Executive functions and the self-regulation of eating behavior: A review

Experiences of discrimination and snacking behavior in Black and Latinx children

Little is known about how discrimination contributes to health behaviors in childhood. We examined the association between children's exposure to discrimination and their snacking behavior in a sample of youth of color (N = 164, Mage = 11.5 years, 49% female, 60% Black, 40% Hispanic/Latinx). We also explored whether children's body mass index (BMI) or sleepiness moderated the association between discrimination and calorie consumption. The significant link between discrimination and calorie consumption was moderated by children's BMI, such that discrimination was associated with calorie consumption for children with BMI percentiles above 79%. Children's sleepiness did not serve as an additional moderator. Efforts to promote health should consider children's broader socio-contextual experiences, including discrimination, as factors that may shape eating patterns.

Increased self-regulation of eating behavior is associated with reduced generalized anxiety disorder in Saudi Arabia

Introduction

There is a growing body of evidence suggesting that self-regulation of eating behavior (SREB) is closely linked to dietary habits and mental health. However, little is known about these relationships within the Saudi Arabian population. This study aimed to address this gap.

Methods

A digital cross-sectional study was conducted utilizing the SREB and generalized anxiety disorder (GAD-7) questionnaires, along with a brief survey about dietary habits. Linear and logistic regression analyses were employed to examine these associations, with a total of 651 Saudi participants enrolled in the study.

Results

The results showed that only 15.5% of participants demonstrated a high capacity for SREB, while 65% experienced moderate or severe symptoms of GAD. Greater SREB was significantly associated with reduced GAD scores (β = -0.13, 95% CI; -0.12 to -0.03; p < 0.001) and lower BMI (β = -0.10, 95% CI; 0.08 to -0.00; p = 0.01). Additionally, predictive factors for high capacity for SREB included higher daily intake of fruits (OR = 2.90, 95% CI; 1.44 to 5.84; p = 0.003) and regular breakfast consumption (OR = 1.64, 95% CI; 1.01 to 2.63; p = 0.04).

Discussion

These findings suggest that enhancing SREB may be a promising strategy for obesity prevention and improving mental health outcomes among the Saudi population. Implementing interventions aimed at promoting healthier dietary habits could support the physical and mental well-being of this population.

Peer influence on eating behaviour in early childhood: A scoping review

OBJECTIVE

Peers can significantly influence eating behaviours in school-aged children and adolescents. Studies vary in methodology and terminology and report inconsistent age and sex differences. No review has collated evidence within early childhood. This review aims to explore what is currently known about peer influence and eating behaviours in young children and identify knowledge gaps regarding commonly assessed eating behaviours, peer definitions, peer influence assessment methods, and theoretical frameworks.

METHODS

A search of electronic databases (Embase, ERIC, Medline, APA PsycInfo, Scopus) was conducted. The review included peer-reviewed, primary research that explored peer influence on eating behaviour in any group context, published between 1980 and 2023, available in English full-text. Participants were aged between two and seven years. Primary and secondary screening were conducted by two authors. Data extraction was conducted by one author with a second author duplicating 25%.

RESULTS

Twenty-six of the 3961 unique identified studies met inclusion criteria. Most studies (76%) report peers to influence eating behaviours. Peer influence was a primary aim in 18 studies, of which 17 were experimental, and peer influence emerged as a finding in seven studies. All phenomena of interest varied widely. Eating behaviour concept definitions were inconsistent, with four studies assessing hypothetical eating behaviours. Peers varied by age, familiarity, and in-person versus remote exposures. Six theoretical frameworks were referenced, and eleven studies lacked theoretical underpinning. No studies measured peer influence directly or obtained children's perspectives.

CONCLUSIONS

Peers may influence eating behaviours within early childhood. Peer familiarity and age potentially impact peer influence magnitude. Variations in study design and peer definitions make comparisons challenging. Future research should utilise observational designs to explore peer influence on child eating behaviours within naturalistic settings.

Exploration of Food Attitudes and Management of Eating Behavior from a Psycho-Nutritional Perspective

BACKGROUND/OBJECTIVES

This study investigates the relationship between food attitudes and the management of eating behavior from a psycho-nutritional perspective, with a focus on the Health Belief Model (HBM). The objective was to explore how emotional food cravings influence different aspects of eating behavior and dietary attitudes, and to identify indirect pathways through which these cravings affect attitudes toward dieting behaviors.

METHODS

Data were collected from 659 participants using validated scales that assessed dieting tendencies, bulimia and food preoccupation, culinary behaviors, food preoccupation, expectations of positive outcomes, and emotional food cravings. Descriptive statistics, Pearson's correlations, and network analysis were employed to uncover significant associations among these variables. A sequential mediation analysis was conducted using SPSS PROCESS Macro Model 6 to identify indirect pathways.

RESULTS

The analysis revealed significant associations among the variables. Emotional food craving had a negative indirect effect on dieting attitudes through bulimia tendencies (effect size: -0.523) and a positive indirect effect through food preoccupation (effect size: 0.1006). These results highlight the complex interplay between emotional food cravings, bulimia tendencies, and food preoccupation in shaping dieting attitudes.

CONCLUSIONS

The findings emphasize the complex dynamic between emotional food cravings, bulimia tendencies, and food preoccupation, and their collective impact on dieting attitudes. This study provides insights into potential intervention strategies aimed at improving eating habits by addressing emotional food cravings and their indirect effects on dietary behavior.

"Regulating my anxiety worsens the safety of my driving": The synergistic influence of spatial anxiety and Self-regulation on driving behavior

Spatial Anxiety (SA) can be defined as the fear and apprehension experienced during tasks that require spatial thinking and may negatively impact the execution of daily actions. Although it has been explored in several research fields, limited research has explored the effects of SA on specific driving behaviours. In the current study, it was hypothesised that the severity of SA affects risky driving behaviours, and that this relationship is mediated by the driver's self-regulation abilities. Self-reported SA symptoms, driving self-regulation abilities, and risky driving behaviours (i.e., errors, violations, and lapses) were examined in 838 Italian drivers. Data were analysed through linear regressions and path analysis models, controlling for sociodemographic variables. The results showed the negative effects of SA on driving errors and lapses. As hypothesised, a driver's self-regulation abilities mediated the influence of SA on driving lapses, but not on errors nor violations. These findings suggest that the inclination to self-regulate the SA experienced while driving contribute to increase the occurrence of driving lapses. Showing specific pathways through which SA impacts risky driving, these results provide valuable insights for the development of 'driver-focused' road safety interventions.

Eating competence is related to executive function skills in college students

PURPOSE

This study aimed to determine the relationship between eating competence (EC) and executive function (EF) skills in college students.

METHODS

This cross-sectional study was part of a larger study in which an online survey was administered during autumn quarter 2020 to undergraduate students at a northwestern U.S. public university. Sociodemographic data were collected, along with measures of EC (16-item Satter Eating Competence Inventory, ecSI-2.0™) and EF skills (27-item Executive Function Index, EFI). Multiple linear regression was used to examine the ecSI-2.0™ total score and its four domain scores with each of the five EF skills.

RESULTS

Of the 1996 respondents included in the final analyses, 40.2 % were eating competent (total ecSI-2.0™ ≥32). The mean ecSI-2.0™ score among participants was 28.7. Gender distribution was 72.0 % women, 23.3 % men, and 4.7 % trans-and-gender non-conforming (TGNC) or preferred not to answer. EFI scores were higher among women (70.9) than among men (68.2) and TGNC (64.9). Both total ecSI-2.0™ score and the contextual skills domain were significantly associated with four of the EFI subscales. Internal regulation was related to impulse control and motivational drive. Further significant associations were found with other domains of ecSI-2.0™ and specific EFI subscales.

CONCLUSION

EF skills are associated with EC in college students, particularly skills related to food management and internal regulation. Since both EF and EC can be developed, this study offers promise for future research in an increasingly gender-diverse and neurodiverse college population during a time of increasing independence and autonomy.

