Effect of ambience on food intake and food choice

Nature's beauty versus urban bustle: Chinese folk music influences food choices by inducing mental imagery of different scenes

Previous research has demonstrated that music can impact people's food choices by triggering emotional states. We reported two virtual reality (VR) experiments designed to examine how Chinese folk music influences people's food choices by inducing mental imagery of different scenes. In both experiments, young healthy Chinese participants were asked to select three dishes from an assortment of two meat and two vegetable dishes while listening to Chinese folk music that could elicit mental imagery of nature or urban scenes. The results of Experiment 1 revealed that they chose vegetable-forward meals more frequently while listening to Chinese folk music eliciting mental imagery of nature versus urban scenes. In Experiment 2, the participants were randomly divided into three groups, in which the prevalence of their mental imagery was enhanced, moderately suppressed, or strongly suppressed by performing different tasks while listening to the music pieces. We replicated the results of Experiment 1 when the participants' mental imagery was enhanced, whereas no such effect was observed when the participants' mental imagery was moderately or strongly suppressed. Collectively, these findings suggest that music may influence the food choices people make in virtual food choice tasks by inducing mental imagery, which provides insights into utilizing environmental cues to promote healthier food choices.

Taste Preferences at Different Ambient Temperatures and Associated Changes in Gut Microbiota and Body Weight in Mice

Taste, dietary choices, and gut microbiota are often analyzed as major factors of metabolic health. Populations living in cold or hot regions have different dietary habits. This study aims to investigate the potential association among ambient temperature, food taste preferences, and cecal microbiota community profiles in mice. By exposing mice to mixed diets containing sweet, sour, salty, and bitter flavors at low (4 °C) and high (37 °C) ambient temperatures, the taste preferences of mice at both ambient temperatures were in the order of saltiness > sweetness > bitterness > sourness. Exposing mice to sweet, sour, salty, and bitter diets, respectively, revealed that in a low-temperature environment, mice consuming salty (5.00 ± 1.49 g), sweet (4.99 ± 0.35 g), and sour (3.90 ± 0.61 g) diets had significantly higher weight gain compared to those consuming normal feeds (2.34 ± 0.43 g, p < 0.05). Conversely, in a high-temperature environment, no significant changes in body weight were observed among mice consuming different flavored diets (p > 0.05). In a low-temperature environment, mice fed sour and sweet diets showed a significant difference in the gut microbiota composition when compared to those fed a normal diet. A higher abundance of Lachnospiraceae, UBA1819, and Clostridiales was identified as the most significant taxa in the sour group, and a higher abundance of Ruminiclostridium was identified in the sweet group. These differences were associated with microbial pathways involved in carbohydrate metabolism, amino acid metabolism, and energy metabolism. A high-temperature environment exhibited only minor effects on the gut microbiota profile. Overall, our findings provide evidence for temperature-modulated responses to the taste, gut microbiota functions, and body weight changes in mice.

ESPEN guideline on nutrition and hydration in dementia - Update 2024

BACKGROUND & AIMS

Dementia is accompanied by a variety of changes that result in an increased risk of malnutrition and low-intake dehydration. This guideline update aims to give evidence-based recommendations for nutritional care of persons with dementia in order to prevent and treat these syndromes.

METHODS

The previous guideline version was reviewed and expanded in accordance with the standard operating procedure for ESPEN guidelines. Based on a systematic search in three databases, strength of evidence of appropriate literature was graded by use of the SIGN system. The original recommendations were reviewed and reformulated, and new recommendations were added, which all then underwent a consensus process.

RESULTS

40 recommendations for nutritional care of older persons with dementia were developed and agreed, seven at institutional level and 33 at individual level. As a prerequisite for good nutritional care, organizations caring for persons with dementia are recommended to employ sufficient qualified staff and offer attractive food and drinks with choice in a functional and appealing environment. Nutritional care should be based on a written care concept with standardized operating procedures. At the individual level, routine screening for malnutrition and dehydration, nutritional assessment and close monitoring are unquestionable. Oral nutrition may be supported by eliminating potential causes of malnutrition and dehydration, and adequate social and nursing support (including assistance, utensils, training and oral care). Oral nutritional supplements are recommended to improve nutritional status but not to correct cognitive impairment or prevent cognitive decline. Routine use of dementia-specific ONS, ketogenic diet, omega-3 fatty acid supplementation and appetite stimulating agents is not recommended. Enteral and parenteral nutrition and hydration are temporary options in patients with mild or moderate dementia, but not in severe dementia or in the terminal phase of life. In all stages of the disease, supporting food and drink intake and maintaining or improving nutrition and hydration status requires an individualized, comprehensive approach. Due to a lack of appropriate studies, most recommendations are good practice points.

CONCLUSION

Nutritional care should be an integral part of dementia management. Numerous interventions are available that should be implemented in daily practice. Future high-quality studies are needed to clarify the evidence.

Prevention, Assessment, and Management of Malnutrition in Older Adults with Early Stages of Cognitive Disorders

Malnutrition is common in older adults, and its risk is greater in those living with dementia. Relative to cognitively healthy peers, the prevalence of malnutrition is also increased in individuals with early stages of cognitive disorders owing to pathophysiological, cognitive, and psychosocial changes related to cognitive impairment. Malnutrition is associated with adverse health outcomes, including faster cognitive and functional decline. Here, we provide an overview of the prevention, assessment, and management of malnutrition in older adults, with a special focus on the aspects that are important to consider in individuals with early stages of cognitive disorders. Strategies to prevent malnutrition include systematic screening for malnourishment using validated tools to detect those at risk. If the screening reveals an increased risk of malnutrition, a detailed assessment including the individual's nutritional, medical, and functional status as well as dietary intake should be performed. The management of malnutrition in the early stages of cognitive disorders should be based on the findings of a comprehensive assessment and be personalized according to the individual's specific characteristics. In the article, we also provide an overview of the evidence on vitamin supplements and specific dietary patterns to prevent cognitive decline or attenuate its progression.

