Attention! Can choices for low value food over high value food be trained?

Neural correlates underlying preference changes induced by food Go/No-Go training

Consistently not responding to appetitive foods during food go/no-go training could change individuals' food choices and sometimes even body weight, however, fewer studies have explored the neural pathways underlying the effects of food go/no-go training. In this study, we scanned eighty-six female participants using functional magnetic resonance imaging and investigated the neural bases of preference changes in a binary food choice task following action (e.g., go) or inaction (e.g., no-go) toward distinct foods within a food go/no-go training paradigm. In line with prior behavioral work, we found that participants' food preferences changed as a function of food go/no-go training, with participants choosing more "go" over "no-go" foods for consumption following training. At a neural level, preference changes were inversely associated with frontoparietal and salience network activity when choosing go (vs. no-go) foods. Additionally, task-related functional connectivities from the inferior parietal lobule to the pre-supplementary motor cortex, dorsolateral prefrontal cortex, and dorsal anterior cingulate cortex were related to these preference changes. Together, current work supports that food go/no-go training reliably changes people's preferences. More importantly, our findings suggest that a neural pathway centered on areas traditionally associated with selective attention may interface with prefrontal regions to guide preference changes induced by food go/no-go training, though future studies using other tasks (e.g., passive viewing tasks) are still needed to test this potential neural mechanism.

Attentional capture by signals of reward persists following outcome devaluation

Attention, the mechanism that prioritizes stimuli in the environment for further processing, plays an important role in behavioral choice. In the present study, we investigated the automatic orienting of attention to cues that signal reward. Such attentional capture occurs despite negative consequences, and we investigated whether this counterproductive and reflexive behavior would persist following outcome devaluation. Thirsty participants completed a visual search task in which the color of a distractor stimulus in the search display signaled whether participants would earn water or potato chips for making a rapid eye movement to a diamond target, but looking at the colored distractor was punished by omission of the signaled reward. Nevertheless, participants looked at the water-signaling distractor more frequently than the chip-signaling distractor. Half the participants then drank water ad libitum before continuing with the visual search task. Although the water was now significantly less desirable for half of the participants, there was no difference between groups in the tendency for the water-signaling distractor to capture attention. These findings suggest that once established, counterproductive attentional bias to signals of reward persists even when those outcomes are no longer valuable. This suggests a "habit-like" attentional mechanism that prioritizes reward stimuli in the environment for further action, regardless of whether those stimuli are aligned with current goals or currently desired.

Memory for individual items is related to nonreinforced preference change

It is commonly assumed that memories contribute to value-based decisions. Nevertheless, most theories of value-based decision-making do not account for memory influences on choice. Recently, new interest has emerged in the interactions between these two fundamental processes, mainly using reinforcement-based paradigms. Here, we aimed to study the role memory processes play in preference change following the nonreinforced cue-approach training (CAT) paradigm. In CAT, the mere association of cued items with a speeded motor response influences choices. Previous studies with this paradigm showed that a single training session induces a long-lasting effect of enhanced preferences for high-value trained stimuli, that is maintained for several months. We hypothesized that CAT increases memory of trained items, leading to enhanced accessibility of their positive associative memories and in turn to preference changes. In two preregistered experiments, we found evidence that memory is enhanced for trained items and that better memory is correlated with enhanced preferences at the individual item level, both immediately and 1 mo following CAT. Our findings suggest that memory plays a central role in value-based decision-making following CAT, even in the absence of external reinforcements. These findings contribute to new theories relating memory and value-based decision-making and set the groundwork for the implementation of novel nonreinforced behavioral interventions that lead to long-lasting behavioral change.

Effects of go/no-go training on food-related action tendencies, liking and choice

Inhibitory control training effects on behaviour (e.g. 'healthier' food choices) can be driven by changes in affective evaluations of trained stimuli, and theoretical models indicate that changes in action tendencies may be a complementary mechanism. In this preregistered study, we investigated the effects of food-specific go/no-go training on action tendencies, liking and impulsive choices in healthy participants. In the training task, energy-dense foods were assigned to one of three conditions: 100% inhibition (no-go), 0% inhibition (go) or 50% inhibition (control). Automatic action tendencies and liking were measured pre- and post-training for each condition. We found that training did not lead to changes in approach bias towards trained foods (go and no-go relative to control), but we warrant caution in interpreting this finding as there are important limitations to consider for the employed approach-avoidance task. There was only anecdotal evidence for an effect on food liking, but there was evidence for contingency learning during training, and participants were on average less likely to choose a no-go food compared to a control food after training. We discuss these findings from both a methodological and theoretical standpoint and propose that the mechanisms of action behind training effects be investigated further.