Breadth of substance use is associated with the selection of a larger food portion size via elevated impulsivity

Substance use is associated with altered or elevated food consumption and disordered eating. In the present study we examined whether breadth (variety) of drug use was associated with elevated portion size in a general population sample as it was in persons in recovery from substance use disorder. Furthermore, measures of emotional eating, impulsivity, food misuse, food craving were taken as possible mediators and reward responsiveness was examined as a potential moderator of this association. 444 adults (48.6 % women, mean age of 47.8 years) completed an online study in which they were asked to make judgements of ideal portion size for 6 different foods using a validated online tool that allowed participants to adjust the portion size of images of foods. Ideal portion size has been identified as a strong predictor of actual consumption. Participants were also asked to report the number of substances used in the past and provide anthropometric information. The results confirmed that breadth of drug use was associated with selection of higher portion size. Reward responsiveness was not a moderator of this relationship. Of the tested mediators, only impulsivity mediated the association between breadth of drug use and portion size. The results show that impulsivity may underlie the association between eating and substance use.

Exploring the moderating roles of dispositional mindfulness and body image flexibility in the association between body dissatisfaction and disordered eating in Chinese adolescents

OBJECTIVES

Previous research suggests potential moderating roles of dispositional mindfulness and body image flexibility in the association between body dissatisfaction and disordered eating. However, relevant research is mainly conducted on adult women from Western countries, and limited evidence exists for adolescent samples, especially from non-Western contexts (e.g., China). Thus, this study aimed to examine the moderating roles of dispositional mindfulness and body image flexibility in the relationship between body dissatisfaction and disordered eating in Chinese adolescents.

METHOD

We recruited 545 Chinese adolescents (53.9% boys, aged 12-16 years) who completed measures of body dissatisfaction, dispositional mindfulness, body image flexibility, and disordered eating. Moderation analyses were examined with PROCESS macro on SPSS.

RESULTS

In separate models, both higher dispositional mindfulness and body image flexibility weakened relationships between body dissatisfaction and disordered eating. However, when both dispositional mindfulness and body image flexibility were entered into the same moderation model, only body image flexibility showed a significant moderating effect.

DISCUSSION

Both dispositional mindfulness and body image flexibility may weaken the association between body dissatisfaction and disordered eating in adolescents. However, body image flexibility might have a stronger effect than dispositional mindfulness. These findings suggest that interventions aimed at reducing body dissatisfaction to prevent disordered eating in adolescents may pay more attention to adolescents' body image flexibility.

Executive function, perceived stress and eating behaviours among Chinese young adults

Young adults in a transitional period may experience more stress and, hence, suffer from an increased risk of unhealthy eating. Executive function (EF) involves not only inhibitory control and mental flexibility (the 'cool' facet) to facilitate resistance to immediate temptations, but also affective decision making (the 'hot' facet) that helps to regulate emotional eating. The effects of different facets of EF and their interactions with perceived stress on eating behaviours remained underexplored. In this study, 594 young adults in their graduation year of post-secondary education were included. We used latent profile analysis to identify major patterns of eating behaviours and analysed their associations with perceived stress, and both the 'cool' and 'hot' facets of EF using multinominal logistic regression models. Latent profile analysis identified three clusters of eating patterns: non-approaching moderate eaters (N = 312, 52.5%), approaching eaters (N = 229, 38.6%), and approaching-and-avoidant eaters (N = 53, 8.9%). Logistic regression models found that the approaching-and-avoidant eating pattern was associated with higher perceived stress (OR = 3.16, p value = 0.007) and poorer affective decision-making (OR = 0.97, p value = 0.006). Stratified analysis further revealed that higher perceived stress was significantly associated with approaching-and-avoidant eating only among individuals with poorer affective decision-making. These findings suggest that individuals with poorer emotional regulation may face greater difficulties in regulating eating behaviours when experiencing higher stress. Interventions for people with a mixed pattern of approaching-and-avoidance eating should focus on providing support to regulate emotion-related eating.

Generalization of food devaluation following food-specific go/no-go training

The benefit of food-specific inhibition training on modulating food valuation and eating behaviors has been established, but generalization to untrained foods is seldomly examined. This study investigated whether stimulus variability and practice order, found to effect generalization in motor learning, can improve generalization following food-specific inhibition training. Ninety-three young adults practiced the Go/No-Go task online in three training conditions: 1) Constant (N = 30): inhibition practiced on one food stimulus; 2) Variable-Blocked (N = 32): inhibition practiced on 6 food stimuli, each in a separate block; and 3) Variable-Random (N = 31): inhibition practiced on 6 food stimuli in random order. Consistent with our hypothesis, the Variable-Random group showed better generalization of inhibition to untrained foods than the Constant and the Variable-Blocked groups immediately after training, demonstrating the benefit of stimulus variability and random practice order. This effect was not present 24 h after training. The Variable-Random group also showed decreased desire to eat untrained foods, exhibiting generalization of food devaluation. However, this effect was only present 24 h after training. The Constant group showed increased desire to eat untrained foods immediately and 24 h after training. The Variable-Blocked group did not differ from either group in the desire to eat to untrained foods, suggesting that random order is important for exposing the benefit of variability. The findings illustrate that presenting various training items in random order can improve generalization of food-specific inhibition training. However, inconsistencies found in the timing of generalization effects and modest effect sizes warrant additional investigation into generalization principles of food-specific inhibition training.

Comprehensive elucidation of resting-state functional connectivity in anorexia nervosa by a multicenter cross-sectional study

BACKGROUND

Previous research on the changes in resting-state functional connectivity (rsFC) in anorexia nervosa (AN) has been limited by an insufficient sample size, which reduced the reliability of the results and made it difficult to set the whole brain as regions of interest (ROIs).

METHODS

We analyzed functional magnetic resonance imaging data from 114 female AN patients and 135 healthy controls (HC) and obtained self-reported psychological scales, including eating disorder examination questionnaire 6.0. One hundred sixty-four cortical, subcortical, cerebellar, and network parcellation regions were considered as ROIs. We calculated the ROI-to-ROI rsFCs and performed group comparisons.

RESULTS

Compared to HC, AN patients showed 12 stronger rsFCs mainly in regions containing dorsolateral prefrontal cortex (DLPFC), and 33 weaker rsFCs primarily in regions containing cerebellum, within temporal lobe, between posterior fusiform cortex and lateral part of visual network, and between anterior cingulate cortex (ACC) and thalamus (p < 0.01, false discovery rate [FDR] correction). Comparisons between AN subtypes showed that there were stronger rsFCs between right lingual gyrus and right supracalcarine cortex and between left temporal occipital fusiform cortex and medial part of visual network in the restricting type compared to the binge/purging type (p < 0.01, FDR correction).

CONCLUSION

Stronger rsFCs in regions containing mainly DLPFC, and weaker rsFCs in regions containing primarily cerebellum, within temporal lobe, between posterior fusiform cortex and lateral part of visual network, and between ACC and thalamus, may represent categorical diagnostic markers discriminating AN patients from HC.

Emotional eating, internet overuse, and alcohol intake among college students: a pilot study with virtual reality

Introduction

The term emotional eating (EE) describes the tendency to eat as an automatic response to negative emotions and has been linked to anxiety and depression, common symptoms among the university population. The EE tendencies have also been associated with excessive internet use and an increase in alcohol intake among young university students.

Methods

The aim of this study is to examine the relationship between the tendency towards EE and other health-compromising behaviors, such as excessive internet use or high alcohol intake. Additionally, it aims to investigate the association of these risky behaviors with the participants' performance level in a virtual reality (VR) task that assesses their executive functioning, and to assess impulsivity and levels of anxiety and depression.

Results

The results associate EE with excessive internet (r = 0.332; p < 0.01). use but not with alcohol consumption. Alcohol consumption was not associated with anxiety, depression, or impulsivity, but it was related to altered executive functions in the VR task: flexibility and working memory explained 24.5% of the variance. By contrast, EE and internet overuse were not related to executive function but were associated with impulsivity, depression, and anxiety. Impulsivity and depressive symptoms accounted for 45% of the variance in EE. Depression, trait anxiety and impulsivity explained 40.6% of the variance in internet overuse.

Discussion

The results reveal distinct patterns of psychological and neuropsychological alterations associated with alcohol consumption compared to emotional eating (EE) and excessive internet use. These findings underscore significant differences in the contributing factors between addictions and other substance-free addictive behaviors. For a deeper understanding of the various contributing factors to EE in college students, further research is recommended.