Effect of the rs2821557 Polymorphism of the Human Kv1.3 Gene on Olfactory Function and BMI in Different Age Groups

The sense of smell plays an important role in influencing the eating habits of individuals and consequently, their body weight, and its impairment has been associated with modified eating behaviors and malnutrition problems. The inter-individual variability of olfactory function depends on several factors, including genetic and physiological ones. In this study, we evaluated the role of the Kv1.3 channel genotype and age, as well as their mutual relationships, on the olfactory function and BMI of individuals divided into young, adult and elderly groups. We assessed olfactory performance in 112 healthy individuals (young n = 39, adult n = 36, elderly n = 37) based on their TDI olfactory score obtained through the Sniffin' Sticks test and their BMI. Participants were genotyped for the rs2821557 polymorphism of the human gene encoding Kv1.3 channels, the minor C allele of which was associated with a decreased sense of smell and higher BMIs compared to the major T allele. The results show that TT homozygous subjects obtained higher TDI olfactory scores and showed lower BMIs than CC homozygous subjects, in all age groups considered. Furthermore, the positive effect of the T allele on olfactory function and BMI decreased with increasing age. The contribution of the genetic factor is less evident with advancing age, while the importance of the age factor is compensated for by genetics. These results show that genetic and physiological factors such as age act to balance each other.

Effects of a Comprehensive Dietary Intervention Program, Promoting Nutrition Literacy, Eating Behavior, Dietary Quality, and Gestational Weight Gain in Chinese Urban Women with Normal Body Mass Index during Pregnancy

In urban Chinese women with normal body weight during pregnancy, we implemented a comprehensive dietary intervention program aimed at enhancing nutrition literacy, dietary quality, and gestational weight gain. The methods included both online and offline health education on prenatal nutrition, weekly weight monitoring, family back education practices, and real-time dietary guidance. The intervention was delivered to randomly assigned control and intervention group participants from gestational week 12 to week 24. The intervention group (n = 44; 100% complete data) showed significant differences (mean (SD)) compared to the control group (n = 42; 95.5% complete data) in nutrition literacy (53.39 ± 6.60 vs. 43.55 ± 9.58, p < 0.001), restrained eating (31.61 ± 7.28 vs. 28.79 ± 7.96, p < 0.001), Diet Quality Distance (29.11 ± 8.52 vs. 40.71 ± 7.39, p < 0.001), and weight gain within the first 12 weeks of intervention (4.97 ± 1.33 vs. 5.98 ± 2.78, p = 0.029). However, there was no significant difference in the incidence of gestational diabetes (2 (4.5%) vs. 4 (9.5%), p = 0.629). Participants in the intervention group reported an overall satisfaction score of 4.70 ± 0.46 for the intervention strategy. These results emphasize the positive role of comprehensive dietary intervention in promoting a healthy diet during pregnancy.

A quantitative information measure applied to texture perception attributes during mastication

We have calculated an entropy or information measure of previously reported experimentally determined temporal dominance of sensations (TDS) data of texture attributes for two sets of emulsion filled gels throughout the mastication cycle. The samples were emulsion filled gels and two-layered emulsion filled gels. We find that the entropy measure follows an average curve, which is different for each set. The specifics of the entropy curve may serve as a fingerprint for the perception of a specific food sample.

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

TRIAL REGISTRATION

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

Weighing heavy: Heavy serving dishes increase food serving

The current work demonstrates that people serve themselves greater amounts of food when carrying heavier serving dishes. This effect occurs because increases in carried weight lower consumers' sensitivity to the weight of the food served. Decreased sensitivity to weight of food served in turn leads people to continue serving past the point where they would normally stop. The paper demonstrates this effect across two lab studies involving actual food serving (with a third lab study extending the outcomes to unhealthy food choices reported in the S1 Appendix). The studies also demonstrate liking for the food moderates the effect, such that carrying greater weight leads people to serve an increased amount of liked, but not of less well liked, foods. The findings extend prior research regarding the effects of dish weight on food judgment to provide a first demonstration of effects of weight not only on judgment but on behavior. In this, they help expand our understanding of the ways in which elements in the eating environment effects food consumption. In addition, the studies provide initial evidence for the mechanism behind the phenomenon: reduced sensitivity to weight. The research carries important implications for public well being, given that increases in serving sizes may contribute to obesity.

Exploring the determinants of food choice in Chinese immigrants living in Australia and Chinese people living in mainland China: A qualitative study

BACKGROUND

The present study aimed to qualitatively explore the food choice determinants of both Chinese immigrants living in Australia and Chinese people living in mainland China.

METHODS

Eight Chinese Australian participants (female, n = 5; male, n = 3) and ten mainland Chinese participants (female, n = 5; male, n = 5) were recruited from Australia (primarily in Melbourne, Victoria) and China (predominantly in Zhengzhou, Henan province) between June 2021 and March 2022. Participants were diverse in age, socio-economic background, occupation and health status. Semi-structured in-depth interviews were conducted in Mandarin either face-to-face or using online video/voice calls. Interviews were audio-recorded and transcribed verbatim. Investigator triangulation was used to enhance scientific rigour.

RESULTS

Four themes were identified: (1) food choice determinants were shaped by traditional and modern nutrition perceptions and personal food philosophy; (2) physiological responses to food provide direct feedback that impacts future food choices; (3) consideration of convenience was a predominant influencer of food choice; and (4) the differences in food environments between China and Australia promoted distinctive food choice determinants for Chinese people.

CONCLUSIONS

Chinese Australian and mainland Chinese participants' food choices are shaped by traditional Chinese nutrition philosophy, modern Western nutrition science and the contemporary food environment. There are clear cultural characteristics in their food choice determinants that should be considered by health educators, nutrition professionals and nutrition policymakers when developing culturally appropriate health interventions for Chinese people.

Development and validation of a new questionnaire to assess perceptions regarding DWELL: Design for WELLness

Designing home environments for health and wellness is a crucial strategy for disease prevention and health promotion. Yet, there is not a tool to evaluate perceptions regarding home design for health and wellness. This study aimed to develop and validate a new instrument to measure people's perceptions regarding the concept of DWELL: Design for WELLness in the home environment. We developed a short 5-item online questionnaire to detect changes in knowledge, awareness, engagement and self-efficacy regarding DWELL. The instrument was validated in an online study. Of the 613 mothers who answered the questionnaire initially, 397 answered the questionnaire a second time. Factor analysis and Cronbach's alpha indicated that all five DWELL questions load into one single factor (the model explained 61.84% of total variance), and measure a reliable scale of the same construct, with high levels of internal consistency (Cronbach's α = 0.85) at both first and second administrations. Spearman correlations between DWELL first and second administrations of the questionnaire indicated moderate-to-high test-retest reliability (0.55-0.70, p < 0.001). DWELL was found to be a valid tool which fills a gap in the public health literature. This measure serves as a free and convenient online instrument to gain insights regarding the effect of modifying environments for disease prevention and health promotion. The tool may be used to assess perceptions in the conditions leading wellness promotion in the home.

