-PR. All data are reported as mean ± SEM. VASs did not affect lunch intake (484 ± 50 kcal) compared with no VASs (500 ± 53 kcal, nonsignificant). Thus, neither past appetite responses nor the use of appetite VASs influenced ingestive behavior in healthy adults. This trial was part of a larger acute, randomized crossover trial registered at clinicaltrials.gov as NCT03154606.

Calorie information and dieting status modulate reward and control activation during the evaluation of food images

Several public health departments throughout North America have responded to the obesity epidemic by mandating that restaurants publish calories at the point of purchase-with the intention of encouraging healthier food decisions. To help determine whether accompanying calorie information successfully changes a food's appetitive value, this study investigated the influence of calorie information on brain responses to food images. During functional magnetic resonance imaging (fMRI) scanning, dieting (N = 22) and non-dieting (N = 20) participants viewed pictures of food with and without calorie information and rated their desire to eat the food. When food images were paired with calorie information, not only did self-reported desire to eat the food decrease, but reward system activation (Neurosynth-defined from the term "food") decreased and control system activation (the fronto-parietal [FP] control system) increased. Additionally, a parametric modulation of reward activation by food preferences was attenuated in the context of calorie information. Finally, whole brain multivariate pattern analysis (MVPA) revealed patterns of activation in a region of the reward system-the orbitofrontal cortex (OFC)-that were more similar for food images presented with and without calorie information in dieting than non-dieting participants, suggesting that dieters may spontaneously consider calorie information when viewing food. Taken together, these results suggest that calorie information may alter brain responses to food cues by simultaneously reducing reward system activation and increasing control system activation. Moreover, individuals with greater experience or stronger motivations to consider calorie information (i.e., dieters) may more naturally do so, as evidenced by a greater degree of representational similarity between food images with and without calorie information. Combining an awareness of calories with the motivation to control them may more effectively elicit diet-related behavior change.

Priming food intake with weight control cues: systematic review with a meta-analysis

BACKGROUND

A growing number of studies suggest that exposure to cues which are associated with weight control can prime or prompt controlled food intake in tempting food environments. However, findings are mixed and understanding which types of cues and for whom such cues may be most effective is needed to inform subsequent research and societal applications. A systematic review and meta-analysis were conducted to evaluate the effects of exposure to weight control cues compared with control cues on food intake.

METHODS

PsycINFO, Medline, Embase and Web of Science were searched using key terms. Hedge's g was used to calculate effect sizes based on mean food intake, standard deviations and sample sizes extracted from relevant publications and, a random effects model was used for the meta-analysis.

RESULTS

Twenty-five articles consisting of 26 studies were eligible. Data from 25 studies (31 effect sizes) were available for the meta-analysis. Overall, weight control cues reduced food intake, albeit to a trivial effect (ES: -0.149, 95% CI: -0.271 to - 0.027). Subgroup analyses when studies which induced negative affect were removed showed that for individuals with strong weight control goals the effect was small-to-moderate (ES: -0.440, 95% CI: -0.718 to - 0.163), whereas for individuals with weak weight control goals this effect was trivial and non-significant (ES: 0.014, 95% CI: -0.249 to 0.278). Cue type and level of engagement did not significantly moderate the effect; however, specific cues (low-calorie foods and thin models) and attended engagement yielded significant effects. Caution is needed interpreting these findings as most studies were rated with high risk of bias and a number of studies could not be included in the subgroup analyses.

CONCLUSIONS

Based on the data available, weight control cues reduce food intake in individuals with strong weight control goals. Further research is needed to explore longer term effects of cue exposure and confirm underlying mechanisms. PROSPERO registry#CRD42016052396.

Examination of Protein Quantity and Protein Distribution across the Day on Ad Libitum Carbohydrate and Fat Intake in Overweight Women

Background: The effects of meal-specific protein quantity and protein distribution throughout the day on daily food intake are relatively unknown. Objectives: The aims were to test 1) whether the consumption of higher-protein (HP) compared with normal-protein (NP) meals consumed at each eating occasion reduce free-living, daily carbohydrate and fat intakes in overweight women during energy balance conditions and 2) whether the distribution of protein consumed throughout the day affects food intake outcomes. Methods: Seventeen women [mean ± SEM age: 33 ± 1 y; body mass index (in kg/m2): 27.8 ± 0.1] completed the following tightly controlled, crossover design study. Participants were provided with and randomly consumed three 6-d eucaloric diets containing NP or HP (15% or 25% of energy as protein, respectively). The protein content within the NP diet used an even distribution pattern (EVEN; 21 ± 1 g protein/meal) throughout the day, whereas the protein contents within the HP diets used either EVEN (35 ± 1 g protein/meal) or an uneven distribution pattern (UNEVEN; 19 ± 1 g protein/breakfast, 26 ± 1 g protein/lunch, 63 g protein/dinner). On day 7 of each diet, the participants were asked to consume the diet-specific absolute protein quantity (in grams) at each eating occasion but were provided with a surplus of carbohydrate- and fat-rich foods to consume, ad libitum, during each eating occasion. Results: Eating more protein (HP compared with NP) or evenly distributing protein throughout the day (HP-EVEN compared with HP-UNEVEN) did not reduce the consumption of ad libitum fat- and carbohydrate-rich foods throughout the day (NP-EVEN: 2850 ± 240 kcal/d; HP-EVEN: 2910 ± 240 kcal/d; HP-UNEVEN: 3160 ± 200 kcal/d). Despite the lack of differences in daily energy intake, the breakfast meal within the HP-EVEN diet led to lower ad libitum carbohydrate and fat intakes than the breakfast meals in the NP-EVEN and HP-UNEVEN diet conditions (P < 0.05). Conclusion: Providing 30 g protein/meal at each eating occasion throughout the day did not influence free-living, daily intake of highly palatable, carbohydrate- and fat-rich foods in overweight women. This trial was registered at clinicaltrials.gov as NCT02614729.