Food-related inhibitory control training reduces food liking but not snacking frequency or weight in a large healthy adult sample

Inhibitory control training has recently been used as an intervention to aid healthy eating and encourage weight loss. The aim of this pre-registered study was to explore the effects of training on food liking, food consumption and weight loss in a large (n = 366), predominantly healthy-weight sample. Participants received four training sessions within a week, in which they had to inhibit their responses to either energy-dense foods (active group) or non-food images (control group). Subjective food ratings, food consumption frequency and weight were measured pre- and post-training. At two-weeks post-training, the active group reported a greater reduction in liking for energy-dense foods, compared to the control group. Active participants also reported a significantly greater increase in healthy food liking, immediately post-training, relative to the control group. There was no statistically significant difference between groups for the change in consumption of trained foods or for weight loss. These findings are partially consistent with previous research conducted in smaller, more overweight samples. Exploratory analyses suggest that some effects of training may be driven by awareness effects. Methodological differences across findings and avenues for future investigation are discussed.

Enhanced Bottom-Up and Reduced Top-Down fMRI Activity Is Related to Long-Lasting Nonreinforced Behavioral Change

Behavioral change studies and interventions focus on self-control and external reinforcements to influence preferences. Cue-approach training (CAT) has been shown to induce preference changes lasting months by merely associating items with neutral cues and speeded responses. We utilized this paradigm to study neural representation of preferences and their modification without external reinforcements. We scanned 36 participants with fMRI during a novel passive viewing task before, after and 30 days following CAT. We preregistered the predictions that activity in memory, top-down attention, and value-processing regions will underlie preference modification. While most theories associate preferences with prefrontal regions, we found that “bottom-up” perceptual mechanisms were associated with immediate change, whereas reduced “top-down” parietal activity was related to long-term change. Activity in value-related prefrontal regions was enhanced immediately after CAT for trained items and 1 month after for all items. Our findings suggest a novel neural mechanism of preference representation and modification. We suggest that nonreinforced change of preferences occurs initially in perceptual representation of items, putatively leading to long-term changes in “top-down” processes. These findings offer implementation of bottom-up instead of top-down targeted interventions for long-lasting behavioral change.

Modifying food items valuation and weight with gamified executive control training

Recent lines of research suggest that repeated executive control of motor responses to food items modifies their perceived value and in turn their consumption. Cognitive interventions involving the practice of motor control and attentional tasks have thus been advanced as potential approach to improve eating habits. Yet, their efficacy remains debated, notably due to a lack of proper control for the effects of expectations. We examined whether a one-month intervention combining the practice of Go/NoGo and Cue approach training modified the perceived palatability of food items (i.e. decrease in unhealthy and increase in healthy food items' palatability ratings), and in turn participants' weights. We assessed our hypotheses with a parallel, double-blind, randomized controlled trial. Motivation and adherence to the intervention were maximized by a professional-level gamification of the training tasks. The control intervention differed from the experimental intervention only in the biasing of the stimulus-response mapping rules, enabling to balance expectations between the two groups and thus to conclude on the causal influence of motoric control on items valuation. We found a larger decrease of the unhealthy items' palatability ratings in the experimental (20.6%) than control group (13.1%). However, we did not find any increase of the healthy items' ratings or weight loss. Overall, the present registered report confirms that the repeated inhibition of motor responses to food cues, together with the development of attentional biases away from these cues, reduces their perceived value.