Relationships between feeding behaviors and emotions: an electroencephalogram (EEG) frequency analysis study

Feeding behaviors may be easily affected by emotions, both being based on brain activity; however, the relationships between them have not been explicitly defined. In this study, we investigated how emotional environments modulate subjective feelings, brain activity, and feeding behaviors. Electroencephalogram (EEG) recordings were obtained from healthy participants in conditions of virtual comfortable space (CS) and uncomfortable space (UCS) while eating chocolate, and the times required for eating it were measured. We found that the more participants tended to feel comfortable under the CS, the more it took time to eat in the UCS. However, the EEG emergence patterns in the two virtual spaces varied across the individuals. Upon focusing on the theta and low-beta bands, the strength of the mental condition and eating times were found to be guided by these frequency bands. The results determined that the theta and low-beta bands are likely important and relevant waves for feeding behaviors under emotional circumstances, following alterations in mental conditions.

The effect of background music tempo on eating speed and food intake volume within in healthy women

BACKGROUND

The effects of the different tempos of background music (BGM) on food intake and eating speed have not been fully studied.

AIM

The study aimed to investigate the influence of changing the tempo of BGM during meals on food intake and to explore strategies to support appropriate eating behavior.

METHODS

Twenty-six healthy young adult women participated in this study. In the experimental phase, each participant ate a meal under three separate conditions: fast (120% speed), moderate (original, 100% speed), and slow (80% speed) BGM. The same music was used for each condition, and appetite before and after eating, the amount of food consumed, and eating speed were recorded.

RESULTS

The results showed that food intake (g, mean ± standard error (SE)) was slow: 317.9 ± 22.2, moderate: 400.7 ± 16.0, and fast: 342.9 ± 22.0. Eating speed (g/s, mean ± SE) was slow: 28.1 ± 2.8, moderate: 34.2 ± 2.7, and fast: 27.2 ± 2.4. The analysis showed that the moderate condition showed greater speed than the fast and slow conditions (slow-fast: p = .008; moderate-slow: p = .012; moderate-fast: p = .004). Moreover, the food intake in the moderate condition was significantly higher than that in the slow and fast conditions (moderate-slow: p < .001; moderate-fast: p < .001), and there was no significant difference between the slow and fast conditions in this regard (p = .077).

CONCLUSION

These results suggest that original tempo BGM led to higher food intake compared to the faster and slower tempo conditions. These findings suggest that listening to music at an original tempo during meals may support appropriate eating behavior.

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

Background

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

Objectives

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

Methods

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

Results

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

Conclusions

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

Dining comfort in elderly care facility dining rooms and influencing factors before and after the outbreak of the COVID-19 pandemic

Introduction

The COVID-19 pandemic has changed dining modes in elderly care facilities. This study explores the relationship between the dining environment of four elderly care facilities and the sensitivity of the elderly residents to it before and after the outbreak of the COVID-19 pandemic.

Methods

The study examined differences in subjective comfort levels by measuring the facilities' physical environment, analysing dining behavior, and surveying the elderly residents. And the study examined how the interaction between the physical environment factors, demographic factors, and dining mode affected the residents' evaluation of their dining comfort.

Results

(1) The physical environmental parameters of the four dining rooms differed between the pre- and post-epidemic periods, as shown by increased Sound Pressure Level (SPL), humidity, and temperature levels. (2) The residents' evaluations of physical environment comfort also changed after the outbreak of the COVID-19 pandemic. The subjective comfort levels of the 'dining with baffle' and 'dining across a seat' modes decreased, though the level of the former was slightly higher than that of the latter. The elderly had stronger SPL tolerance in the dining with baffle mode and dining across a seat mode, and their subjective comfort levels for thermal environment and air quality were higher in the dining across a seat mode. (3) When dining time, crowd density, and communication frequency were kept equal, the subjective comfort level of the elderly in the dining with baffle mode and dining across a seat mode was lower than that in the 'normal' dining mode, when the level in the dining with baffle mode was lower than that in the dining across a seat mode. (4) Differences were observed in subjective comfort levels according to age, education level, and residence duration across the dining modes.

Discussion

The need for changes in dining modes during the COVID-19 isolation period require dining rooms in elderly care facilities to design their physical environments in a way that improves dining comfort for the elderly.

Visual Cues and Optimal Defaults in Fast-Food Combo Meals Benefit Health-Concerned Consumers-A Randomized Scenario-Based Experiment

BACKGROUND

The use of low-calorie menu items as optimal defaults and visual cues may nudge consumers to healthier choices at restaurants. However, little is known regarding their effects on emotions and behavioral intentions, particularly among people with different levels of health concern.

OBJECTIVE

Evaluate optimal defaults and visual cues' effect on anticipated pleasure and order intention depending upon consumers' health concern level.

DESIGN

Between-subjects randomized scenario-based experiment.

PARTICIPANTS/SETTING

In all, 636 US adults recruited through an online crowdsourcing platform in July 2020.

INTERVENTION

Participants saw 1 of 6 menu boards in a fast-food drive-through simulation. Half the menu boards included meal photos with (1) menu items to be arranged as a combo by choice (ie, create-your-own combo); (2) traditional combos that included high-calorie default items; or (3) optimal combos that included low-calorie default items. The remaining 3 boards were identical without photos.

MAIN OUTCOME MEASURES

Anticipated pleasure, order intention, and health concern were evaluated with 7-point Likert scales.

ANALYSIS

Statistical tests included multiple regression, Kruskal-Wallis, χ², and analysis of variance. Education and sex were tested as potential confounders.

RESULTS

Optimal combos negatively affected anticipated pleasure (P = .003) and order intention (P < .001) compared with choice combos. Order intention reduction was the same for traditional and optimal combos (P = .128). The presence of photos changed order intention for optimal combos but varied by consumer's health concern level. When health concern was lower, photos decreased the likelihood of ordering the optimal combos (B = -3.06, P = .001), but when health concern was higher, photos enhanced ordering intention compared with the choice group (B = 0.60, P = .001). The photos did not affect anticipated pleasure for any level of health concern.