Exploratory insights into prefrontal cortex activity in continuous glucose monitoring: findings from a portable wearable functional near-infrared spectroscopy system

The escalating global prevalence of diabetes highlights an urgent need for advancements in continuous glucose monitoring (CGM) technologies that are non-invasive, accurate, and user-friendly. Here, we introduce a groundbreaking portable wearable functional near-infrared spectroscopy (fNIRS) system designed to monitor glucose levels by assessing prefrontal cortex (PFC) activity. Our study delineates the development and application of this novel fNIRS system, emphasizing its potential to revolutionize diabetes management by providing a non-invasive, real-time monitoring solution. Fifteen healthy university students participated in a controlled study, where we monitored their PFC activity and blood glucose levels under fasting and glucose-loaded conditions. Our findings reveal a significant correlation between PFC activity, as measured by our fNIRS system, and blood glucose levels, suggesting the feasibility of fNIRS technology for CGM. The portable nature of our system overcomes the mobility limitations of traditional setups, enabling continuous, real-time monitoring in everyday settings. We identified 10 critical features related to blood glucose levels from extensive fNIRS data and successfully correlated PFC function with blood glucose levels by constructing predictive models. Results show a positive association between fNIRS data and blood glucose levels, with the PFC exhibiting a clear response to blood glucose. Furthermore, the improved regressive rule principal component analysis (PCA) method outperforms traditional PCA in model prediction. We propose a model validation approach based on leave-one-out cross-validation, demonstrating the unique advantages of K-nearest neighbor (KNN) models. Comparative analysis with existing CGM methods reveals that our paper's KNN model exhibits lower RMSE and MARD at 0.11 and 8.96%, respectively, and the fNIRS data were highly significant positive correlation with actual blood glucose levels (r = 0.995, p < 0.000). This study provides valuable insights into the relationship between metabolic states and brain activity, laying the foundation for innovative CGM solutions. Our portable wearable fNIRS system represents a significant advancement in effective diabetes management, offering a promising alternative to current technologies and paving the way for future advancements in health monitoring and personalized medicine.

The Influence of Social Dynamics on Biological Aging and the Health of Historically Marginalized Populations: A Biopsychosocial Model for Health Disparities

Historically marginalized populations are susceptible to social isolation resulting from their unique social dynamics; thus, they incur a higher risk of developing chronic diseases across the course of life. Research has suggested that the cumulative effect of aging trajectories per se, across the lifespan, determines later-in-life disease risks. Emerging evidence has shown the biopsychosocial effects of social stress and social support on one's wellbeing in terms of inflammation. Built upon previous multidisciplinary findings, here, we provide an overarching model that explains how the social dynamics of marginalized populations shape their rate of biological aging through the inflammatory process. Under the framework of social stress and social support theories, this model aims to facilitate our understanding of the biopsychosocial impacts of social dynamics on the wellbeing of historically marginalized individuals, with a special emphasis on biological aging. We leverage this model to advance our mechanistic understanding of the health disparity observed in historically marginalized populations and inform future remediation strategies.

Which aspects of education are health protective? a life course examination of early education and adulthood cardiometabolic health in the 30-year study of early child care and Youth Development (SECCYD)

BACKGROUND

Past research describes robust associations between education and health, yet findings have generally been limited to the examination of education as the number of years of education or educational attainment. Little is known about the specific features or processes underpinning education that are health protective. The objective of the current study was to address this gap by examining specific aspects of early education pertaining to student characteristics and experiences, as well as features of the classroom environment, in predicting cardiometabolic health in adulthood.

METHODS

Subjects were 1364 participants in the NICHD Study of Early Child Care and Youth Development (SECCYD, 1991-2009) and recent SECCYD 30-year follow-up, the Study of Health in Early and Adult Life (SHINE, 2018-2022). Models examined individual education indicators (student social skills, student-teacher relationship quality, and classroom emotional and instructional quality in the period of elementary school and student academic performance between ages 54 months and 15 years) in relation to a composite of cardiometabolic risk in adulthood (ages 26-31), reflecting central adiposity, blood pressure, insulin resistance, inflammation, and dyslipidemia. Models were adjusted for key explanatory factors including socio-demographics, infant characteristics, parental socioeconomic status (SES), and child health status. Follow-up analyses were performed to test potential mediators of early education effects on adult health, including adult SES (educational attainment, household income) and health behaviors (diet quality, activity level, sleep duration, smoking).

RESULTS

In adjusted models, results showed greater student social skills, indexed by a mean of annual teacher ratings between kindergarten and 6th grade, predicted lower cardiometabolic risk in adulthood (β=-0.009, p <.05). In follow-up analyses, results showed the protective effect of student social skills on cardiometabolic risk may be mediated by adult income (β=-0.0014, p <.05) and diet quality (β=-0.0031, p <.05). Effects of the other early education indicators were non-significant (ps > 0.05).

CONCLUSIONS

Findings point to the potential significance of early student social competence as a link to long-term health, possibly via the acquisition of resources needed for the maintenance of health, as well as through engagement in health behaviors supporting healthy eating. However, more research is needed to replicate these findings and to elaborate on the role of early student social competence and the pathways explaining its effects on cardiometabolic health in adulthood.

Tunneling, cognitive load and time orientation and their relations with dietary behavior of people experiencing financial scarcity - an AI-assisted scoping review elaborating on scarcity theory

BACKGROUND

The concept of a financial scarcity mindset has raised much attention as an explanation for poor decision-making and dysfunctional behavior. It has been suggested that financial scarcity could also impair dietary behavior, through a decline in self-control. Underlying cognitive mechanisms of tunneling (directing attention to financial issues and neglecting other demands), cognitive load (a tax on mental bandwidth interfering with executive functioning) and time orientation (a shift towards a present time horizon, versus a future time horizon) may explain the association between financial scarcity and self-control related dietary behavior. The current scoping review gathers recent evidence on how these mechanisms affect dietary behavior of people experiencing financial scarcity. It builds on a theoretical framework based on insights from behavioral economics and health psychology.

METHODS

A literature search was executed in six online databases, which resulted in 9.975 papers. Search terms were tunneling, cognitive load and time orientation, financial scarcity, and dietary behavior. Screening was performed with ASReview, an AI-ranking tool. In total, 14 papers were included in the scoping review. We used PRISMA-ScR guidelines for reporting.

RESULTS

Limited evidence indicates that a scarcity mindset could increase tunneling, through attentional narrowing on costs of food, which then directly impacts dietary behavior. A scarcity mindset involves experiencing financial stress, which can be understood as cognitive load. Cognitive load decreases attentional capacity, which could impair self-control in dietary choices. Financial scarcity is related to a present time orientation, which affects dietary choices by shifting priorities and decreasing motivation for healthy dietary behavior.

CONCLUSIONS

A scarcity mindset affects dietary behavior in different ways. Tunneling and a shift in time orientation are indicative of an attentional redirection, which can be seen as more adaptive to the situation. These may be processes indirectly affecting self-control capacity. Cognitive load could decrease self-control capacity needed for healthy dietary behavior because it consumes mental bandwidth. How a changing time orientation when experiencing financial scarcity relates to motivation for self-control in dietary behavior is a promising theme for further inquiry.

The effect of cognitive reappraisal on food craving and consumption: Does working memory capacity influence reappraisal ability? An event-related potential study

Regulating cravings for unhealthy foods in favour of healthier options is essential for weight management. Cognitive reappraisal, which involves changing the meaning of a stimulus to modify its emotional impact, has shown promise for regulating food craving and consumption. Eighty participants were presented with high-calorie (HC) and low-calorie (LC) food pictures preceded by cues signalling instructions to naturally view the food (i.e., passive viewing; LOOK) or to imagine the future consequences of consuming that food (i.e., cognitive reappraisal; REGULATE). Participants' subjective craving and event-related potentials (ERPs) were measured, and food consumption after the task was assessed. Participants' working memory capacity (WMC) was measured with the automated Operation Span task. During cognitive reappraisal, cravings for HC foods decreased, whereas cravings for LC foods increased, compared to passive viewing. Cravings for LC and HC foods were correlated with consumptions of LC and HC foods, respectively. Occipital N1 (100-200ms) amplitudes were more negative for LC than for HC pictures, but were not modulated by strategy (LOOK or REGULATE), whereas early posterior negativity (EPN; 200-300ms) was not sensitive to food type (HC or LC) or strategy. Late positive potential (LPP; 400-1000ms) ERPs were largest in the HC-REGULATE condition, possibly due to cognitive processes induced by focusing on the consequences of unhealthy foods. Late LPP (1000-3000ms) was not affected by food type or strategy. LPP amplitudes were not correlated with cravings. WMC was weakly correlated with cravings for LC following reappraisal, suggesting that WMC may influence reappraisal ability. In sum, focusing on future consequences of eating may promote healthier food choices through craving regulation. Further research is needed to examine how regulatory effects evolve over time and how they relate to WMC and brain activity.

