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Epstein LH, Rizwan A, Rashid S, Bickel WK, Ghanim H. Glucose response to sugar challenge moderates the effect of insulin resistance on reinforcing value of sugar-sweetened yogurt. Appetite 2024; 193:107160. [PMID: 38101518 DOI: 10.1016/j.appet.2023.107160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 11/20/2023] [Accepted: 12/09/2023] [Indexed: 12/17/2023]
Abstract
We have shown insulin resistance is associated with the choice of sugar-sweetened over monk fruit sweetened yogurt. This study extends this research by assessing the association between insulin resistance and reinforcing value for sugar versus monk fruit-sweetened yogurt, and testing the hypothesis that this effect is moderated by greater blood glucose response in people with insulin resistance. Eighteen people with overweight/obesity (BMI = 35.8 kg/m2, range 26.2-48.5) with varying degrees of insulin resistance (Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) = 2.6, range of 0.6-8.0) had blood glucose measured for 2 h after a sugar challenge. Over six days, they consumed, in a double-blind fashion, novel flavored-colored sugar or monk fruit-sweetened yogurts, and the reinforcing value of sugar or monk fruit-sweetened yogurts and delay discounting (DD) were measured. HOMA-IR (r = 0.62, p = .006) and insulin (r = 0.51, p = .03) were related to the reinforcing value of sugar-sweetened, but not monk fruit-sweetened yogurt (r = -0.07, -0.10, respectively). The blood glucose area under the curve moderated the relationship between HOMA-IR and the reinforcing value of sugar-sweetened yogurt (p = .02). People with greater HOMA-IR and greater blood glucose excursions responded the most for sugar-sweetened yogurt. These results extend previous research and confirm the hypothesis that individual differences in response to sugar may activate brain reward centers and condition people to prefer high-sugar foods. DD was related to sugar reinforcement (r = -0.46, p = .03), consistent with the idea that those with high sugar reinforcement desire immediate gratification, and DD moderated the relationship between HOMA-IR and the reinforcing value of sugar-sweetened yogurt (p < .001). Research should test whether reducing insulin resistance would permit people with insulin resistance to choose lower-sugar foods.
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Affiliation(s)
- Leonard H Epstein
- Department of Pediatrics, Jacobs School of Medicine, And Biomedical Sciences, Buffalo, NY, USA; University at Buffalo, Buffalo, NY, USA.
| | - Ashfique Rizwan
- Department of Pediatrics, Jacobs School of Medicine, And Biomedical Sciences, Buffalo, NY, USA; University at Buffalo, Buffalo, NY, USA
| | - Sameeha Rashid
- Department of Pediatrics, Jacobs School of Medicine, And Biomedical Sciences, Buffalo, NY, USA; University at Buffalo, Buffalo, NY, USA
| | - Warren K Bickel
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at Virginia Tech Carillion School of Medicine, USA
| | - Husam Ghanim
- University at Buffalo, Buffalo, NY, USA; Division of Endocrinology Diabetes and Metabolism, Jacobs School of Medicine, and Biomedical Sciences, USA
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Epstein LH, Biondolillo MJ, Rizwan A, Ghanim H, Dandona P, Bickel WK, Paluch RA. Insulin Resistance and Glycated Hemoglobin in Obesity Are Associated With Preference for Sugar-Sweetened Yogurt: A Pilot Study. Psychosom Med 2023; 85:289-293. [PMID: 36799726 PMCID: PMC10528876 DOI: 10.1097/psy.0000000000001171] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVE Insulin resistance is associated with elevated activation of food reward, which should be associated with an increased reinforcing value of food. Research has also shown that sugar is a macronutrient strongly associated with reward and reinforcing value of food. This research is designed to assess whether insulin resistance is associated with a stronger preference for sugar-sweetened, thus elevating blood glucose responses in obese people with varying degrees of insulin resistance. METHODS Thirteen people with obesity (body mass index, 39.1 kg/m 2 ; range, 30.0-45.1 kg/m 2 ) with varying degrees of insulin resistance (Homeostatic Model Assessment of Insulin Resistance, 5.2; range, 0.7-11.6) consumed novel flavored-colored yogurts that were sweetened with either sugar or monkfruit daily for 6 days to assess whether when given the choice of sugar-sweetened versus monkfruit-sweetened yogurts to consume, participants preferred sugar-sweetened yogurts. RESULTS Participants consumed a greater amount ( p = .009) and percentage ( p = .04) of sugar-sweetened yogurt earned than monkfruit-sweetened yogurt. The percent of sugar-sweetened versus monkfruit-sweetened yogurt consumed in relationship to amount earned was related to insulin resistance ( r = 0.64, p = .019), glycated hemoglobin ( r = 0.61, p = .027), insulin ( r = 0.58, p = .007), and glucose ( r = 0.56, p = .048). CONCLUSIONS Insulin resistance is associated with preference for sugar-sweetened foods in participants with obesity, which may make it hard to make dietary changes. Research is needed to assess whether treatments that improve insulin resistance also change the preference for sugar-sweetened or high-glycemic-index foods.