CONCLUSIONS

The adverse effect of optimal defaults and how visual cues may reduce their negative effect should be considered in menu design.

Recognising eating disorders in older people

Changes in eating behaviours, weight and mental health in older people may be related to psychological distress and indicate the presence of a diagnosable eating disorder, rather than 'anorexia of ageing'. Eating disorders in older people may be overlooked because signs and symptoms are assumed to be part of normal ageing. The role of nurses in the care of older people with eating disorders is likely to be detection, referral and support in accessing specialist intervention. This article offers an overview of eating disorders in older people and discusses why they may arise, why they may not be detected and how to recognise them. The authors describe a framework that nurses can use when assessing older people to determine whether they may have an eating disorder.

Food Desires and Hedonic Discrimination in Virtual Reality Varying in Product–Context Appropriateness among Older Consumers

Immersive virtual reality (VR) videos can replicate complex real-life situations in a systematic, repeatable and versatile manner. New product development trajectories should consider the complexities of daily life eating situations. The creation of immersive contexts of a product with varying levels of appropriateness could be a useful tool for product developers in evaluating the extent to which context may influence food acceptance and eating behavior. This study explored virtual reality (VR) as an efficient context-enhancing technology through evaluations of protein-enriched rye breads and compared the effects of a VR-simulated congruent (VR restaurant) and incongruent (VR cinema) contexts on the acceptance in older consumers. A total of 70 participants were immersed in the two VR contexts and a neutral control context in a randomized order. The responses indicating the desire and liking for rye breads were measured, and the extent of immersion during context exposure was assessed by levels of the sense of presence and engagement. Immersive VR induced positive sensations of presence and a heightened level of engagement. The VR restaurant and neutral contexts were perceived as more appropriate for consuming rye breads and induced higher desire and liking for rye breads, which supported the notion of the alignment of congruent contexts with food desire and liking. The study provides new perspectives, practical methodologies, and discoveries in regard to the creation and application of VR-immersed contexts in food product evaluation. Moreover, it focused on a consumer segment (older consumers) that has seldom been investigated in previous relevant studies. The findings suggest that immersive VR technology, as a tool for evaluating contextual factors, is important for new product development. The good user experience among older consumers further indicated the potential value of VR as a context-enhancing tool for product development.

Soft Economic Incentives and Soft Behavioral Interventions on the Public's Green Purchasing Behaviour - The Evidence from China

Purpose

To explore the effects of "soft" behavioral intervention policies (eg, green emotions, social norms) and "soft" economic incentive policies (eg, high-intensity subsidies, low-intensity subsidies) and their combinations on the public's green product purchasing behavior.

Participants and Methods

An online questionnaire experiment was conducted on Chinese users using Credamo online questionnaire platform to explore the effects of different "soft" intervention policies on consumers' green purchasing behavior, and the sample data were examined using multiple regression. In Study 1, a total of 460 valid samples were collected to explore the differences in the effects of single intervention policies; in Study 2, a total of 556 valid samples were collected to explore the effects of a combination of soft policies.

Results

In the area of green product purchasing, both behavioral interventions and economic incentives alone can promote green consumption behavior; economic incentives have a more positive impact on guiding consumers to green consumption; the combination of "soft" behavioral interventions and "soft" economic incentives has a positive impact on green consumption. The combination of "soft" behavioral intervention policies and "soft" economic incentive policies is more effective than the individual policies.

Conclusion

The experimental results of Study 1 show that the policy effects of both behavioral intervention policies and economic incentive intervention policies are evident for goods with different value attributes. Meanwhile, comparing the two types of soft intervention policies, we find that the effect of economic incentive intervention policies is stronger than that of soft behavioral intervention policies. In Study 2, the empirical analysis of the policy mix shows that the policy mix is more effective. The combination of "soft" economic incentive policies and "soft" behavioral intervention policies can effectively increase the salience of policy instruments, and the effect of policy combinations is greater than that of single policies.

Healthy eating in daily life: the role of relative autonomous motivation when it is difficult

Most people try to eat healthy, but the temptation of unhealthy foods (among other factors) can make it difficult. Despite these difficulties, some people still achieve their healthy eating goals. Following self-determination theory (SDT; Ryan & Deci, 2000), we propose that relative autonomous motivation (RAM) can foster people’s effort in pursuing health goals. In two daily diary studies, we tested the hypothesis that RAM predicts attainment of healthy eating goals, especially when it is difficult. In Study 1, we focused on difficulties associated with trying to eat certain foods while avoiding others, whereas in Study 2, we focused on difficulties associated with the availability of unhealthy and healthy foods. Multilevel analyses provided some support our hypothesis, and highlighted the role of RAM for eating (vs. skipping) lunch and packing a lunch–two approach-based healthy eating strategies. We discuss these findings in relation to SDT and propose directions for future research on within-person changes in motivation and other sources of difficulty.

Contextual and Individual Variables as Predictors of Energy-Dense Meals in Food Choices

Diets based on meals that provide a large amount of energy and consumed frequently often increase the rate of growth of the body mass index (overweight or obesity) and, in turn, the risk of suffering from non-communicable diseases. In order to make a food choice, it is necessary to search for foods in the environment, taking into account physical and social variables (contextual variables) which, together with individual variables, delimit the situation of food selection. The objective of this study was to evaluate the effect of social facilitation, portion size, salience of food, and food preference or rejection on the selection of energy-dense foods by young college students. To do so, we performed a factorial experiment in which unaccompanied and accompanied participants (levels of social facilitation) as they went through the process of choosing from different options of main dishes, beverages, and desserts then noted the reasons for their selection (preference or rejection of the food). Results showed significant differences between the group of accompanied participants and salience of food in the selection of the energy-dense main dishes and desserts (pizza, spaghetti, and chocolate cake). A significant relationship was also identified between accompanied participants, hedonistic/sensory reasons (food preference or rejection category), and salience of food in the selection of the energy-dense main dishes. In conclusion, key findings of the variables that constitute the situation that predicts the selection of energy-dense foods have emerged from this study, when participants and the given level of social facilitation (in this case, being accompanied) were faced with the conditions of the food salience of the meals of their preference regarding its taste and appearance.