Edible Flowers, Old Tradition or New Gastronomic Trend: A First Look at Consumption in Portugal versus Costa Rica

This study investigated the knowledge and use of edible flowers (EF) in two countries, Portugal, in Europe, and Costa Rica, in Latin America, and aimed to evaluate the similarities and/or differences regarding the utilization of EF in gastronomy. This work consisted of a questionnaire survey, undertaken on a sample of 290 participants. The results indicate that most people surveyed (87%) have heard about EF but believe there is not enough information about them (96%). Only one third of participants consider there are risks associated with the consumption of EF, being those related to toxicity and pesticides. Significant differences (p < 0.05) were found between participants from the two countries but not with different professional areas. About half (48%) of the participants had already consumed EF, mostly for decoration or confection of dishes (77% positive answers) and in salads (75%). The flowers consumed most frequently were chamomile and rose, respectively, in Costa Rica and Portugal. Reasons pointed out to consume EF include decoration, taste, novelty and aroma, while aspects such as nutritional value or antioxidant capacity are prized by fewer consumers. EF were mostly acquired in supermarkets, cultivated at home or collected in the wild. In general, most participants (85%) consider the use of EF in gastronomy interesting, but less than one third (27%) believe we should eat EF more often. Finally, discriminant function analysis revealed that country was the variable for which the differences in the consumption of EF was more pronounced, while education level and age group showed the lowest variability between groups.

The affective priming paradigm as an indirect measure of food attitudes and related choice behaviour

In this Registered Report, we assessed the utility of the affective priming paradigm (APP) as an indirect measure of food attitudes and related choice behaviour in two separate cohorts. Participants undertook a speeded evaluative categorization task in which target words were preceded by food primes that differed in terms of affective congruence with the target, explicit liking (most liked or least liked), and healthiness (healthy or unhealthy). Non-food priming effects were tested as a manipulation check, and the relationship between food priming effects and impulsive choice behaviour was also investigated using a binary food choice task. As predicted, priming effects were observed for both healthy and unhealthy foods, but there was no difference in the magnitude of these effects. This may suggest that the paradigm is most sensitive to affective, but not cognitive, components of attitudes (i.e., healthiness), but alternative theoretical explanations and implications of this finding are discussed. Food and non-food priming effects were observed in both reaction time (RT) and error rate (ER) data, but contrary to expectations, we found no association between food RT priming effects and choice behaviour. All findings from confirmatory analyses regarding RT and ER priming effects, and the absence of the expected correlations between priming effects and impulsive food choices, were successfully replicated in the online cohort of participants. Overall, this study confirms the robustness of the APP as an indirect measure of food liking and raises questions about its applied value for research of eating behaviours.

Training choices toward low value options

Food decisions are driven by differences in value of choice alternatives such that high value items are preferred over low value items. However, recent research has demonstrated that by implementing the Cue-Approach Training (CAT) the odds of choosing low value items over high value items can be increased. This effect was explained by increased attention to the low value items induced by CAT. Our goal was to replicate the original findings and to address the question of the underlying mechanism by employing eye-tracking during participants’ choice making. During CAT participants were presented with images of food items and were instructed to quickly respond to some of them when an auditory cue was presented (cued items), and not without this cue (uncued items). Next, participants made choices between two food items that differed on whether they were cued during CAT (cued versus uncued) and in pre-training value (high versus low). As predicted, results showed participants were more likely to select a low value food item over a high value food item for consumption when the low value food item had been cued compared to when the low value item had not been cued. Important, and against our hypothesis, there was no significant increase in gaze time for low value cued items compared to low value uncued items. Participants did spend more time fixating on the chosen item compared to the unchosen alternative, thus replicating previous work in this domain. The present research thus establishes the robustness of CAT as means of facilitating choices for low value over high value food but could not demonstrate that this increased preference was due to increased attention for cued low value items. The present research thus raises the question how CAT may increase choices for low value options.

Enhanced striatal and prefrontal activity is associated with individual differences in nonreinforced preference change for faces

Developing effective preference modification paradigms is crucial to improve the quality of life in a wide range of behaviors. The cue‐approach training (CAT) paradigm has been introduced as an effective tool to modify preferences lasting months, without external reinforcements, using the mere association of images with a cue and a speeded button response. In the current work for the first time, we used fMRI with faces as stimuli in the CAT paradigm, focusing on face‐selective brain regions. We found a behavioral change effect of CAT with faces immediately and 1‐month after training, however face‐selective regions were not indicative of behavioral change and thus preference change is less likely to rely on face processing brain regions. Nevertheless, we found that during training, fMRI activations in the ventral striatum were correlated with individual preference change. We also found a correlation between preference change and activations in the ventromedial prefrontal cortex during the binary choice phase. Functional connectivity among striatum, prefrontal regions, and high‐level visual regions was also related to individual preference change. Our work sheds new light on the involvement of neural mechanisms in the process of valuation. This could lead to development of novel real‐world interventions.