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Affiliation(s)
- Leonard H Epstein
- From the Department of Pediatrics (Epstein, Biondolillo, Rizwan, Paluch) and Division of Endocrinology Diabetes and Metabolism (Ghanim, Dandona), Jacobs School of Medicine, and Biomedical Sciences, University at Buffalo, Buffalo, New York; and Addiction Recovery Research Center (Bickel), Fralin Biomedical Research Institute at Virginia Tech Carillion School of Medicine, Roanoke, Virginia
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Higgins KA, Rawal R, Baer DJ, O'Connor LE, Appleton KM. Scoping Review and Evidence Map of the Relation between Exposure to Dietary Sweetness and Body Weight-Related Outcomes in Adults. Adv Nutr 2022; 13:2341-2356. [PMID: 36041167 PMCID: PMC9776634 DOI: 10.1093/advances/nmac090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/20/2022] [Accepted: 08/22/2022] [Indexed: 01/29/2023] Open
Abstract
Numerous governmental and health organizations recommend reduced intake of added sugars due to the health risks associated with excess intake, including the risk of obesity. Some organizations further recommend avoiding dietary sweetness, regardless of the source. A scoping review and evidence map were completed to characterize the research that investigated associations between dietary sweetness and body weight. The aim was to identify and map published studies that have investigated total dietary sweetness, sweet food/beverages, sugar, or sweetener intake, and body weight-related outcomes and/or energy intake. Using preregistered search terms (osf.io/my7pb), 36,779 publications (duplicates removed) were identified from PubMed, Cochrane Library, and Scopus and screened for inclusion. Eligible studies were clinical trials, longitudinal cohorts, case-control studies, cross-sectional studies, and systematic reviews conducted among adults (age ≥18 y), which were performed to investigate associations between dietary sweetness, sweet foods/beverages, sugar, or sweetener (energetic or nonenergetic) intake and body weight, BMI, adiposity, and/or energy intake. A total of 833 eligible publications were identified, detailing 804 studies. Only 7 studies (0.9% of included studies; 2 clinical trials, 4 cross-sectional studies, and 1 with another design type) investigated associations between total dietary sweetness and body weight-related outcome and/or energy intake. An additional 608 (75.6%) studies investigated intakes of sweet foods/beverages, sugar, or sweetener, and body weight-related outcomes and/or energy intake, including 225 clinical trials, 81 longitudinal cohorts, 4 case-control studies, and 280 cross-sectional studies. Most studies (90.6%) did not measure the sweetness of the diet or individual foods consumed. Ninety-two (11.4%) publications reported data from studies on dietary patterns that included sweet foods/beverages alongside other dietary components and 97 (12.1%) systematic reviews addressed different but related research questions. Although there is a breadth of evidence from studies that have investigated associations between intakes of sweet foods and beverages, sugars, and sweeteners and body weight, there is a limited depth of evidence on the association between total dietary sweetness and body weight.