A new perspective for evaluating the efficacy of tACS and tDCS in improving executive functions: A combined tES and fNIRS study

BACKGROUND

Executive function enhancement is considered necessary for improving the quality of life of patients with neurological or psychiatric disorders, such as attention-deficit/hyperactivity disorder, obsessive-compulsive disorder and Alzheimer's disease. Transcranial electrical stimulation (tES) has been shown to have some beneficial effects on executive functioning, but the quantification of these improvements remains controversial. We aimed to explore the potential beneficial effects on executive functioning induced by the use of transcranial alternating current stimulation (tACS)/transcranial direct current stimulation (tDCS) on the right inferior frontal gyrus (IFG) and the accompanying brain function variations in the resting state.

METHODS

We recruited 229 healthy adults to participate in Experiments 1 (105 participants) and 2 (124 participants). The participants in each experiment were randomly divided into tACS, tDCS, and sham groups. The participants completed cognitive tasks to assess behavior related to three core components of executive functions. Functional near-infrared spectroscopy (fNIRS) was used to monitor the hemodynamic changes in crucial cortical regions in the resting state.

RESULTS

Inhibition and cognitive flexibility (excluding working memory) were significantly increased after tACS/tDCS, but there were no significant behavioral differences between the tACS and tDCS groups. fNIRS revealed that tDCS induced decreases in the functional connectivity (increased neural efficiency) of the relevant cortices.

CONCLUSIONS

Enhancement of executive function was observed after tES, and the beneficial effects of tACS/tDCS may need to be precisely evaluated via brain imaging indicators at rest. tDCS revealed better neural benefits than tACS during the stimulation phase. These findings might provide new insights for selecting intervention methods in future studies and for evaluating the clinical efficacy of tES.

State-level working memory and dysregulated eating in children and adolescents: An exploratory ecological momentary assessment study

BACKGROUND

Children with loss of control (LOC) eating and overweight/obesity have relative deficiencies in trait-level working memory (WM), which may limit adaptive responding to intra- and extra-personal cues related to eating. Understanding of how WM performance relates to eating behavior in real-time is currently limited.

METHODS

We studied 32 youth (ages 10-17 years) with LOC eating and overweight/obesity (LOC-OW; n = 9), overweight/obesity only (OW; n = 16), and non-overweight status (NW; n = 7). Youth completed spatial and numerical WM tasks requiring varying degrees of cognitive effort and reported on their eating behavior daily for 14 days via smartphone-based ecological momentary assessment. Linear mixed effects models estimated group-level differences in WM performance, as well as associations between contemporaneously completed measures of WM and dysregulated eating.

RESULTS

LOC-OW were less accurate on numerical WM tasks compared to OW and NW (ps < .01); groups did not differ on spatial task accuracy (p = .41). Adjusting for between-subject effects (reflecting differences between individuals in their mean WM performance and its association with eating behavior), within-subject effects (reflecting variations in moment-to-moment associations) revealed that more accurate responding on the less demanding numerical WM task, compared to one's own average, was associated with greater overeating severity across the full sample (p = .013). There were no associations between WM performance and LOC eating severity (ps > .05).

CONCLUSIONS

Youth with LOC eating and overweight/obesity demonstrated difficulties mentally retaining and manipulating numerical information in daily life, replicating prior laboratory-based research. Overeating may be related to improved WM, regardless of LOC status, but temporality and causality should be further explored.

PUBLIC SIGNIFICANCE STATEMENT

Our findings suggest that youth with loss of control eating and overweight/obesity may experience difficulties mentally retaining and manipulating numerical information in daily life relative to their peers with overweight/obesity and normal-weight status, which may contribute to the maintenance of dysregulated eating and/or elevated body weight. However, it is unclear whether these individual differences are related to eating behavior on a moment-to-moment basis.

Higher visceral adipose tissue is associated with decreased memory suppression ability on food-related thoughts: A 1-year prospective ERP study

Memory about food and eating is crucial in regulating appetite and eating behaviors. Successfully stopping vivid imagination of delicious food could help reduce food craving and thus reduce the possibility of further intake. Memory inhibition is a cognitive process that involves intentional suppression of certain memories coming to consciousness. Successful memory suppression derives from inhibitory control. Although considerable work has consistently observed the impairment in motor or response inhibitory control among individuals with obesity, there has been a lack of investigation into the influence of bodyweight status on memory inhibitory control. To fill this gap, current study investigated behavioral and neurophysiological correlates of memory suppression in young women. Using Think/No-Think task and event-related potentials among 47 females, we found that participants with higher visceral adipose tissue (VAT) showed a tendency towards decreased suppression ability for memories related to food but not memories related to nonfood items. In depth analysis showed that decrease in the differences in P2 amplitudes between suppression vs. retrieval of food-related memories mediated the impairment of suppression ability by high VAT. We then tested whether individual differences in memory suppression ability as well as ERP correlates predicted future BMI or VAT change over 1-year follow-up. Results showed that P2 amplitudes when retrieving food-related memory could predict VAT change at 1-year follow-up among participants with healthy BMI. These observations suggest a hypersensitivity inference hypothesis underlying memory control impairments. To be specific, deficits in memory suppression may be in part resulted from elevated sensitivity to the cues coupling with food-related memory. It extends previous studies of memory suppression with food rewards and provides the first evidence to help understand the relationship between inhibitory control on food-related memory and obesity.

Challenges and opportunities for conceptualizing intuitive eating in autistic people

Although intuitive eating (IE) has become an increasingly adopted intervention target, current conceptualisations of IE have yet to pivot away from (neuro)normative physiology and phenomenology. Autistic individuals commonly report disordered eating behaviours and/or poorer well-being but appear to benefit from adaptive interventions using an affirmative approach. This article uses autism as a case example to summarise challenges related to IE's prevailing conceptualisation, before proposing how future research and current practice can be extended to the autistic population. Scholars are encouraged to evaluate the full 10-principal IE framework while utilising a participatory-led approach. We argue that research using a mixed methods design is urgently needed to comprehensively explore the (re)conceptualisation of IE in autistic people. While IE shows promise for producing positive outcomes in the autistic population, we discuss the potential challenges for research and practice due to its current emphasis on accurate interoception, emotional awareness and processing, and executive functioning. This suggests the need for research and practice to integrate autistic needs and experiences into future developments with an affirmative approach. Public Significance: IE is an effective intervention for reducing disordered eating behaviours. Autistic individuals commonly present disordered eating behaviours and have unique nutritional needs which often require intervention. However, there is limited understanding of IE among the autistic population. Research-informed definitions involving autistic perspectives will support translating the IE framework to this underrepresented population.

Children at high familial risk for obesity show executive functioning deficits prior to development of excess weight status

OBJECTIVE

The objective of this study was to determine whether children with healthy weight who vary by familial risk for obesity differ in executive functioning.

METHODS

Children (age 7-8 years) without obesity (n = 93, 52% male) who differed by familial risk for obesity (based on maternal weight status) completed go/no-go and stop-signal tasks to assess inhibitory control and an N-back task to assess working memory. Dual energy x-ray absorptiometry measured adiposity. Linear and mixed-effect models assessed unique effects and relative importance analysis-quantified relative effects of familial risk and percent body fat.

RESULTS

Children at high compared with low familial risk showed worse inhibitory control; however, child adiposity was not associated with inhibitory control. Both high familial risk and greater child adiposity were associated with worse N-back performance when cognitive demand was high (2-back), but not low (0- and 1-back). The relative effect of familial risk on executive functioning was 2.7 to 16 times greater than the relative effect of percent body fat.

CONCLUSIONS

These findings provide initial evidence that deficits in executive functioning may precede the development of obesity in children at high familial risk for this disease. Additional family risk studies are needed to elucidate the pathways through which maternal obesity influences child executive functioning and risk for obesity.

