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Elsworth RL, Hinton EC, Flynn AN, Merrell LH, Hamilton-Shield JP, Lawrence NS, Brunstrom JM. Development of Momentary Appetite Capture (MAC): A versatile tool for monitoring appetite over long periods. Appetite 2024; 194:107154. [PMID: 38081544 DOI: 10.1016/j.appet.2023.107154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 01/08/2024]
Abstract
Understanding how an intervention impacts appetite in real-life settings and over several days remains a challenging and under-explored research question. To this end, we developed Momentary Appetite Capture (MAC), a form of ecological momentary assessment that combines automated text messaging with an online platform. Participants report their appetite using visual analogue scales (hunger, desire to eat, and fullness) and a virtual portion-size selection task. In two separate studies, we assessed the feasibility and test-retest reliability of MAC. Participants were prompted every 2 hours over a 14-hour window, and they repeated this assessment over two consecutive weekdays. For each participant, we calculated a daily time-averaged area under the curve (AUC) for each appetite measure. In Study One (N = 25) time-averaged AUC was significantly positively correlated across test days for hunger (r = 0.563, p = .003), desire to eat (r = 0.515, p = .008) and prospective portion size (r = 0.914, p < .001), but not for fullness (r = 0.342, p = .094). Participants completed 95% of MACs (380 of 400), and we used participant feedback to improve the MAC tool and study protocol for Study Two. In Study Two (N = 31), 94% of MACs were completed (468 of 496). Across days, time-averaged AUC was significantly positively correlated for hunger (r = 0.595, p = < .001), fullness (r = 0.501, p = .004), desire to eat (r = 0.585, p < .001), and prospective portion size (r = 0.757, p < .001). Together, these studies suggest that MAC could be an acceptable and reliable tool to track appetite throughout the day. In the future, MAC could be used to explore the impact of weight-loss interventions on natural fluctuations in appetite.
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Affiliation(s)
- Rebecca L Elsworth
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, UK.
| | - Elanor C Hinton
- NIHR Bristol Biomedical Research Centre, University of Bristol and University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Annika N Flynn
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, UK
| | - Lucy H Merrell
- Centre for Nutrition, Exercise and Metabolism, Department for Health, University of Bath, Bath, UK
| | - Julian P Hamilton-Shield
- NIHR Bristol Biomedical Research Centre, University of Bristol and University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Jeffrey M Brunstrom
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, UK; NIHR Bristol Biomedical Research Centre, University of Bristol and University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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Brunstrom JM, Flynn AN, Rogers PJ, Zhai Y, Schatzker M. Human nutritional intelligence underestimated? Exposing sensitivities to food composition in everyday dietary decisions. Physiol Behav 2023; 263:114127. [PMID: 36787811 DOI: 10.1016/j.physbeh.2023.114127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/03/2023] [Accepted: 02/11/2023] [Indexed: 02/16/2023]
Abstract
The social and cultural significance of food is woven into every aspect of our dietary behaviour, and it contributes to our complex interaction with food. To find order within this complexity scientists often look for dietary 'universals' - phenomena or basic principles that guide our food choice and meal size, irrespective of wider context. One such idea is that taste characteristics provide a signal for dietary composition (e.g., sweet taste signals carbohydrate). Others have suggested that behaviour is guided by learning and is based on associations that form between the flavour of a food and its post-ingestive effects. Despite a large body of research, evidence supporting both processes is equivocal, leading some to conclude that humans are largely indifferent to food composition. Here, we argue that human abilities to gauge the nutritional composition or value of food have been underestimated, and that they can be exposed by embracing alternative methods, including cross-cultural comparisons, large nutrition surveys, and the use of virtual portion-selection tools. Our group has focused on assessments of food choice and expected satiety, and how comparisons across everyday foods can reveal non-linear relationships with food energy density, and even the potential for sensitivity to micronutrient composition. We suggest that these abilities might reflect a complex form of social learning, in which flavour-nutrient associations are not only formed but communicated and amplified across individuals in the form of a cuisine. Thus, rather than disregarding sociocultural influences as extraneous, we might reimagine their role as central to a process that creates and imbues a 'collective dietary wisdom.' In turn, this raises questions about whether rapid dietary, technological, and cultural change disrupts a fundamental process, such that it no longer guarantees a 'nutritional intelligence' that confers benefits for health.