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Affiliation(s)
| | - Rita Rawal
- US Department of Agriculture, Agricultural Research Service, Beltsville Human Nutrition Research Center, Food Components and Health Laboratory, Beltsville, MD, USA
| | - David J Baer
- US Department of Agriculture, Agricultural Research Service, Beltsville Human Nutrition Research Center, Food Components and Health Laboratory, Beltsville, MD, USA
| | - Lauren E O'Connor
- US Department of Agriculture, Agricultural Research Service, Beltsville Human Nutrition Research Center, Food Components and Health Laboratory, Beltsville, MD, USA
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Parnarouskis L, Leventhal AM, Ferguson SG, Gearhardt AN. Withdrawal: A key consideration in evaluating whether highly processed foods are addictive. Obes Rev 2022; 23:e13507. [PMID: 36196649 PMCID: PMC9786266 DOI: 10.1111/obr.13507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 07/04/2022] [Accepted: 09/20/2022] [Indexed: 12/30/2022]
Abstract
Researchers are currently debating whether theories of addiction explain compulsive overeating of highly processed (HP) foods (i.e., industrially created foods high in refined carbohydrates and/or fat), which contributes to obesity and diet-related disease. A subset of individuals consumes HP foods with behavioral phenotypes that mirror substance use disorders. Withdrawal, the emergence of aversive physical and psychological symptoms upon reduction or cessation of substance use, is a core component of addiction that was central to historical debates about other substances' addictive potential (e.g., nicotine and cocaine). However, no one has systematically considered evidence for whether HP foods cause withdrawal, which represents a key knowledge gap regarding the utility of addiction models for understanding compulsive overeating. Thus, we reviewed evidence for whether animals and humans exhibit withdrawal when reducing or eliminating HP food intake. Controlled experimental evidence indicates animals experience HP food withdrawal marked by neural reward changes and behaviors consistent with withdrawal from other addictive substances. In humans, preliminary evidence supports subjective withdrawal-like experiences. However, most current human research is limited to retrospective recall. Further experimental research is needed to evaluate this construct. We outline future research directions to investigate HP food withdrawal in humans and consider potential clinical implications.
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Affiliation(s)
| | - Adam M Leventhal
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Stuart G Ferguson
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Ashley N Gearhardt
- Department of Psychology, The University of Michigan, Ann Arbor, Michigan, USA
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Effects of 6-month episodic future thinking training on delay discounting, weight loss and HbA1c changes in individuals with prediabetes. J Behav Med 2022; 45:227-239. [PMID: 35006500 PMCID: PMC8744570 DOI: 10.1007/s10865-021-00278-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 12/22/2021] [Indexed: 12/22/2022]
Abstract
People with prediabetes are at risk for type 2 diabetes. They may discount the future delay discounting (DD), and not engage in preventive health behaviors. Episodic future thinking (EFT) can reduce DD when future scenarios are cued, but research is needed to assess long-term effects of EFT and when EFT is not cued. This study tested EFT training compared to control for people with prediabetes enrolled in a 6-month weight loss program on DD, weight, HbA1c, and physical activity. Results showed a reliable EFT effect on reducing DD in cued (p = 0.0035), and uncued DD tasks (p = 0.048), and significant overall changes in weight (p < 0.001), HbA1c (p, 0.001) and physical activity (p = 0.003), but no significant differences in these outcomes by group (p’s > 0.05). Sixty-eight percent of the sample ended below the prediabetes HbA1c range. These results suggest that DD can be modified over extended periods, and the effects of EFT can be observed without EFT cues. However, these data do not suggest that changes in weight, HbA1c or physical activity were due to EFT training. The study was initiated before the COVID-19 pandemic which provided the opportunity to compare differences for people treated in-person or remotely. Analyses showed no differences in DD, weight, HBA1c or physical activity outcomes were observed between in-person and remote treatment, suggesting telehealth is a scalable approach to treating prediabetes.