Infant temperament and mealtime distractions as predictors of preschool Children's bite speed during family mealtime

Eating behaviors are shaped at an early age, persist into adulthood, and are implicated in the development of physical health outcomes, including obesity. Faster bite speed has been identified as an obesogenic eating behavior, prompting researchers to examine child and family factors associated with children's variability in bite speed. Child temperament, involving phenotypes of reactivity and regulation, and distractions in family food contexts are fruitful areas of investigation, but few studies have examined the interplay among these factors and their associations with bite speed. To address the gap in the literature, we examined relations between early child temperament, family mealtime distractions, and children's observed bite speed. Caregiver report of child temperament at 3 months was measured using the Infant Behavior Questionnaire Very Short Form - Revised. Child mealtime distractions and bite speed were assessed using family mealtime videos that were collected during home visits when children were 18-24 months of age (n = 109). Results revealed that children who were reported to be higher on orienting/regulation at 3 months, and who were more distracted during mealtimes at 18-24 months, had relatively slower bite speeds. No significant interactions were found. The findings from this correlational study inform further investigations into the implications of early temperament and food contexts for the development of eating behaviors implicated in obesity risk.

Calorie Compensation and Self-Regulation of Food Intake in College Students

OBJECTIVE

To examine self-regulation of food intake among college students.

DESIGN

Randomized cross-over study completed between September and November, 2019.

SETTING

A large public university, Florida International University in South Florida.

PARTICIPANTS

A total of 60 undergraduate college students, mean age of 19.8 ± 1.43 years old, 62% female, 74% Hispanic, 76% White.

INTERVENTION(S)

Participants attended 2 trials 1 week apart. During each visit, students were offered a preload drink (either 0 or 210 kcal) followed by a buffet-style lunch. Food intake was estimated using weights and pictures of the plates before and after eating and was compared between the 2 sessions.

MAIN OUTCOME MEASURE(S)

Self-regulation by calculating compensation indices (COMPX) and their correlation with students' body mass index (BMI).

ANALYSIS

Intake differences were examined using Welch and t tests. Regression analysis was used to assess correlations.

RESULTS

Students exhibited the ability to calorie compensate when intake is manipulated with a mean COMPX of 95.57 ± 71.19. No score was perfect. There was a significant correlation between BMI and COMPX scores (F = 10.71, P < 0.001, r² = 0.292). Food choices differed between different BMI categories.

CONCLUSIONS AND IMPLICATIONS

Participants showed some degree of self-regulation, which suggests opportunities for creating effective interventions to improve health status and promote a more sustainable method to control consumption among college students.

Organizational Food Environments: Advancing Their Conceptual Model

Understanding the complexity of the elements that constitute organizational food environments and their operating dynamics is essential to improving their healthiness. This study developed a conceptual model of organizational food environments. For this purpose, a comprehensive literature review was conducted, a first version of the conceptual model was prepared, a panel of experts was consulted, the model was improved, a second panel of experts was consulted, and the model was finalized. The model consists of four components (the institutional level, internal level of eating spaces, surroundings, and the decisional level) and 10 dimensions related to the institutional level and internal level of eating spaces (the availability, accessibility, affordability, quality, food and nutrition information, and promotion of foods, beverages, and culinary preparations and the availability, acceptability, convenience, ambience, and infrastructure of the eating space), as expressed in a graphical scheme. The conceptual model presented here offers innovative elements which contribute to understanding of the organizational food environment. It can guide the development of both assessment studies of food environments and interventions for their improvement.

Evolving Food Choices Among the Urban Indian Middle-Class: A Qualitative Study

One of the leading risk factors for an escalating obesity burden in India is non-nutritious choices. Underpinned by the nutrition transition theory, this qualitative inquiry was designed to understand the urban middle-class Indian consumers’ views about processed foods and rapidly changing food choices. The study consisted of two phases, the first phase consisted of focus group discussions pertaining to the definition and conception of processed foods and the second phase consisted of interviews regarding the changing food environment. A convenience sample of Indian consumers aged 40–65 years were recruited from Mumbai and Kochi to participate in focus group discussions (FGD1 – nine participants and FGD2 – seven participants) and semi-structured face-to-face interviews (N = 22). Both discussions and interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyze the transcribed data. Features of processed foods mentioned were chemical and physical processing, prolonged shelf life and poor nutritional quality. Factors influencing food choices and consumption of processed foods reported by participants could be categorized into changes in the socio-cultural environment and changes in the food environment. Changes in the socio-cultural environment included globalization and urbanization, long work days and sedentary living, rise in income levels and decrease in household cooking. Changes in the food environment included increased availability and accessibility of processed foods, replacement of traditional Indian diet with Western food, food as indicators of status, food advertisements and convenience. These results are consistent with nutrition transition theory and provide useful direction for public health policies aimed at promoting healthy diets.

Nature Ambience in a Lunch Restaurant Has the Potential to Evoke Positive Emotions, Reduce Stress, and Support Healthy Food Choices and Sustainable Behavior: A Field Experiment among Finnish Customers

Laboratory experiments have indicated that exposure to restorative ambiences in food environments can lead to beneficial outcomes for consumers, but there is little evidence if this positive effect holds true in real-life consumption conditions. Therefore, the aim of this study was to analyze the effects of lunch restaurant ambience on customers’ emotional responses, stress recovery, food choices, and generation of plate waste. The expectation was that ambience inducing positive emotional responses would lead to alleviated stress, healthier food choices, and reduced plate waste. A field experiment with a baseline and two experimental ambiences (‘nature ambience’ to induce positive emotions and ‘fast food ambience’ to induce less positive emotions) including visual and auditory stimuli was conducted in a lunch restaurant for one week per ambience. Emotional responses, and objective and subjective stress were measured from a subgroup of participants (n = 32). Food choices and plate waste were measured for all customers (n = 1610–1805 depending on the study week). During ‘nature ambience’ week, customers more often chose vegetarian dishes and generated less plate waste. The results on emotional responses and stress recovery were partially in line with the expectations. The study provides real-life evidence that restaurant ambience modification could lead to beneficial consequences for customers.