Is ventromedial prefrontal cortex critical for behavior change without external reinforcement?

Cue-approach training (CAT) is a novel paradigm that has been shown to induce preference changes towards items without external reinforcements. In the task, the mere association of a neutral cue and a speeded button response has been shown to induce a behavioral choice preference change lasting for months. This paradigm includes several phases: after the training of individual items, behavior change is manifested in binary choices of items with similar initial values. Neuroimaging data have implicated the ventromedial prefrontal cortex (vmPFC) in the choice phase of this task. However, the neural mechanisms underlying the preference changes induced by training remain unclear. Here, we asked whether the ventromedial frontal lobe (VMF) is critical for the non-reinforced preference change induced by CAT. For this purpose, 11 participants with focal lesions involving the VMF and 30 healthy age-matched controls performed the CAT. The VMF group was similar to the healthy age-matched control group in the ranking and training phases. As a group, the healthy age-matched controls exhibited a training-induced behavior change, while the VMF group did not. However, on an individual level analysis we found that some of the VMF participants showed a significant preference shift. Thus, we find mixed evidence for the role of VMF in this paradigm. This is another step towards defining the mechanisms underlying the novel form of behavioral change that occurs with CAT.

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We tested participants with focal lesions involving ventromedial frontal lobe (VMF).

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Participants performed a behavioral change task without external reinforcements.

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The VMF group did not exhibit behavior change but some individuals in it did.

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We find mixed evidence for the role of VMF in this paradigm.

Gaze Amplifies Value in Decision Making

When making decisions, people tend to choose the option they have looked at more. An unanswered question is how attention influences the choice process: whether it amplifies the subjective value of the looked-at option or instead adds a constant, value-independent bias. To address this, we examined choice data from six eye-tracking studies ( Ns = 39, 44, 44, 36, 20, and 45, respectively) to characterize the interaction between value and gaze in the choice process. We found that the summed values of the options influenced response times in every data set and the gaze-choice correlation in most data sets, in line with an amplifying role of attention in the choice process. Our results suggest that this amplifying effect is more pronounced in tasks using large sets of familiar stimuli, compared with tasks using small sets of learned stimuli.

Spacing of cue-approach training leads to better maintenance of behavioral change

The maintenance of behavioral change over the long term is essential to achieve public health goals such as combatting obesity and drug use. Previous work by our group has demonstrated a reliable shift in preferences for appetitive foods following a novel non-reinforced training paradigm. In the current studies, we tested whether distributing training trials over two consecutive days would affect preferences immediately after training as well as over time at a one-month follow-up. In four studies, three different designs and an additional pre-registered replication of one sample, we found that spacing of cue-approach training induced a shift in food choice preferences over one month. The spacing and massing schedule employed governed the long-term changes in choice behavior. Applying spacing strategies to training paradigms that target automatic processes could prove a useful tool for the long-term maintenance of health improvement goals with the development of real-world behavioral change paradigms that incorporate distributed practice principles.

The Cue-Approach Task as a General Mechanism for Long-Term Non-Reinforced Behavioral Change

Recent findings show that preferences for food items can be modified without external reinforcements using the cue-approach task. In the task, the mere association of food item images with a neutral auditory cue and a speeded button press, resulted in enhanced preferences for the associated stimuli. In a series of 10 independent samples with a total of 255 participants, we show for the first time that using this non-reinforced method we can enhance preferences for faces, fractals and affective images, as well as snack foods, using auditory, visual and even aversive cues. This change was highly durable in follow-up sessions performed one to six months after training. Preferences were successfully enhanced for all conditions, except for negative valence items. These findings promote our understanding of non-reinforced change, suggest a boundary condition for the effect and lay the foundation for development of novel applications.