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Epstein LH, Carr KA. Food reinforcement and habituation to food are processes related to initiation and cessation of eating. Physiol Behav 2021; 239:113512. [PMID: 34217735 DOI: 10.1016/j.physbeh.2021.113512] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/25/2021] [Accepted: 06/28/2021] [Indexed: 01/11/2023]
Abstract
An individual bout of eating involves cues to start eating, as well as cues to terminate eating. One process that determines initiation of eating is food reinforcement. Foods with high reinforcing value are also likely to be consumed in greater quantities. Research suggests both cross-sectional and prospective relationships between food reinforcement and obesity, food reinforcement is positively related to energy intake, and energy intake mediates the relationship between food reinforcement and obesity. A process related to cessation of eating is habituation. Habituation is a general behavioral process that describes a reduction in physiological or affective response to a stimulus, or a reduction in the behavioral responding to obtain a stimulus. Repeated exposure to the same food during a meal can result in habituation to that food and a reduction in consumption. Habituation is also cross-sectionally and prospectively related to body weight, as people who habituate slower consume more in a meal and are more overweight. Research from our laboratory has shown that these two processes independently influence eating, as they can account for almost 60% of the variance in ad libitum intake. In addition, habituation phenotypes show reliable relationships with reinforcing value, such that people who habituate faster also find food less reinforcing. Developing a better understanding of cues to start and stop eating is fundamental to understanding how to modify eating behavior. An overview of research on food reinforcement, habituation and food intake for people with a range of weight status and without eating disorders is provided, and ideas about integrating these two processes that are related to initiation and termination of a bout of eating are discussed.
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Affiliation(s)
- Leonard H Epstein
- Jacobs School of Medicine and Biomedical Sciences, Department of Pediatrics, University at Buffalo, G56 Farber Hall, 3435 Main Street, Building #26, Buffalo, New York 14214-3000, USA.
| | - Katelyn A Carr
- Jacobs School of Medicine and Biomedical Sciences, Department of Pediatrics, University at Buffalo, G56 Farber Hall, 3435 Main Street, Building #26, Buffalo, New York 14214-3000, USA.
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Casperson SL, Jahns L, Temple JL, Appleton KM, Duke SE, Roemmich JN. Consumption of a Variety of Vegetables to Meet Dietary Guidelines for Americans' Recommendations Does Not Induce Sensitization of Vegetable Reinforcement Among Adults with Overweight and Obesity: A Randomized Controlled Trial. J Nutr 2021; 151:1665-1672. [PMID: 33758940 DOI: 10.1093/jn/nxab049] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/26/2021] [Accepted: 02/10/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Food reinforcement, or the motivation to obtain food, can predict choice and consumption. Vegetable consumption is well below recommended amounts for adults, so understanding how to increase vegetable reinforcement could provide valuable insight into how to increase consumption. OBJECTIVES We sought to determine whether daily consumption of the Dietary Guidelines for Americans (DGA) recommendations for vegetable intake induces sensitization of vegetable reinforcement in adults with overweight and obesity. METHODS Healthy adults with a BMI ≥ 25 kg/m2 who consumed ≤1 cup-equivalent of vegetables/day were randomly assigned to a vegetable intervention (VI; n = 55) or an attention control (AC; n = 55) group. The VI consisted of the daily provision of vegetables in the amounts and types recommended by the DGA (∼270 g/day) for 8 weeks. Participants were followed for an additional 8 weeks to assess sustained consumption. Compliance was measured weekly by resonance Raman light-scattering spectroscopy (RRS). Vegetable reinforcement was tested at weeks 0, 8, 12, and 16 using a computer choice paradigm. RESULTS In the VI group, RRS intensity increased from week 0 to 8 (from 22,990 to 37,220), returning to baseline by week 16 (27,300). No change was observed in the AC group. There was no main effect of treatment (P = 0.974) or time (P = 0.14) and no treatment x time interaction (P = 0.44) on vegetable reinforcement. There was no moderating effect of sex (P = 0.07), age (P = 0.60), BMI (P = 0.46), delay discounting (P = 0.24), 6-n-propylthiouracil taster status (P = 0.15), or dietary disinhibition (P = 0.82) on the change in vegetable reinforcement. CONCLUSIONS These findings suggest no effects of the provision of a variety of vegetables to meet DGA recommendations for 8 weeks on vegetable reinforcement and highlight the difficulty in increasing vegetable consumption in adults. This trial was registered at clinicaltrials.gov as NCT02585102.