Does inhibitory control spill over to eating behaviors? Two preregistered studies of inhibitory spillover effects on food intake and reactions to food stimuli

Overweight and obesity are worldwide conditions associated with detrimental medical and psychosocial outcomes. As inhibitory control deficits are thought to contribute to weight gain, they are a worthwhile target for new approaches. Previous research has shown that the execution of inhibitory control in one domain leads to a concurrent increase of inhibitory control in another domain, an effect denoted as inhibitory spillover effect (ISE). Therefore, we assumed that exertion of inhibitory control in a food-unrelated domain in overweight and normal weight individuals will decrease food intake in a simultaneous bogus taste test (BTT; study 1) as well as increase food-specific response inhibition ability in a stop signal task (SST; study 2). We assumed stronger effects in overweight individuals. In both studies ISE was induced via cognitive priming and compared to a neutral condition in a group of overweight (OW: n = 46 for study 1, n = 46 for study 2) and normal weight (NW: n = 46 for study 1, n = 46 for study 2) individuals. In the ISE condition with an inhibitory control priming task, participants had to learn and retain control-related words while simultaneously performing a BTT (study 1) or SST (study 2). In the neutral condition, participants followed the same protocol, albeit memorizing neutral (i.e., control-unrelated) words. There was no significant interaction of weight group × cognitive priming condition neither regarding food intake (study 1) nor regarding food-related response inhibition (study 2). Cognitive priming, as implemented in the present studies, does not instigate an ISE strong enough to improve inhibitory control during food intake or food-related response inhibition. Relevant practical and theoretical aspects as well as implications for future research on the ISE are discussed.

Engineering Virtuous health habits using Emotion and Neurocognition: Flexibility for Lifestyle Optimization and Weight management (EVEN FLOW)

Interventions to preserve functional independence in older adults are critically needed to optimize 'successful aging' among the large and increasing population of older adults in the United States. For most aging adults, the management of chronic diseases is the most common and impactful risk factor for loss of functional independence. Chronic disease management inherently involves the learning and adaptation of new behaviors, such as adopting or modifying physical activity habits and managing weight. Despite the importance of chronic disease management in older adults, vanishingly few individuals optimally manage their health behavior in the service of chronic disease stabilization to preserve functional independence. Contemporary conceptual models of chronic disease management and health habit theory suggest that this lack of optimal management may result from an underappreciated distinction within the health behavior literature: the behavioral domains critical for initiation of new behaviors (Initiation Phase) are largely distinct from those that facilitate their maintenance (Maintenance Phase). Psychological factors, particularly experiential acceptance and trait levels of openness are critical to engagement with new health behaviors, willingness to make difficult lifestyle changes, and the ability to tolerate aversive affective responses in the process. Cognitive factors, particularly executive function, are critical to learning new skills, using them effectively across different areas of life and contextual demands, and updating of skills to facilitate behavioral maintenance. Emerging data therefore suggests that individuals with greater executive function are better able to sustain behavior changes, which in turn protects against cognitive decline. In addition, social and structural supports of behavior change serve a critical buffering role across phases of behavior change. The present review attempts to address these gaps by proposing a novel biobehavioral intervention framework that incorporates both individual-level and social support system-level variables for the purpose of treatment tailoring. Our intervention framework triangulates on the central importance of self-regulatory functioning, proposing that both cognitive and psychological mechanisms ultimately influence an individuals' ability to engage in different aspects of self-management (individual level) in the service of maintaining independence. Importantly, the proposed linkages of cognitive and affective functioning align with emerging individual difference frameworks, suggesting that lower levels of cognitive and/or psychological flexibility represent an intermediate phenotype of risk. Individuals exhibiting self-regulatory lapses either due to the inability to regulate their emotional responses or due to the presence of executive functioning impairments are therefore the most likely to require assistance to preserve functional independence. In addition, these vulnerabilities will be more easily observable for individuals requiring greater complexity of self-management behavioral demands (e.g. complexity of medication regimen) and/or with lesser social support. Our proposed framework also intuits several distinct intervention pathways based on the profile of self-regulatory behaviors: we propose that individuals with intact affect regulation and impaired executive function will preferentially respond to 'top-down' training approaches (e.g., strategy and process work). Individuals with intact executive function and impaired affect regulation will respond to 'bottom-up' approaches (e.g., graded exposure). And individuals with impairments in both may require treatments targeting caregiving or structural supports, particularly in the context of elevated behavioral demands.

Back to the future: Progressing memory research in eating disorders

OBJECTIVE

Human behaviors, thoughts, and emotions are guided by memories of the past. Thus, there can be little doubt that memory plays a fundamental role in the behaviors (e.g., binging), thoughts (e.g., body-image concerns), and emotions (e.g., guilt) that characterize eating disorders (EDs). Although a growing body of research has begun to investigate the role of memory in EDs, this literature is limited in numerous ways and has yet to be integrated into an overarching framework.

METHODS

In the present article, we provide an operational framework for characterizing different domains of memory, briefly review existing ED memory research within this framework, and highlight crucial gaps in the literature.

RESULTS

We distinguish between three domains of memory-episodic, procedural, and working-which differ based on functional attributes and underlying neural systems. Most recent ED memory research has focused on procedural memory broadly defined (e.g., reinforcement learning), and findings within all three memory domains are highly mixed. Further, few studies have attempted to assess these different domains simultaneously, though most behavior is achieved through coordination and competition between memory systems. We, therefore, offer recommendations for how to move ED research forward within each domain of memory and how to study the interactions between memory systems, using illustrative examples from other areas of basic and clinical research.

DISCUSSION

A stronger and more integrated understanding of the mechanisms that connect memory of past experiences to present ED behavior may yield more comprehensive theoretical models of EDs that guide novel treatment approaches.

PUBLIC SIGNIFICANCE

Memories of previous eating-related experiences may contribute to the onset and maintenance of eating disorders (EDs). However, research on the role of memory in EDs is limited, and distinct domains of ED memory research are rarely connected. We, therefore, offer a framework for organizing, progressing, and integrating ED memory research, to provide a better foundation for improving ED treatment and intervention going forward.

Applying psycho-behavioural phenotyping in obesity characterization

Individual differences in obesity, beyond being explained by metabolic and medical complications, are understood by alterations in eating behaviour which underlie psychological processes. From this psychological perspective, studies have identified several potential characteristic features at the psycho-behavioural level that could additionally explain the maintenance of chronic excess weight or the unsuccessful results of current treatments. To date, despite the growing evidence, the heterogeneity of the psychological evidence associated with obesity has made it challenging to generate consensus on whether these psycho-behavioural phenotypes can be a complement to improve outcomes of existing interventions. For this reason, this narrative review is an overview focused on summarizing studies describing the psycho-behavioural phenotypes associated with obesity. Based on the literature, three psychological constructs have emerged: reward dependence, cognitive control, and mood and emotion. We discuss the clinical implications of stratifying and identifying these psycho-behavioural profiles as potential target for interventions which may ensure a better response to treatment in individuals with obesity. Our conclusions pointed out a considerable overlap between these psycho-behavioural phenotypes suggesting bidirectional interactions between them. These findings endorse the complexity of the psycho-behavioural features associated with obesity and reinforce the need to consider them in order to improve treatment outcomes.

Role of Cognitive Control in Psychotherapy: An Integrated Review

Background

Cognitive control (CC), including shifting, updating, and inhibiting functions, may play an integral role in various aspects of psychotherapy; however, research on this is limited. This review aims to link the disparate lines of evidence on CC as they relate to psychotherapy processes, techniques, and outcomes.

Methods

A systematic search of the literature on neuropsychological domains relating to psychotherapy in adults with anxiety/depression yielded 18 eligible studies. The review also uses a narrative format to explore other potential links between CC and psychotherapy that are underinvestigated, and highlights the need for research and application to evidence-based practice of psychotherapy.

Results and conclusions

Findings suggest that CC may predict psychotherapy outcomes and also improve as a function of psychotherapy. Analog sample studies suggest a possible link between CC and techniques for regulation of cognition and emotion, such as reappraisal, mindfulness, and cognitive restructuring. CC may also play an integral role in the regulation of behavior. Study of CC in the context of psychotherapy may potentially explain individual differences in psychotherapy outcomes and mechanisms of action of various psychotherapy techniques and processes. Such an understanding may have possible implications for "best fit" matching clients to therapies and modifying psychological interventions to account for poorer CC abilities. CC may be enhanced through training and further research is warranted on the impact of such training in facilitating better long-term psychotherapy outcomes.

