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Tucker JA, Buscemi J, Murphy JG, Reed DD, Vuchinich RE. Addictive behavior as molar behavioral allocation: Distinguishing efficient and final causes in translational research and practice. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:1-12. [PMID: 35787099 PMCID: PMC9811182 DOI: 10.1037/adb0000845] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Translational research on addictive behaviors viewed as molar behavioral allocation is critically reviewed. This work relates rates of behavior to rates of reinforcement over time and has been fruitfully applied to addictive behaviors, which involve excessive allocation to short-term rewards with longer term costs. METHOD Narrative critical review. RESULTS This approach distinguishes between final and efficient causes of discrete behaviors. The former refers to temporally extended behavior patterns into which the act fits. The latter refers to environmental stimuli or internal psychological mechanisms immediately preceding the act. Final causes are most clear when addictive behaviors are studied over time as a function of changing environmental circumstances. Discrete acts of addictive behavior are part of an extended/molar behavior pattern when immediate constraints on engagement are low and few rewarding alternatives are available. Research framed by efficient causes often use behavioral economic simulation tasks as individual difference variables that precede discrete acts. Such measures show higher demand for addictive commodities and steeper discounting in various risk groups, but whether they predict molar addictive behavior patterning is understudied. CONCLUSIONS Although efficient cause analysis has dominated translational research, research supports viewing addictive behavior as molar behavioral allocation. Increasing concern with rate variables underpinning final cause analysis and considering how study methods and temporal units of analysis inform an efficient or final cause analysis may advance understanding of addictive behaviors that occur over time in dynamic environmental contexts. This approach provides linkages between behavioral science and disciplines that study social determinants of health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Jalie A. Tucker
- University of Florida and Center for Behavioral Economic Health
Research, Gainesville, FL
| | | | | | - Derek D. Reed
- University of Kansas and Cofrin Logan Center for Addiction Research
& Treatment, Lawrence, KS
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Salcido A, Robles EH, Chaudhary K, Alvarado L, Iñiguez SD, Vargas-Medrano J, Diaz-Pacheco V, Villanos MT, Gadad BS, Martin SL. Association of ADHD and Obesity in Hispanic Children on the US-Mexico Border: A Retrospective Analysis. Front Integr Neurosci 2022; 15:749907. [PMID: 35069136 PMCID: PMC8766828 DOI: 10.3389/fnint.2021.749907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/12/2021] [Indexed: 11/16/2022] Open
Abstract
Pediatric obesity and Attention Deficit Hyperactivity Disorder (ADHD) are rising health concerns in the United States, especially among Hispanic children and adolescents. Research on Hispanic children and adolescents indicates disproportionately higher prevalence rates of obesity in this community but scant data on ADHD prevalence rates. In contrast, a plethora of research studies across the general population examines the relationship between childhood obesity and ADHD. In addition, there is a lack of research that examines the role of ethnicity and sub-ethnic group correlations in ADHD, particularly in the Hispanic population. Existing studies in the general population indicate ADHD may be a risk factor for being overweight compared to normal controls. The objective of the present study is to examine the prevalence of obesity in children with ADHD compared to children in the general population in a predominately Hispanic sample on the US-Mexico border. A total of 7,270 pediatric medical records were evaluated. The retrospective analysis included Body Mass Index (BMI) and related health variables, and ethnicity and showed that children with ADHD are more likely to be underweight. In conclusion, no significant relationship existed between obesity and ADHD among Hispanic children on the US-Mexico Border, and instead we found the opposite correlation.