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Affiliation(s)
- Jeffrey M Brunstrom
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom; NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston, NHS Foundation Trust and University of Bristol, United Kingdom.
| | - Annika N Flynn
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Peter J Rogers
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Yujia Zhai
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Mark Schatzker
- Modern Diet and Physiology Research Center, Affiliated with Yale School of Medicine, Yale University, United States
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Caballero S, Moënne-Loccoz C, Delgado M, Luarte L, Jimenez Y, Galgani JE, Perez-Leighton CE. Eating contexts determine the efficacy of nutrient warning labels to promote healthy food choices. Front Nutr 2023; 9:1026623. [PMID: 36687700 PMCID: PMC9852898 DOI: 10.3389/fnut.2022.1026623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 12/14/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction Unhealthy food choices increase the risk of obesity and its co-morbidities. Nutrition labels are a public health policy that aims to drive individuals toward healthier food choices. Chile has been an example of this policy, where mandatory nutrient warning labels (NWL) identify processed foods high in calories and critical nutrients. Eating contexts influence individual food choices, but whether eating contexts also influence how NWL alter the decision process and selection during food choice is unknown. Methods In an online mouse-tracking study, participants prompted to health, typical, or unrestricted eating contexts were instructed to choose between pairs of foods in the presence or absence of NWL. Conflict during choices was analyzed using mouse paths and reaction times. Results NWL increased conflict during unhealthy food choices and reduced conflict during healthy choices in all contexts. However, the probability that NWL reversed an unhealthy choice was 80% in a healthy, 37% in a typical, and 19% in an unrestricted context. A drift-diffusion model analysis showed the effects of NWL on choice were associated with an increased bias toward healthier foods in the healthy and typical but not in the unrestricted context. Discussion These data suggest that the efficacy of NWL to drive healthy food choices increases in a healthy eating context, whereas NWL are less effective in typical or unrestricted eating contexts.
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Affiliation(s)
- Sara Caballero
- Departamento de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile,Programa de Magister en Nutrición, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cristóbal Moënne-Loccoz
- Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio Delgado
- Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis Luarte
- Departamento de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile,Programa Interdisciplinario de Neurociencia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Yanireth Jimenez
- Departamento de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - José E. Galgani
- Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile,Departamento de Nutrición, Diabetes y Metabolismo, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudio E. Perez-Leighton
- Departamento de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile,Programa Interdisciplinario de Neurociencia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile,*Correspondence: Claudio E. Perez-Leighton,
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Embling R, Lee MD, Price M, Wilkinson LL. Testing an online measure of portion size selection: a pilot study concerned with the measurement of ideal portion size. Pilot Feasibility Stud 2021; 7:177. [PMID: 34535184 PMCID: PMC8446476 DOI: 10.1186/s40814-021-00908-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 08/31/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Portion size is known to be a key driver of food intake. As consumed portions are often pre-planned, 'ideal portion size'-an individual's preferred meal size selected prior to eating-has been identified as a strong predictor of actual consumption. However, assessments of ideal portion size have predominantly relied on laboratory-based computer tasks, limiting use online. Therefore, this cross-sectional study sought to pilot test the validity of a web-based tool to measure ideal portion size. METHODS In an online study (N = 48), participants responded to images of a range of foods. Each food was photographed in a series of different portions and loaded into an 'image carousel' that would allow participants to change the size of the displayed portion by moving a slider left-to-right. Using this image carousel, participants selected their ideal portion size. They also completed measures of expected satiety and expected satiation and self-reported their age and body mass index (BMI). A non-parametric correlation matrix was used to explore associations between ideal portion size and identified predictors of food intake. RESULTS Supporting convergent validity of this measure, ideal portion size was significantly correlated with expected satiety (rs = .480) and expected satiation (rs = -.310) after controlling for effects of baseline hunger and fullness, consistent with past research. Similarly, supporting divergent validity of this measure, ideal portion size was not significantly correlated with age (rs = -.032) or BMI (rs = -.111,). CONCLUSIONS Pilot results support the validity of this web-based portion size selection tool used to measure ideal portion size, though further research is needed to validate use with comparisons to actual food intake.