Cool executive functions and their association with body mass & fatness and the FTO gene in school-aged children

The FTO gene rs9936909 polymorphism is one of the well-documented single nucleotide polymorphisms in the context of increased risk of obesity, including in children. Few studies have tested the association of the FTO gene with cognitive functions. Deficits of "cool" executive functions (EFs) are considered a potential risk factor for excessive weight. The aims of our study were to investigate whether cool EFs are associated with the Body Mass Index, the Fat Mass Index and the risk of excess body mass and overfatness in neurotypically school-aged children, and whether the FTO gene polymorphism is involved in development of this possible association. The sample consisted of 553 children aged 6-12 years old. A body composition analysis, a neuropsychological assessment of EFs, and FTO polymorphism genotyping were performed in the children studied. The study found a significant association of an interference effect in theStroop Color-Word Interference Task and the risk of excessive body fatness, but not excessive body mass. There were no explicit associations between the FTO genotype and EFs deficits. Environmental factors, and particularly low maternal education, appeared to be the strongest contributors to the increased risk of obesity.

Children with lower ratings of executive functions have a greater response to the portion size effect

Deficits in executive functions (EFs), a set of cognitive processes related to self-regulation, are associated with the development of obesity. Prior studies from our group showed that lower food-cue related activation in brain regions implicated in self-regulation was related to a larger portion size effect. We tested the hypothesis that lower EFs in children would be positively related to the portion size effect. Healthy weight children aged 7-8 y (n = 88), who varied by maternal obesity status, participated in a prospective study. At baseline, the parent primarily in charge of feeding completed the Behavior Rating Inventory of Executive Function (BRIEF2) to assess child EFs, including Behavioral (BRI), Emotional (ERI), and Cognitive (CRI) indices. At 4 baseline sessions, children consumed meals in which the portion sizes of foods (pasta, chicken nuggets, broccoli, and grapes) varied by visit (total meal weight of 769, 1011, 1256, or 1492g). Intake increased with increasing portions in a linear trajectory (p < 0.001). EFs moderated the portion size effect such that lower BRI (p = 0.003) and ERI (p = 0.006) were associated with steeper increases in intake as portions increased. As amount of food increased, children in the lowest functioning tertiles for BRI and ERI increased intake by 35% and 36%, respectively, compared to children in the higher tertiles. Increases in intake among children with lower EFs were for higher- but not lower-energy-dense foods. Thus, in healthy weight children who varied by obesity risk, lower parentally reported EFs were associated with a larger portion size effect, and these results were independent of child and parent weight status. Therefore, EFs may be target behaviors that could be strengthened to help children moderate excess intake in response to large portions of energy-dense foods.

Impulsivity and self-regulation: A dual-process model of risky driving in young drivers in Iran

The dual-process model of risky driving (Lazuras, Rowe, Poulter, Powell, & Ypsilanti, 2019) suggested that regulatory processes mediate the effect of impulsivity on risky driving. The current study aimed to examine the cross-cultural generalisability of this model to Iranian drivers, who are from a country with a markedly higher rate of traffic collisions. We sampled 458 Iranian drivers aged 18 to 25 using an online survey measuring impulsive processes including impulsivity, normlessness and sensation-seeking, and regulatory processes comprising emotion-regulation, trait self-regulation, driving self-regulation, executive functions, reflective functioning and attitudes toward driving. In addition, we used the Driver Behaviour Questionnaire to measure driving violations and errors. Executive functions and driving self-regulation mediated the effect of attention impulsivity on driving errors. Executive functions, reflective functioning, and driving self-regulation mediated the relationship between motor impulsivity and driving errors. Finally, attitudes toward driving safety significantly mediated the relationship of both normlessness and sensation-seeking with driving violations. These results support the mediatory role of cognitive and self-regulatory capacities in the connection between impulsive processes and driving errors and violations. Overall, the present study confirmed the validity of the dual-process model of risky driving in a sample of young drivers in Iran. Implications for educating drivers and implementing policies and interventions based on this model are discussed.

Systematic Review of General Parenting Intervention Impacts on Child Weight as a Secondary Outcome

General parenting interventions have improved parent-child relationships and child behavior, with emerging evidence that they may also reduce prevalence of pediatric overweight/obesity. We conducted a systematic review on interventions that were designed to promote positive parenting and examined child weight post-hoc. We searched for studies published through January 2022 that promoted positive parenting among parents of children ages 0-18 years and reported effects on body weight as an ancillary outcome, with no intervention content focused on energy balance (e.g., feeding, physical activity). This search was carried out within ClinicalTrials.gov, ISRCTN Registry, PubMed, PsycINFO, Web of Science, and Connected Papers. Studies were imported into EndNote X9 and assessed independently by two investigators. In total, 753 clinical trials and 723 publications were assessed, and six publications met inclusion criteria. All cohorts were low-income and interventions targeted expectant mothers up through parents of adolescents. Follow-ups occurred when participants were between 2 and 25 years. Significant improvements in weight-related outcomes were observed across all studies for the intervention arm as a whole or for certain subgroups, and reasons underlying these gains tended to differ by participants' age. The magnitude of effect sizes ranged from medium to large. Interventions focused on general positive parenting are efficacious at lowering risk of overweight/obesity without focusing on physical health. Promoting attachments among infants, restructuring a toddler's home environment, praising preschoolers, and communicating with adolescents may optimize weight outcomes in parenting interventions adapted for obesity prevention.

Loss of Control over Eating, Inhibitory Control, and Reward Sensitivity in Children and Adolescents: A Systematic Review

OVERVIEW

In recent years, there has been increasing clinical and empirical interest in the concept of pediatric loss of control over eating, particularly about its link with the executive functions related to the concept of impulsivity, such as inhibitory control and reward sensitivity. However, there has yet to be a comprehensive literature synthesis about the associations between these variables. A comprehensive literature synthesis would help identify future research directions to advance the field in this area. Therefore, this systematic review aimed to synthesize evidence concerning the associations between loss of control over eating, inhibitory control, and reward sensitivity in children and adolescents.

METHODS

The systematic review was conducted according to the guidelines proposed by PRISMA in Web of Science, Scopus, PubMed, and PsycINFO. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the risk of bias.

RESULTS

Twelve studies met the selection criteria and were included in the final review. Overall, methodological heterogeneity, variability in assessment methods, and the age of participants make it difficult to draw general conclusions. Nevertheless, most studies with community samples of adolescents indicate that inhibitory control difficulties are linked to the concept of loss of control eating. The presence of obesity seems to be associated with inhibitory control difficulties, regardless of the presence of loss of control eating. Studies on reward sensitivity are scarcer. However, it has been suggested that higher reward sensitivity is related to loss of control eating behaviors in young people, particularly binge eating.

CONCLUSIONS

The literature on the link between loss of control eating and trait-level facets of impulsivity (low inhibitory control and higher reward sensitivity) among young people remains limited, and more studies on children are needed. Findings from this review may make healthcare professionals more aware of the potential clinical importance of targeting the trait-level facets of impulsivity and help to inform existing and future weight-loss/maintenance interventions in childhood and adolescence.

Decision-making difficulties mediate the association between poor emotion regulation and eating disorder symptoms in adolescence

BACKGROUND

The emergence of eating problems during childhood increases the risk for eating disorders (EDs) during young adulthood. Previous studies highlight a relationship between poor self-regulation and onset of eating pathology. In this study, we investigated whether this association is mediated by decision-making difficulties.

METHODS

To test this hypothesis, we used data from the Millennium Cohort Study. Decision-making performance was assessed with the Cambridge Gambling Task at age 11. Principal components analysis was used to derive an index of ED symptoms at age 14. The trajectories of scores of two subscales of the Child Social Behaviour Questionnaire, Independence and Self-Regulation (ISR) and Emotional Dysregulation (EmotDy), were modelled from ages 3 to 7 years in a latent growth curve analysis. The individual predicted values of the intercept (set at baseline, 3 years) and the slope (rate of annual change) were then used in the mediation analysis.

RESULTS

In our sample of 11 303 individuals, there was evidence for mediation by three measures of decision-making at age 11 (poor quality of decision-making, delay aversion and low risk-adjustment) in the association between EmotDy across ages 3-7 and ED symptoms at age 14 even after the adjustment for relevant covariates. We found no evidence of association between ISR and ED symptoms.

CONCLUSION

Our findings suggest that emotion regulation processes during childhood may be relevant for the future onset of ED symptoms via their association with decision-making skills. These findings, obtained from a large, representative, sample, shed light on the relationship between self-regulation, decision-making and symptoms of EDs.

Motivational Interviewing in Pediatric Obesity: A Meta-analysis of the Effects on Behavioral Outcomes

BACKGROUND

Currently, the effects of motivational interviewing (MI) on children's behavioral changes remain obscure.

PURPOSE

This systematic review and meta-analysis examined the effects of MI on children's lifestyle behavioral changes (fruits and vegetables [F/V], dairy, sugary beverages, calories, snacks, fat intake, moderate vigorous physical activity [MVPA], and screen time).