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Affiliation(s)
- Alyssa Salcido
- Department of Psychiatry, Paul L Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, United States
| | - Eden Hernandez Robles
- Department of Psychiatry, Paul L Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, United States
| | - Kiran Chaudhary
- Department of Psychiatry, Paul L Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, United States
| | - Luis Alvarado
- Biostatistics and Epidemiology Consulting Lab, Texas Tech University Health Sciences Center El Paso, El Paso, TX, United States
| | - Sergio D. Iñiguez
- Department of Psychology, The University of Texas at El Paso, El Paso, TX, United States
| | - Javier Vargas-Medrano
- Department of Psychiatry, Paul L Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, United States
- Department of Psychiatry, Texas Tech University Health Sciences Center, El Paso, TX, United States
| | - Valeria Diaz-Pacheco
- Department of Psychiatry, Paul L Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, United States
- Department of Psychiatry, Texas Tech University Health Sciences Center, El Paso, TX, United States
| | - Maria Theresa Villanos
- Department of Pediatrics, Paul L. Foster School of Medicine, Texas Tech University Health Science Center, El Paso, TX, United States
| | - Bharathi S. Gadad
- Department of Psychiatry, Paul L Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, United States
- Department of Psychiatry, Texas Tech University Health Sciences Center, El Paso, TX, United States
- Bharathi S. Gadad,
| | - Sarah L. Martin
- Department of Psychiatry, Paul L Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, United States
- *Correspondence: Sarah L. Martin,
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Grøndahl MFG, Johannesen J, Kristensen K, Knop FK. Treatment of type 2 diabetes in children: what are the specific considerations? Expert Opin Pharmacother 2021; 22:2127-2141. [PMID: 34420454 DOI: 10.1080/14656566.2021.1954160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction: The number of individuals under 18 years of age with type 2 diabetes is increasing at an alarming rate worldwide. These patients are often characterized by obesity and they often experience a more rapid disease progression than adults with type 2 diabetes. Thus, focus on prevention and management of complications and comorbidities is imperative. With emphasis on weight loss and optimal glycemic control, treatment includes lifestyle changes and pharmacotherapy, which in this patient group is limited to metformin, liraglutide and insulin. In selected cases, bariatric surgery is indicated.Areas covered: This perspective article provides an overview of the literature covering pathophysiology, diagnosis, characteristics and treatment of pediatric type 2 diabetes, and outlines the gaps in our knowledge where further research is needed. The paper draws on both mechanistic studies, large scale intervention trials, epidemiological studies and international consensus statements.Expert opinion: Type 2 diabetes in pediatric patients is an increasing health care problem, and the current treatment strategies do not successfully meet the many challenges and obstacles in this patient group. Treatments must be early, intensive, multifaceted and durable. Also, prevention of obesity and type 2 diabetes in at-risk children should be addressed and prioritized on all levels.
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Affiliation(s)
- Magnus F G Grøndahl
- Center for Clinical Metabolic Research, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Johannesen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Pediatrics, Copenhagen University Hospital, Herlev and Gentofte, Denmark
| | - Kurt Kristensen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Steno Diabetes Center Aarhus - Children and Adolescence, Aarhus University, Aarhus, Denmark
| | - Filip K Knop
- Center for Clinical Metabolic Research, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Novo Nordisk Foundation for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Guarnizo-Herreño CC, Courtemanche C, Wehby GL. Effects of Contextual Economic Factors on Childhood Obesity. Matern Child Health J 2019; 23:1317-1326. [PMID: 31214948 DOI: 10.1007/s10995-019-02777-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To examine the association between changes in contextual economic factors on childhood obesity in the US. METHODS We combined data from 2003, 2007, and 2011/2012 National Surveys of Children's Health for 129,781 children aged 10-17 with 27 state-level variables capturing general economic conditions, labor supply, and the monetary or time costs of calorie intake, physical activity, and cigarette smoking. We employed regression models controlling for demographic factors and state and year fixed effects. We also examined heterogeneity in economic effects by household income. RESULTS Obesity risk increased with workforce proportion in blue-collar occupations, urban sprawl, female labor force participation, and number of convenience stores but declined with median household income, smoking ban in restaurants, and full service restaurants per capita. Most effects were specific to low income households, except for density of supercenters/warehouse clubs which was significantly associated with higher overweight/obesity risk only in higher income households. CONCLUSIONS FOR PRACTICE Changes in state-level economic factors related to labor supply and monetary or time cost of calorie intake may affect childhood obesity especially for children in low-income households. Policymakers should consider these effects when designing programs aimed at reducing childhood obesity.
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Affiliation(s)
- Carol C Guarnizo-Herreño
- Departamento de Salud Colectiva, Facultad de Odontología, Universidad Nacional de Colombia, Bogotá, Colombia
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Charles Courtemanche
- Department of Economics, Georgia State University, Atlanta, GA, USA
- National Bureau of Economic Research, Cambridge, MA, USA
| | - George L Wehby
- Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, IA, USA.
- National Bureau of Economic Research, Cambridge, MA, USA.