The sound of silence: Presence and absence of sound affects meal duration and hedonic eating experience

The interplay between external auditory cues in the eating environment and cognitive processes, such as distraction, may influence food intake, but how and the degree to which they do is unclear. We report an experiment designed to investigate the effects of different sonic atmospheres on meal duration, food intake and evaluations, and responses to the sonic eating environment. In a quasi-naturalistic cafeteria setting, participants (N = 248) were eating a lunch meal whilst being in one of four conditions: slow music, fast music, cafeteria noise, and silence. The results revealed that participants eating their lunch while exposed to some kind of background sound spent more time on their meal than those eating in silence. In terms of music tempo, slow music prolonged meal duration compared to fast music, but did not lead to increased intake. The appropriateness and liking of the sonic atmosphere were positively correlated with the overall pleasantness of the eating experience and liking of the food. The findings provide support for existing evidence documenting the importance of ambient sound in relation to food experiences and provide further insights into how individuals perceive and respond to sonic meal environments. Results are discussed in terms of recommendations for future design of eating environments in different contexts.

Relationship between Olfactory Function and BMI in Normal Weight Healthy Subjects and Patients with Overweight or Obesity

Smell plays a critical role in food choice and intake by influencing energy balance and body weight. Malnutrition problems or modified eating behaviors have been associated with olfactory impairment or loss. The obesity epidemic is a serious health problem associated with an increased risk of mortality and major physical comorbidities. The etiopathogenesis of obesity is complex and multifactorial, and one of the main factors contributing to the rapid increase in its incidence is the environment in which we live, which encourages the overconsumption of foods rich in energy, such as saturated fats and sugars. By means of the “Sniffin’ Sticks” test, we measured the olfactory threshold, discrimination and identification score (TDI score) in patients of the Obesity Center of the University Hospital (OC; n = 70) and we compared them with that of healthy normal weight controls (HC; n = 65). OC patients demonstrated a significantly lower olfactory function than HC subjects both general and specific for the ability to discriminate and identify odors, even when they were considered separately as females and males. For OC patients, a negative correlation was found between body mass index (BMI) and olfactory scores obtained by each subject, both when they were divided according to gender and when they were considered all together. Besides, normosmic OC patients showed a significantly lower BMI than hyposmic ones. A reduced sense of smell may contribute to obesity involving the responses of the cephalic phase, with a delay in the achievement of satiety and an excessive intake of high-energy foods and drinks.

Solo Dining at Home in the Company of ICT Devices

The consumption of a solo meal is often subject to negative associations. Studies indicate that solo diners use information and communication technology (ICT) devices such as smartphones, to mitigate negative experiences such as boredom and loneliness, especially when dining in a public context. However, we know less about the motivation to use such devices and consequent meal experiences in a private context. For this exploratory qualitative study, we asked participants to fill out a cultural probe kit to capture their dining experience and use of ICT devices over a period of seven days. Once completed, the content was discussed with participants during a semi-structured interview. Data was analyzed using thematic analysis in a deductive and inductive form leading to four themes: (1) The experience of eating with others; (2) The use of electronic devices while eating; (3) The meaning of food; and (4) Relaxing features and influences. Participants indicated that eating alone can be a pleasurable experience that people enjoy and perceive as relaxing. ICT devices were named to play an essential part in the dining experience. The entertainment that devices provide can mitigate feelings of loneliness and uncomfortable silence when eating by oneself. We reflect on the findings and point out potential design avenues for future studies.

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

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

Polish Adaptation of the Dutch Eating Behaviour Questionnaire (DEBQ): The Role of Eating Style in Explaining Food Intake-A Cross-Sectional Study

Knowledge of associations between emotional, external, and restrained eating with food choices is still limited due to the inconsistent results of the previous research. The aim of the study was to adopt the Dutch Eating Behavior Questionnaire (DEBQ) and then to examine the relationship between emotional, external, and restrained eating styles and dietary patterns distinguished on the basis of intake of fruit and vegetables (fresh and processed separately), fruit and/or vegetable unsweetened juices, sweets and salty snacks, and the adequacy of fruit and vegetable intake. The cross-sectional study was conducted in 2020, in a sample of 1000 Polish adults. The questionnaire consisted of the Dutch Eating Behavior Questionnaire, questions on selected food groups intake, and metrics. DEBQ structure was tested using both exploratory and confirmatory factor analysis (EFA, CFA) and structural equation modelling (SEM), while multi-group analysis was used to test measurement invariance. Logistic regression was applied to investigate the association between eating styles and dietary patterns, identified with the use of K-means cluster analysis. EFA, CFA and SEM revealed a three-factor, 29-item tool with satisfactory psychometric parameters. Restrained eating (ResEat) and external eating (ExtEat) were found to decrease chances of low intake of both favorable (fruit, vegetables, and unsweetened juices) and unfavorable (sweets and salty snacks) foods and increased the chances of their moderate intake. ResEat increased the probability of the high intake of favorable and moderate or high intake of unfavorable foods. ResEat and ExtEat were predisposed to adequate intake of fruit and vegetables while emotional eating had the opposite effect. Gender, education, and BMI were also found to determine food intake. Our results provide evidence that both eating styles and sociodemographic characteristics should be taken into account while explaining food intake as they may favor healthy and unhealthy eating in different ways.

Impact of COVID-19 lockdown on the perception of home meals and meal-related variables: a large-scale study within the Italian population during the acute phase of the pandemic

Italy was the first European country struck by the COVID-19 epidemic and experienced a national lockdown. This study explored the effect of lockdown on the perception of any meals prepared and/or conducted at home (home meals) and investigated which variables played a role in this. A group of Italians (n=3,060) not suspected/diagnosed as having COVID-19 (18-91 years old; 33% males) completed an online survey during the first lockdown (April 2020). Liking for home meals either increased (51% of the population) or did not vary (43%), while it decreased for only 6% of respondents. Total meal intake similarly either increased (51%) or remained unchanged (33%). Core variables describing meal perception (Liking for meal, Pleasure in meal preparation, Meal duration, Meal Time, Overall food intake, Snack intake) were positively associated with each other. Two clusters with different perceptions of home meals were found, characterised by an increased appreciation (Cl1, 61%) and an unchanged appreciation (Cl2, 39%), respectively. In the acute phase of lockdown, increased meal pleasure was associated with home togetherness (not living alone), cooking with others more often, having high cooking dynamism (use of different kitchen tools, engaging in online food-related activities like using online recipe/website for cooking, use of ready-to-eat meal delivery), and being young, a student or a worker (Cl1). Conversely, Cl2 showed an unchanged meal pleasure, and it was mostly associated with living alone (before and during lockdown), being elderly, retired, widowed, having a low degree of cooking-related activities and dedicating a small weekly budget to food. Variables strictly describing the meal were discussed. Lockdown did not homogenously affect the population in terms of meal pleasure, and high enjoyment of meals was related to high meal involvement. Younger subjects seemed to be more resilient and appreciated meals more due to high cooking dynamism, food-related activities and togetherness. Public health policies could consider these outputs to set up interventions that use meal-dedication activities to increase meal pleasure in vulnerable targets or in subjects experiencing poorly appreciated diets in similar future stressful situations.