METHODS

Six databases (CINAHL, Cochrane, Embase, PsycINFO, PubMed, and Web of Sciences) from 2005 to 2022 were searched. Thirty-one intervention studies with a comparison group met the criteria. Random-effects models were performed to estimate the pooled effects; exploratory moderation analyses with mixed-effects models were used to explore potential intervention moderators.

RESULTS

The pooled effect size was 0.10 (p = .334) on ↑F/V, 0.02 (p = .724) on ↑dairy, -0.29 (p < .001) on ↓calories, -0.16 (p = .054) on ↓sugary beverages, -0.22 (p = .002) on ↓snacks, -0.20 (p = .044) on ↓fat, 0.22 (p = .001) on ↑MVPA, and -0.06 (p = .176) on ↓screen time. The effects of MIs were moderated by ↑MI sessions regarding ↓snacks (B = -0.04, p = .010). Multicomponent and clinical programs had greater effects on dairy intake than their counterparts (0.09 vs. -0.21, p = .034; 0.12 vs. -0.14, p = .027, respectively). Similarly, interventions with a fidelity check resulted in greater dairy intake than those without a check (0.29 vs. -0.15, p = .014). A few long-term follow-up assessments revealed effects on ↓F/V (-0.18; p = .143, k = 2), ↓dairy (-0.13, p = .399, k = 4), ↓MVPA (-0.04; p = .611, k = 6), and ↑screen time (0.12; p = .242, k = 4).

CONCLUSIONS

Our findings support the short-term effects of MI on improving children's lifestyle behaviors. Additional investigations are needed to better sustain children's long-term behavioral changes.

Associations among body mass index, working memory performance, gray matter volume, and brain activation in healthy children

To investigate the neural mechanisms underlying the association between poorer working memory performance and higher body mass index (BMI) in children. We employed structural-(sMRI) and functional magnetic resonance imaging (fMRI) with a 2-back working memory task to examine brain abnormalities and their associations with BMI and working memory performance in 232 children with overweight/obesity (OW/OB) and 244 normal weight children (NW) from the Adolescent Brain Cognitive Development dataset. OW/OB had lower working memory accuracy, which was associated with higher BMI. They showed smaller gray matter (GM) volumes in the left superior frontal gyrus (SFG_L), dorsal anterior cingulate cortex, medial orbital frontal cortex, and medial superior frontal gyrus, which were associated with lower working memory accuracy. During the working memory task, OW/OB relative to NW showed weaker activation in the left superior temporal pole, amygdala, insula, and bilateral caudate. In addition, caudate activation mediated the relationship between higher BMI and lower working memory accuracy. Higher BMI is associated with smaller GM volumes and weaker brain activation in regions involved with working memory. Task-related caudate dysfunction may account for lower working memory accuracy in children with higher BMI.

Effects of neuromodulation on executive functions and food desires in individuals with obesity: a systematic review

Introduction

Objective: to describe the effects of neuromodulation on the performance of executive functions in overweight and/or individuals with obesity. Methods: articles published in PubMed, ScienceDirect, BIREME, and Web of Science databases were selected using the following combination of descriptors: ("problem solving" OR "executive function" OR memory) AND (tDCS OR TMS) AND obesity. After applying the selection criteria, 08 articles were included for analysis. Results: the articles included had an average of 30.1 participants per study, with a minimum of 12 and a maximum of 76. The overall nutritional status ranged from underweight to grade 3 obesity, and the general mean body mass index was 28,1 kg/m2. Regarding the instruments used to assess executive functions, the most frequent were: the flanker paradigm; binocular rivalry for Continuous Flash Suppression (bCFS/NoCFS); Stroop task; Go/No-Go task; and N-back task. The primary outcomes were dependent on the neuromodulation target site. Reduced food craving and improved performance in the active group were observed from decreased response time and increased precision in cognitive tasks. Conclusion: neuromodulation can generate changes in executive functions, reducing food cravings in overweight and individuals with obesity.

Do executive functions predict physical activity behavior? A meta-analysis

BACKGROUND

Executive functions (EFs) are important determinants of health behaviors. In the present study, a meta-analysis was conducted to investigate the relationship between EFs and physical activity (PA) behavior.

METHODS

Systematic searches were carried out in PsycInfo, MEDLINE, and SPORTDiscus databases throughout April 2021. Prospective empirical studies conducted with general healthy populations across the lifespan, which reported the relationship between baseline EFs and later PA behavior were selected.

RESULTS

Eight studies were found eligible. Results of the multilevel meta-analysis revealed a small but significant total effect size for EFs on PA behavior of z = 0.12. High heterogeneity was observed among studies. When potential moderators were tested, residual heterogeneity remained significant and the effects of the moderators were not significant. The effect size dropped when accounted for publication bias.

CONCLUSIONS

Despite limitations, the study provided evidence for EFs' determinant role on PA behavior. More research is however encouraged to inform PA promotion programs that are well-prepared for individual differences in EFs.

Potential mechanisms and modulators of food intake during pregnancy

Dietary choice during pregnancy is crucial not only for fetal development, but also for long-term health outcomes of both mother and child. During pregnancy, dramatic changes in endocrine, cognitive, and reward systems have been shown to take place. Interestingly, in different contexts, many of these mechanisms play a key role in guiding food intake. Here, we review how food intake may be impacted as a function of pregnancy-induced changes across species. We first summarize changes in endocrine and metabolic signaling in the course of pregnancy. Then, we show how these may be related to cognitive function and reward processing in humans. Finally, we link these to potential drivers of change in eating behavior throughout the course of pregnancy.

Executive dysfunction in eating disorders: Relationship with clinical features

Eating disorders (ED) are severe mental disorders that may result in significant functional impairment and disability. Neuropsychological studies have consistently found impaired executive function (EF) among ED patients. EF is particularly involved in fundamental skills of daily living and in behavioral and emotional regulation. In this study, impairment of executive functioning is investigated in patients with eating disorders and the associations with clinical features and clinical subtypes are analyzed.

METHOD

75 female patients (m = 22.01 years, sd = 9.15) with eating disorder (43 restrictive anorexia, 30 binge-eating anorexia and 13 bulimia nervosa) and 37 healthy controls (m = 18.54 years, sd = 4.21) were included in the study. An extensive assessment of executive function domains (verbal fluency, set shifting, attention span, selective attention, working memory, inhibitory control and processing speed) was carried out in both groups. Clinical scales for food intake restriction, binge-eating/purging, depression, anxiety and impulsivity were also administered and correlated with scores on executive function tests.

RESULTS

Patients with an ED had significantly lower scores than healthy controls in performance of several executive function tests, particularly in set shifting, interference control and processing speed (p < .01, in all three domains). Executive function impairment was related to anxious, depressive and eating disorder symptoms (p < .05), regardless of clinical subtype.

CONCLUSIONS

Executive function impairment in eating disorders is associated with greater ED symptomatic severity and might involve a negative treatment outcome. Therefore, cognitive remediation techniques should probably be considered in a number of severe patients with ED.

Neuroanatomical correlates of genetic risk for obesity in children

Obesity has a strong genetic component, with up to 20% of variance in body mass index (BMI) being accounted for by common polygenic variation. Most genetic polymorphisms associated with BMI are related to genes expressed in the central nervous system. At the same time, higher BMI is associated with neurocognitive changes. However, the direct link between genetics of obesity and neurobehavioral mechanisms related to weight gain is missing. Here, we use a large sample of participants (n > 4000) from the Adolescent Brain Cognitive Development cohort to investigate how genetic risk for obesity, expressed as polygenic risk score for BMI (BMI-PRS), is related to brain and behavioral measures in adolescents. In a series of analyses, we show that BMI-PRS is related to lower cortical volume and thickness in the frontal and temporal areas, relative to age-expected values. Relatedly, using structural equation modeling, we find that lower overall cortical volume is associated with higher impulsivity, which in turn is related to an increase in BMI 1 year later. In sum, our study shows that obesity might partially stem from genetic risk as expressed in brain changes in the frontal and temporal brain areas, and changes in impulsivity.

Loss of control as a transdiagnostic feature in obesity-related eating behaviours: A systematic review

OBJECTIVE

Emerging evidence suggests that loss of control (LOC) may present as a common feature across disordered eating behaviours. However, there has been limited research on the transdiagnostic nature of LOC in this area. The primary aim of this study was to systematically review disordered eating behaviours and measures of LOC in clinical and non-clinical populations.