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Wilfley DE, Hayes JF, Balantekin KN, Van Buren DJ, Epstein LH. Behavioral interventions for obesity in children and adults: Evidence base, novel approaches, and translation into practice. AMERICAN PSYCHOLOGIST 2018; 73:981-993. [PMID: 30394777 PMCID: PMC6220709 DOI: 10.1037/amp0000293] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Obesity in adults has nearly doubled in the past 30 years and has risen similarly in children and adolescents. Obesity affects all systems of the body, and the serious health consequences of obesity include an increased risk for cardiovascular disease, such as Type 2 diabetes or high blood pressure, which are occurring at ever younger ages. The present article introduces traditional behavioral weight loss strategies designed to change energy-balance behaviors (i.e., dietary and physical activity behaviors) and the contexts within which these interventions have typically been delivered. The applicability of findings from behavioral economics, cognitive processing, and clinical research that may lead to more potent weight loss and weight loss maintenance interventions are also considered. Given the pervasiveness of obesity, this article concludes with a discussion of efforts toward wider scale dissemination and implementation of behavioral treatments designed to address obesity and to reduce the risk of cardiovascular disease. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
- Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine
| | - Jacqueline F Hayes
- Department of Psychological and Brain Sciences, Washington University in St. Louis
| | | | | | - Leonard H Epstein
- Division of Behavioral Medicine, Department of Pediatrics, School of Medicine and Biomedical Sciences, University at Buffalo
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Naess M, Sund ER, Holmen TL, Kvaløy K. Implications of parental lifestyle changes and education level on adolescent offspring weight: a population based cohort study - The HUNT Study, Norway. BMJ Open 2018; 8:e023406. [PMID: 30166309 PMCID: PMC6119406 DOI: 10.1136/bmjopen-2018-023406] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Obesity tends to cluster in families reflecting both common genetics and shared lifestyle patterns within the family environment. The aim of this study was to examine whether parental lifestyle changes over time, exemplified by changes in weight and physical activity, could affect offspring weight in adolescents and if parental education level influenced the relationship. DESIGN, SETTING AND PARTICIPANTS The population-based cohort study included 4424 parent-offspring participants from the Nord-Trøndelag Health Study, Norway. Exposition was parental change in weight and physical activity over 11 years, and outcome was offspring weight measured in z-scores of body mass index (BMI) in mixed linear models. RESULTS Maternal weight reduction by 2-6 kg was significantly associated with lower offspring BMI z-scores: -0.132 (95% CI -0.259 to -0.004) in the model adjusted for education. Parental weight change displayed similar effect patterns on offspring weight regardless of parents' education level. Further, BMI was consistently lower in families of high education compared with low education in the fully adjusted models. In mothers, reduced physical activity level over time was associated with higher BMI z-scores in offspring: 0.159 (95% CI 0.030 to 0.288). Associations between physical activity change and adolescent BMI was not moderated by parental education levels. CONCLUSION Lifestyle changes in mothers were associated with offspring BMI; reduced weight with lower-and reduced physical activity with higher BMI. Father's lifestyle changes, however, did not significantly affect adolescent offspring's weight. Overall, patterns of association between parental changes and offspring's BMI were independent of parental education levels, though adolescents with parents with high education had lower weight in general.
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Affiliation(s)
- Marit Naess
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Research and Development, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway
| | - Erik R Sund
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | - Turid Lingaas Holmen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Kirsti Kvaløy
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Research and Development, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway
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Nelson CC, Colchamiro R, Perkins M, Taveras EM, Leung-Strle P, Kwass J, Woo Baidal JA. Racial/Ethnic Differences in the Effectiveness of a Multisector Childhood Obesity Prevention Intervention. Am J Public Health 2018; 108:1200-1206. [PMID: 30024810 DOI: 10.2105/ajph.2018.304511] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To investigate racial/ethnic and language differences in the effectiveness of the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) study among children aged 2 to 4 years enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). METHODS We performed a multisector quasiexperimental study in 2 MA-CORD intervention communities and 1 comparison community. Using WIC data from 2010 to 2015, we examined intervention effect on child weight and behavior outcomes by child race/ethnicity and parental primary language using multilevel linear regression models with an interaction term. RESULTS Non-Hispanic Black children exposed to the intervention demonstrated a greater decrease in body mass index (BMI) than did other children (P < .05). Racial/ethnic minority children in the comparison site had greater increases in BMI than did their White counterparts (P < .05). There were no differences in intervention effectiveness by race/ethnicity or language for health behaviors. CONCLUSIONS White children demonstrated decreased BMI in both the intervention and control groups. However, intervention minority children demonstrated greater improvements in BMI than did control minority children. Public Health Implications. To reduce racial/ethnic disparities, we need to disseminate effective obesity prevention interventions during early childhood in low-income settings.