A human voice, but not human visual image makes people perceive food to taste better and to eat more: "Social" facilitation of eating in a digital media

Food tastes better and people eat more when eating with others compared to eating alone. Although previous research has shown that watching television facilitates eating, the influencing factors regarding video content are unclear. We compared videos of a person speaking with those of only objects (food and a cell phone) in Experiment 1, and videos of groups of four people talking in Experiment 2. Half of these videos presented human voices (including the objects-only video), while the other half had no audio. Results showed participants rated the popcorn as tasting better and consumed more when eating alone while listening to someone talking, irrespective of whether the person was present or absent in the video in Experiment 1. A similar result was found in Experiment 2, irrespective of the increased number of people talking in the video. In Experiment 3, we assessed to what extent human voices contributed to an increase in food intake and the perceived taste of food by substituting sine-wave speech (SWS) for human voices used in Experiment 1 and found that the perceived taste of food and food intake were not facilitated when participants watched videos with SWS. The present study indicates that the human voice plays a crucial role in the perceived taste of food and consumption amount when people eat alone while watching television. Suggestions to improve food enjoyment when dining alone are discussed.

ESPEN guideline on hospital nutrition

In hospitals through Europe and worldwide, the practices regarding hospital diets are very heterogeneous. Hospital diets are rarely prescribed by physicians, and sometimes the choices of diets are based on arbitrary reasons. Often prescriptions are made independently from the evaluation of nutritional status, and without taking into account the nutritional status. Therapeutic diets (low salt, gluten-free, texture and consistency modified, …) are associated with decreased energy delivery (i.e. underfeeding) and increased risk of malnutrition. The European Society for Clinical Nutrition and Metabolism (ESPEN) proposes here evidence-based recommendations regarding the organization of food catering, the prescriptions and indications of diets, as well as monitoring of food intake at hospital, rehabilitation center, and nursing home, all of these by taking into account the patient perspectives. We propose a systematic approach to adapt the hospital food to the nutritional status and potential food allergy or intolerances. Particular conditions such as patients with dysphagia, older patients, gastrointestinal diseases, abdominal surgery, diabetes, and obesity, are discussed to guide the practitioner toward the best evidence based therapy. The terminology of the different useful diets is defined. The general objectives are to increase the awareness of physicians, dietitians, nurses, kitchen managers, and stakeholders towards the pivotal role of hospital food in hospital care, to contribute to patient safety within nutritional care, to improve coverage of nutritional needs by hospital food, and reduce the risk of malnutrition and its related complications.

The Relationship between Music and Food Intake: A Systematic Review and Meta-Analysis

Food intake has been shown to be related to several environmental factors including the presence of music. However, previous findings of the relationship between music and food intake are inconsistent. In the present study, a systematic review and meta-analysis was conducted to quantitatively review the extent to which music is associated with food intake as well as to investigate potential moderators that might have contributed to the heterogeneity of the existing findings. Literature was searched on four databases (i.e., PsycINFO, Web of Science, PubMed, and ProQuest Dissertations and Theses) and Google Scholar. Nine articles published from 1989 to 2020 met our inclusion criteria. A meta-analysis was carried out via a three-level random-effects model. The overall effect size (i.e., Hedges' g) was 0.19 (95% Confidence Interval: -0.003, 0.386; SE = 0.10, t = 1.99, p = 0.054), indicating a marginally significant but small effect size. Body Mass Index (F(1, 21) = 5.11, p = 0.035) was found to significantly contribute to the heterogeneity of effect sizes, with larger positive effects of music on food intake for individuals with higher BMI. However, music-related features did not significantly moderate the relationship between music and food intake. More experimental studies are needed to update the current meta-analysis and get a better understanding of this topic.

Using food network analysis to understand meal patterns in pregnant women with high and low diet quality

BACKGROUND

Little is known about how meal-specific food intake contributes to overall diet quality during pregnancy, which is related to numerous maternal and child health outcomes. Food networks are probabilistic graphs using partial correlations to identify relationships among food groups in dietary intake data, and can be analyzed at the meal level. This study investigated food networks across meals in pregnant women and explored differences by overall diet quality classification.

METHODS

Women were asked to complete three 24-h dietary recalls throughout pregnancy (n = 365) within a prospective cohort study in the US. Pregnancy diet quality was evaluated using the Healthy Eating Index-2015 (HEI, range 0-100), calculated across pregnancy. Networks from 40 food groups were derived for women in the highest and lowest HEI tertiles at each participant-labeled meal (i.e., breakfast, lunch, dinner, snacks) using Gaussian graphical models. Network composition was qualitatively compared across meals and between HEI tertiles.

RESULTS

In both HEI tertiles, breakfast food combinations comprised ready-to-eat cereals with milk, quick breads with sweets (e.g., pancakes with syrup), and bread with cheese and meat. Vegetables were consumed at breakfast among women in the high HEI tertile only. Combinations at lunch and dinner were more varied, including vegetables with oils (e.g., salads) in the high tertile and sugary foods with nuts, fruits, and milk in the low tertile at lunch; and cooked grains with fats (e.g., pasta with oil) in the high tertile and potatoes with vegetables and meat in the low tertile at dinner. Fried potatoes, sugar-sweetened beverages, and sandwiches were consumed together at all main meals in the low tertile only. Foods were consumed individually at snacks in both tertiles; the most commonly consumed food were fruits in the high HEI tertile and cakes & cookies in the low tertile.

CONCLUSIONS

In this cohort of pregnant women, food network analysis indicated that food combinations differed by meal and between HEI tertiles. Meal-specific patterns that differed between diet quality tertiles suggest potential targets to improve food choices at meals; the impact of meal-based dietary modifications on intake of correlated foods and on overall diet quality should be investigated in simulations and intervention studies.

TRIAL REGISTRATION

PEAS was registered with number NCT02217462 in Clinicaltrials.gov on August 13, 2014.