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Affiliation(s)
- Shanon L Casperson
- USDA Agricultural Research Services, Grand Forks Human Nutrition Research Center, Grand Forks, ND, USA
| | - Lisa Jahns
- USDA Agricultural Research Services, Grand Forks Human Nutrition Research Center, Grand Forks, ND, USA
| | - Jennifer L Temple
- University of Buffalo, Department of Exercise and Nutrition Sciences, Buffalo, NY, USA
| | | | - Sara E Duke
- USDA Agricultural Research Services, Plains Area Office, College Station, TX, USA
| | - James N Roemmich
- USDA Agricultural Research Services, Grand Forks Human Nutrition Research Center, Grand Forks, ND, USA
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Fat and Carbohydrate Interact to Potentiate Food Reward in Healthy Weight but Not in Overweight or Obesity. Nutrients 2021; 13:nu13041203. [PMID: 33917347 PMCID: PMC8067354 DOI: 10.3390/nu13041203] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 01/30/2023] Open
Abstract
Prior work suggests that actual, but not estimated, energy density drives the reinforcing value of food and that energy from fat and carbohydrate can interact to potentiate reward. Here we sought to replicate these findings in an American sample and to determine if the effects are influenced by body mass index (BMI). Thirty participants with healthy weight (HW; BMI 21.92 ± 1.77; M ± SD) and 30 participants with overweight/obesity (OW/OB; BMI 29.42 ± 4.44) rated pictures of common American snacks in 120-kcal portions for liking, familiarity, frequency of consumption, expected satiety, healthiness, energy content, energy density, and price. Participants then completed an auction task where they bid for the opportunity to consume each food. Snacks contained either primarily carbohydrate, primarily fat, or roughly equal portions of fat and carbohydrate (combo). Replicating prior work, we found that participants with HW bid the most for combo foods in linear mixed model analyses. This effect was not observed among individuals with OW/OB. Additionally, in contrast with previous reports, our linear regression analyses revealed a negative relationship between the actual energy density of the snacks and bid amount that was mediated by food price. Our findings support altered macronutrient reinforcement in obesity and highlight potential influences of the food environment on the regulation of food reward.
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Mumena WA, Alamri AA, Mahrous AA, Alharbi BM, Almohaimeed JS, Hakeem MI, Kutbi HA. Knowledge, attitudes, and practices toward added sugar consumption among female undergraduate students in Madinah, Saudi Arabia: A cross-sectional study. Nutrition 2020; 79-80:110936. [PMID: 32818835 DOI: 10.1016/j.nut.2020.110936] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 06/20/2020] [Accepted: 06/24/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVES This study aimed to evaluate knowledge, attitudes, and practices toward added sugar intake and the associations with nutrient intakes and weight status. METHODS This cross-sectional study was conducted among 190 healthy female undergraduate students at Taibah University, Madinah, Saudi Arabia. Demographic, knowledge and attitudes toward added sugar, dietary intake, and anthropometric data (i.e., height, weight, and waist circumference) were collected during face-to-face interviews. RESULTS Approximately half of the students (n = 106; 55.8%) were aware of the health consequences of excessive intake of added sugar, but only 32.6% (n = 62) reported making an effort to reduce their added sugar intake. The data indicated that 8.42% of the students (n = 16) consumed carbonated soft drinks daily, 15.8% (n = 30) consumed fruit drinks daily, and 45.8% (n = 87) consumed sweets daily. Underweight students consumed higher quantities of added sugar (expressed as percent of total energy intake) compared with students in all other weight status groups. Results showed negative associations between percentage of added sugar intake and intakes of fiber, iron, zinc, vitamin D, body mass index, and waist circumference. CONCLUSIONS Our findings indicated that a large proportion of young women had limited knowledge on the health consequences of excessive added sugar intakes. The observed inverse relationships between added sugar and micronutrient intakes and the weight status highlight the urgent need for expanded efforts to improve added sugar-related knowledge and promote the reduction of added sugar intake among young women.