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Affiliation(s)
- Candace C Nelson
- Candace C. Nelson, Rachel Colchamiro, Peggy Leung-Strle, and JoAnn Kwass are with the Massachusetts Department of Public Health, Boston. Meghan Perkins and Elsie M. Taveras are with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA. Jennifer A. Woo Baidal is with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New York, NY
| | - Rachel Colchamiro
- Candace C. Nelson, Rachel Colchamiro, Peggy Leung-Strle, and JoAnn Kwass are with the Massachusetts Department of Public Health, Boston. Meghan Perkins and Elsie M. Taveras are with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA. Jennifer A. Woo Baidal is with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New York, NY
| | - Meghan Perkins
- Candace C. Nelson, Rachel Colchamiro, Peggy Leung-Strle, and JoAnn Kwass are with the Massachusetts Department of Public Health, Boston. Meghan Perkins and Elsie M. Taveras are with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA. Jennifer A. Woo Baidal is with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New York, NY
| | - Elsie M Taveras
- Candace C. Nelson, Rachel Colchamiro, Peggy Leung-Strle, and JoAnn Kwass are with the Massachusetts Department of Public Health, Boston. Meghan Perkins and Elsie M. Taveras are with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA. Jennifer A. Woo Baidal is with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New York, NY
| | - Peggy Leung-Strle
- Candace C. Nelson, Rachel Colchamiro, Peggy Leung-Strle, and JoAnn Kwass are with the Massachusetts Department of Public Health, Boston. Meghan Perkins and Elsie M. Taveras are with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA. Jennifer A. Woo Baidal is with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New York, NY
| | - JoAnn Kwass
- Candace C. Nelson, Rachel Colchamiro, Peggy Leung-Strle, and JoAnn Kwass are with the Massachusetts Department of Public Health, Boston. Meghan Perkins and Elsie M. Taveras are with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA. Jennifer A. Woo Baidal is with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New York, NY
| | - Jennifer A Woo Baidal
- Candace C. Nelson, Rachel Colchamiro, Peggy Leung-Strle, and JoAnn Kwass are with the Massachusetts Department of Public Health, Boston. Meghan Perkins and Elsie M. Taveras are with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA. Jennifer A. Woo Baidal is with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New York, NY
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Adding a reward increases the reinforcing value of fruit. Br J Nutr 2017; 117:611-620. [PMID: 28382893 DOI: 10.1017/s0007114517000381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Adolescents' snack choices could be altered by increasing the reinforcing value (RV) of healthy snacks compared with unhealthy snacks. This study assessed whether the RV of fruit increased by linking it to a reward and if this increased RV was comparable with the RV of unhealthy snacks alone. Moderation effects of sex, hunger, BMI z-scores and sensitivity to reward were also explored. The RV of snacks was assessed in a sample of 165 adolescents (15·1 (sd 1·5) years, 39·4 % boys and 17·4 % overweight) using a computerised food reinforcement task. Adolescents obtained points for snacks through mouse clicks (responses) following progressive ratio schedules of increasing response requirements. Participants were (computer) randomised to three experimental groups (1:1:1): fruit (n 53), fruit+reward (n 60) or unhealthy snacks (n 69). The RV was evaluated as total number of responses and breakpoint (schedule of terminating food reinforcement task). Multilevel regression analyses (total number of responses) and Cox's proportional hazard regression models (breakpoint) were used. The total number of responses made were not different between fruit+reward and fruit (b -473; 95 % CI -1152, 205, P=0·17) or unhealthy snacks (b410; 95 % CI -222, 1043, P=0·20). The breakpoint was slightly higher for fruit than fruit+reward (HR 1·34; 95 % CI 1·00, 1·79, P=0·050), whereas no difference between unhealthy snacks and fruit+reward (HR 0·86; 95 % CI 0·62, 1·18, P=0·34) was observed. No indication of moderation was found. Offering rewards slightly increases the RV of fruit and may be a promising strategy to increase healthy food choices. Future studies should however, explore if other rewards, could reach larger effect sizes.
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