An augmented food strategy leads to complete energy compensation during a 15-day military training expedition in the cold

Soldiers on military expeditions usually fail to compensate for the increase in energy expenditure, with potential deleterious consequences. We therefore analyzed the characteristics of energy compensation in 12 male soldiers, during a 15-day expedition in the cold, while alleviating some of the contextual limitations of food intake (~20-MJ daily bags of easy-to-use, highly palatable and familiar foods with multiple and long breaks allowed during the day). Body and fat mass losses were low and moderate, respectively (-1.13 ± 1.42% and -19.5 ± 15.6%, respectively, p < .021). Mean energy intake (EI) was high (~16.3 MJ) and increased at each third of the expedition (15.3 ± 2.1, 16.1 ± 2.1, and 17.6 ± 2.0 for D1-5, D6-10 and D11-15, respectively, p < .012). This resulted in reaching a neutral energy balance as soon as the D6 to 10 period and reaching normal energy availability during D11 to 15. Participants only increased their EI during the mid-day (10:00-14:00) period (p = .002) whereas hunger and thirst only increased in the morning, with higher scores during D11-15 than D1-5 (p < .009). Last, the reward value of sweet foods was also higher during D11-15 than during D1-5 (p = .026). The changes in body mass were positively associated with EI (r = 0.598, p = .040) and carbohydrate intake (r = 0.622, p = .031). This study indicates that complete energy compensation can be reached in challenging field conditions when food intake is facilitated, offering some guidelines to limit energy deficit during operational missions.

Interventions to Promote Healthy Meals in Full-Service Restaurants and Canteens: A Systematic Review and Meta-Analysis

Out-of-home eating is increasing, but evidence about its healthiness is limited. The present systematic review and meta-analysis aimed to elucidate the effectiveness of full-service restaurant and canteen-based interventions in increasing the dietary intake, food availability, and food purchase of healthy meals. Studies from 2000-2020 were searched in Medline, Scopus, and Cochrane Library using the PRISMA checklist. A total of 35 randomized controlled trials (RCTs) and 6 non-RCTs were included in the systematic review and analyzed by outcome, intervention strategies, and settings (school, community, workplace). The meta-analysis included 16 RCTs (excluding non-RCTs for higher quality). For dietary intake, the included RCTs increased healthy foods (+0.20 servings/day; 0.12 to 0.29; p < 0.001) and decreased fat intake (-9.90 g/day; -12.61 to -7.19; p < 0.001), favoring the intervention group. For food availability, intervention schools reduced the risk of offering unhealthy menu items by 47% (RR 0.53; 0.34 to 0.85; p = 0.008). For food purchases, a systematic review showed that interventions could be partially effective in improving healthy foods. Lastly, restaurant- and canteen-based interventions improved the dietary intake of healthy foods, reduced fat intake, and increased the availability of healthy menus, mainly in schools. Higher-quality RCTs are needed to strengthen the results. Moreover, from our results, intervention strategy recommendations are provided.

Sensory-specific satiety, the variety effect and physical context: Does change of context during a meal enhance food intake?

Food variety has been shown to increase food intake, and sensory-specific satiety (a relative decrease in pleasantness of a food as it is consumed) has been proposed as the mechanism through which variety increases consumption. The aim of this study was to investigate whether variation of eating context can add to experienced meal variety and hence increase consumption even further. A total of 128 participants were assigned to one of four conditions in which they first ate a specific food item (ad libitum) until satiated, after which they consumed a second course ad libitum of either the same or a different food in either the same context or in a different context. We hypothesized that, compared to eating the same food in the same context during the second course, introducing a different food item or changing the context for the second course increases consumption (of the second course), and changing both food and context enhances food intake to a greater degree than only changing the food or changing the context. Results indicated that food variety (introducing a different food) significantly increased consumption in the second course, but that a context switch did not enhance consumption. These results suggest that there is little reason to believe that sensory-specific satiety is context specific.

Flavor alterations in cancer treatment: Extrinsic factors as a means of augmentation

Flavor, comprising taste, smell and somatosensory inputs, is commonly altered in patients undergoing chemotherapy resulting in malnutrition leading to cachexia. A narrative review considered taste and smell alterations associated with malignancies treated using chemotherapy and the various interventions proffered to lessen alterations. Many of the currently used interventions directed towards enhancing intrinsic factors of food appeared ineffective in encouraging intake of adequate nutrition to ward off complications of malnutrition. Counselling is used in some cases with positive results. The use of extrinsic influences commensurate with the principles of food behavior and gastronomy are considered as a means of providing purpose to patients to accommodate flavor loss which when integrated with counseling and appropriate intrinsic factors are potentially a means of curtailing malnutrition and enhancing the psychological status of the patient. The close association between the cephalic phase responses (CPRs) and the control of eating and digestive behaviors is multifaceted, and when the influences of taste and smell are diminished, other contributing factors guiding CPRs may compensate a deficit. The need for the application of a consistent lexicon is essential when describing taste and smell alterations.

Development of a Photographic Food Atlas as a Portion Size Estimation Kit for Malaysian

A photographic food atlas is a series of photographs showing different quantities of different foods. It serves as a portion size estimation aid (PSEA). In Malaysia, the existing food atlases, which display foods in exchanges and standard portion sizes, may not be representative of the actual sizes of the portions of food consumed by the local population. This paper aims to describe the development of a food atlas, namely the 'MY Food Album', and assess its usability as a PSEA. Thirty four participants (aged 31.6±20.9 y) served themselves, in a laboratory setting, what they considered to be typical, small, medium, and large portions of 23 amorphus food items. All food portions were weighed to obtain the mean and standard deviation of the range of food portion sizes to be displayed in the food atlas. Using standard camera and lighting settings, various local foods were photographed at an angle of 45º. A total of 393 food items were categorized into 14 food groups and presented as serial (n=101), guide (n=213) and range (n=79) photographs. The usability of MY Food Album was evaluated by six nutritionists and dietitians using an adapted questionnaire. The food atlas was perceived to be useful to aid in the quantification of food during dietary assessment. It was suggested that the function, dimension and application of fiducial markers be introduced in the food atlas to facilitate its use in size estimation. While MY Food Album was well-accepted as a PSEA, futher validation is required to evaluate the effectiveness of this newly developed food atlas in portion size estimation.