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Affiliation(s)
- Walaa A Mumena
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, P.O. Box 344, Madinah, 42353, Kingdom of Saudi Arabia.
| | - Asma A Alamri
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, P.O. Box 344, Madinah, 42353, Kingdom of Saudi Arabia
| | - Alhanouf A Mahrous
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, P.O. Box 344, Madinah, 42353, Kingdom of Saudi Arabia
| | - Bushra M Alharbi
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, P.O. Box 344, Madinah, 42353, Kingdom of Saudi Arabia
| | - Jumanah S Almohaimeed
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, P.O. Box 344, Madinah, 42353, Kingdom of Saudi Arabia
| | - Maysaa I Hakeem
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, P.O. Box 344, Madinah, 42353, Kingdom of Saudi Arabia
| | - Hebah A Kutbi
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80215, Jeddah, 21589, Kingdom of Saudi Arabia
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Flack KD, Hays HM, Moreland J. The consequences of exercise-induced weight loss on food reinforcement. A randomized controlled trial. PLoS One 2020; 15:e0234692. [PMID: 32555624 PMCID: PMC7302707 DOI: 10.1371/journal.pone.0234692] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 05/29/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Obesity remains a primary threat to the health of most Americans, with over 66% considered overweight or obese with a body mass index (BMI) of 25 kg/m2 or greater. A common treatment option many believe to be effective, and therefore turn to, is exercise. However, the amount of weight loss from exercise training is often disappointingly less than expected with greater amounts of exercise not always promoting greater weight loss. Increases in energy intake have been prescribed as the primary reason for this lack of weight loss success with exercise. Research has mostly focused on alterations in hormonal mediators of appetite (e.g.: ghrelin, peptide YY, GLP-1, pancreatic polypeptide, and leptin) that may increase hunger and/or reduce satiety to promote greater energy intake with exercise training. A less understood mechanism that may be working to increase energy intake with exercise is reward-driven feeding, a strong predictor of energy intake and weight status but rarely analyzed in the context of exercise. DESIGN Sedentary men and women (BMI: 25-35 kg/m2, N = 52) were randomized into parallel aerobic exercise training groups partaking in either two or six exercise sessions/week, or sedentary control for 12 weeks. METHODS The reinforcing value of food was measured by an operant responding progressive ratio schedule task (the behavioral choice task) to determine how much work participants were willing to perform for access to a healthy food option relative to a less healthy food option before and after the exercise intervention. Body composition and resting energy expenditure were assessed via DXA and indirect calorimetry, respectively, at baseline and post testing. RESULTS Changes in fat-free mass predicted the change in total amount of operant responding for food (healthy and unhealthy). There were no correlations between changes in the reinforcing value of one type of food (healthy vs unhealthy) to changes in body composition. CONCLUSION In support of previous work, reductions in fat-free mass resulting from an aerobic exercise intervention aimed at weight loss plays an important role in energy balance regulation by increasing operant responding for food.
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Affiliation(s)
- Kyle D. Flack
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky, United States of America
| | - Harry M. Hays
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky, United States of America
| | - Jack Moreland
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky, United States of America
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Carr KA, Epstein LH. Choice is relative: Reinforcing value of food and activity in obesity treatment. AMERICAN PSYCHOLOGIST 2020; 75:139-151. [PMID: 32052990 PMCID: PMC7313531 DOI: 10.1037/amp0000521] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Persons with obesity find high-energy-dense food and sedentary behaviors highly reinforcing. Diets and exercise programs deprive individuals of many favorite foods and activities, which can counterproductively heighten their value and lead to relapse. Since the value of reinforcers depend on the alternatives available, one approach to reducing food and sedentary activity reinforcement is to build healthy alternative reinforcers. Current behavioral treatment programs for children and adults do not attempt to build alternative reinforcers as substitutes for unhealthy behaviors to reduce the impact of food or activity deprivation on the motivation to eat or be inactive. A goal of the next generation of obesity treatment programs should focus on development of healthy behaviors as reinforcers so that people will be motivated to engage in them. This article provides an overview of relationships among reinforcers, how understanding substitutes and complements can influence eating and activity, and how enriching a person's environment and providing choice architecture can enhance weight control. Ideas for translation of these basic behavioral economic principles to obesity treatment programs are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Katelyn A Carr
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo
| | - Leonard H Epstein
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo
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Reis DJ, Ilardi SS, Namekata MS, Wing EK, Fowler CH. The depressogenic potential of added dietary sugars. Med Hypotheses 2020; 134:109421. [DOI: 10.1016/j.mehy.2019.109421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/29/2019] [Accepted: 10/09/2019] [Indexed: 12/12/2022]
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