METHOD

Electronic searches of the relevant databases were conducted. Selected articles were screened for eligibility and assessed for methodological quality.

RESULTS

Thirty-four studies met inclusion criteria. Findings demonstrated that LOC was associated with disordered eating behaviours across bariatric populations, eating disorder populations, and community populations. Specifically, LOC was associated with binge eating (subjective and objective episodes), grazing, night eating, and emotional or stress eating. Findings also revealed that LOC was inconsistently operationalised across studies, with varied approaches to measuring the construct.

CONCLUSION

Overall, the findings from this review provide support for LOC as a transdiagnostic feature of disordered eating behaviours. Future studies should utilise robust multi-method assessments to measure the severity of LOC, which may provide greater insight into how LOC manifests across different eating disorder presentations.

Characteristics of smartphone-based dietary assessment tools: a systematic review

Smartphones have become popular in assessing eating behaviour in real-life and real-time. This systematic review provides a comprehensive overview of smartphone-based dietary assessment tools, focusing on how dietary data is assessed and its completeness ensured. Seven databases from behavioural, social and computer science were searched in March 2020. All observational, experimental or intervention studies and study protocols using a smartphone-based assessment tool for dietary intake were included if they reported data collected by adults and were published in English. Out of 21,722 records initially screened, 117 publications using 129 tools were included. Five core assessment features were identified: photo-based assessment (48.8% of tools), assessed serving/ portion sizes (48.8%), free-text descriptions of food intake (42.6%), food databases (30.2%), and classification systems (27.9%). On average, a tool used two features. The majority of studies did not implement any features to improve completeness of the records. This review provides a comprehensive overview and framework of smartphone-based dietary assessment tools to help researchers identify suitable assessment tools for their studies. Future research needs to address the potential impact of specific dietary assessment methods on data quality and participants' willingness to record their behaviour to ultimately improve the quality of smartphone-based dietary assessment for health research.

Effect of food cues on time perception: influence of calories and diet control

The aim of this study was to investigate the influence on individuals' time perception of observing a range of foods differing in calorific content. In a first experiment, 92 adult participants performed a temporal bisection task with stimulus durations presented in the form of high- or low-calorie food pictures as well as matched non-food control pictures. In a second experiment, 102 participants performed a strict replication of Experiment 1, without the low-calorie pictures condition as it showed less pronounced effects. Across the two experiments, the data revealed common results. An overestimation of time was observed in relation to high-calorie food pictures when compared with non-food pictures (Experiment 2), and the effect was a function of participants' diet control (Experiments 1 & 2). Contrary to our hypothesis, the more the participants reported controlling their diet, the less they overestimated the time when presented with food stimuli. The participants who controlled their diet reported being less aroused by the high-calorie food pictures, allowing the assumption that the modulation in time overestimation relies on the arousal response generated by high-calorie food pictures.

Memory function performance in individuals classified as overweight, obese, and normal weight

Evidence accumulated to date about the relationship between cognitive impairments and adults who are overweight and obese suggests that excess weight has a great impact on memory function. Nevertheless, most of the literature has focused only on studying the influences on working memory and episodic memory. This study aimed to examine the potential associations of clinical and anthropometric measures [body mass index (BMI), WHR, body fat, visceral fat, muscle mass, and hypertension] with six memory domains, including contextual memory, short-term visual memory, short-term memory, non-verbal memory, short-term phonological memory, and working memory, in a sample of 124 individuals classified as overweight (n = 33), obese (n = 53), and normal weight (n = 38). The results obtained showed that, after controlling for employment situations, people classified as obese had poorer short-term phonological memory and working memory than those with normal weights. Bivariate correlations showed that measures of weight, BMI, waist-hip ratio index, body fat, and visceral fat were inversely associated with memory function. However, muscle mass was not a significant predictor of memory function. Higher systolic blood pressure was also associated with worse memory function. The study provides evidence of the importance of adiposity in health and memory function.

Disinhibited Eating and Executive Functioning in Children and Adolescents: A Systematic Review and Meta-Analysis

A growing body of research suggests disinhibited eating and weaker executive function (EF) are two risk factors for pediatric obesity. Emerging brain imaging and behavioral findings support the notion that EF skills impact eating regulation. However, a major gap in the current literature is a synthesis of the association between various EF skills and disinhibited eating patterns across child development. To address this gap, a systematic review and meta-analysis was conducted to examine the effect of EF skills on disinhibited eating behaviors among youth ages 3-18 years old. PubMed and PsychINFO databases were utilized and data from 15 studies with a total sample of 4909 youth were included. A random effects meta-analysis revealed a small negative effect of overall EF skills on disinhibited eating behavior, r = -0.14, p < 0.01. Analysis of individual EF skills found working memory had an overall medium negative effect on disinhibited eating behavior, r = -0.25, p < 0.05. Taken together, findings from this meta-analysis support an inverse relationship between EF abilities and disinhibited eating patterns in children and adolescents, such that poorer EF abilities are associated with higher levels of disinhibited eating. Given the effect on eating behavior, future research is needed to assess whether EF difficulties may be a barrier to effective weight management in youth. Specifically, research is needed to examine whether EF skills may be a key target to consider for effective obesity prevention and treatment in children and adolescents.

Association between executive function and excess weight in pre-school children

The association between executive function and excess weight is becoming increasingly evident. However, the results of previous studies are still inconclusive, and there is a lack of evidence in early childhood. This study aims to examine the association between executive function, in terms of overall and subscales of executive function (e.g., inhibition, working memory, and shifting), and weight excess in preschoolers. A population-based cross-sectional study was conducted on children aged 2–5 years of age from public and private schools in Chiang Mai, Thailand. Participants’ weights and heights were measured and classified into three weight status groups (i.e., children with normal weight, overweight, and obesity groups). Executive function was assessed using the parent-report Behavior Rating Inventory of Executive Function-Preschool (BRIEF-P). Multivariable polynomial regression was performed to analyze the association between executive function and weight status. A total of 1,181 children were included in the study. After adjusting for confounders, impaired overall executive function significantly increased the probability of being overweight (odds ratio [OR] = 2.47; 95% confidence interval [CI] 1.33 to 4.56). A similar trend of association was also found between impaired inhibition and overweight status (OR = 2.33; 95%CI 1.11 to 4.90). Furthermore, poor working memory was associated with both overweight and obesity (OR = 1.87; 95%CI 1.09 to 3.20 and OR = 1.74; 95%CI 1.09 to 2.78, respectively). Our data suggest that deficits in executive function, particularly inhibition and working memory, are associated with weight excess in preschoolers. Early promotion of executive function may be needed at this developmental age to prevent unhealthy weight status.

A community-based feasibility randomized controlled study to test food-specific inhibitory control training in people with disinhibited eating during COVID-19 in Italy

PURPOSE

The aim of this study was to expand the evidence on the feasibility and impact of food-specific inhibitory control training in a community sample of people with disinhibited eating.

METHODS

Recruitment and data collection were conducted during the COVID-19 outbreak, in Italy. Ninety-four adult individuals with disinhibited eating were randomised to one of two conditions: App-based food-specific inhibitory control training or waiting list. Participants were assessed at baseline, end of intervention (2 weeks following baseline) and follow-up (one week later). The assessment measures included questionnaires about eating behaviour and mood.

RESULTS

Seventy-three percent of the sample reported a diagnosis of binge eating disorder, and 20.4% a diagnosis of bulimia nervosa. Retention rates were 77% and 86% for the food-specific inhibitory control training and the waiting list conditions, respectively. Almost half of the participants allocated to the training condition completed the "recommended" dose of training (i.e., 10 or more sessions). Those in the training condition reported lower levels of wanting for high-energy dense foods (p < 0.05), a trend for lower levels of perceived hunger (p = 0.07), and lower levels of depression (p < 0.05). Binge eating symptoms, disinhibition, wanting for high-energy dense foods, stress and anxiety were significantly lower at end of intervention, compared to baseline (p < .05).

CONCLUSION

Findings corroborated the feasibility of food-specific inhibitory control training, and its impact on high-energy dense foods liking. The study expands the evidence base for food-specific inhibitory control training by highlighting its impact on perceived hunger and depression. The mechanisms underlying these effects remain to be clarified.

LEVEL OF EVIDENCE

Level I, Evidence obtained from at least one properly designed randomized controlled trials; systematic reviews and meta-analyses; experimental studies.