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Affiliation(s)
- Rochelle Embling
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, SA2 8PP, UK.
| | - Michelle D Lee
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, SA2 8PP, UK
| | - Menna Price
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, SA2 8PP, UK
| | - Laura L Wilkinson
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, SA2 8PP, UK
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Hamm JD, Klatzkin RR, Herzog M, Tamura S, Brunstrom JM, Kissileff HR. Recalled and momentary virtual portions created of snacks predict actual intake under laboratory stress condition. Physiol Behav 2021; 238:113479. [PMID: 34058220 DOI: 10.1016/j.physbeh.2021.113479] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 05/05/2021] [Accepted: 05/26/2021] [Indexed: 12/31/2022]
Abstract
Virtual portion tasks have been used to predict food intake in healthy individuals, severity of illness in individuals with anorexia nervosa, and weight loss in bariatric surgery patients. Whether portion creation in response to a recalled interpersonal stress ("recalled stress portions") could be used as a proxy for ad lib intake, after a stressor, remains untested, and the mechanism supporting this relationship is unclear. The present study's goals were: 1) to validate virtual portion tasks as proxies for actual food intake in a stressful context and 2) to test a causal pathway in which these virtual stress portions predict ad lib intake after stress. We proposed that this relationship is mediated by virtual portions created the moment after laboratory stress or rest manipulation (momentary portions), and before the participant actually ate food. At screening, 29 healthy undergraduate white women created virtual portions of eight snacks (apples, olives, potato chips, pretzels, caramel popcorn, milk chocolate) that they typically eat and also portions they recall eating in response to a stressful interpersonal situation. In addition, after a Trier Social Stress Test, or a rest period, on separate days in counterbalanced order, participants created 'momentary' virtual portions of the same snacks presented during screening, and then were given potato chips, mini golden Oreos, and M&Ms to eat. Recalled stress (b = 0.07 ± 0.02, p = 0.003), and momentary stress (b = 0.12 ± 0.02, p = 0.00001), portions of milk chocolate accounted for 29% and 51%, respectively, of the variance in ad lib stress intake of M&Ms. Typical (b = 0.15 ± 0.07, p = 0.03), and momentary rest (b = 0.21 ± 0.06, p = 0.002), portions of chips accounted for 16% and 31%, respectively, of the variance in ad lib rest intake of chips. The causal pathway from recalled stress portion to ad lib stress snack intake was completely mediated by momentary stress portion for milk chocolate and M&Ms (β = 0.04 ± 0.02, z = 2.4, p = 0.0154). These findings illustrate the planning and recall components of eating in response to stress, but not necessarily under rest conditions. This recalled stress virtual portion paradigm has clinical and research value in that it can detect those who overconsume in response to stress.
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Affiliation(s)
- Jeon D Hamm
- Institute of Human Nutrition, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA; Diabetes, Obesity, and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Division of Endocrinology, Department of Medicine, Mount Sinai Morningside Hospital, New York, NY, USA.
| | | | - Musya Herzog
- Division of Endocrinology, Department of Medicine, Mount Sinai Morningside Hospital, New York, NY, USA; Department of Clinical Psychology, Teacher's College, Columbia University, New York, NY, USA
| | - Shoran Tamura
- Department of Medicine, New York Obesity Nutrition Research Center & Division of Endocrinology, Columbia University, New York, NY, USA
| | | | - Harry R Kissileff
- Diabetes, Obesity, and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Division of Endocrinology, Department of Medicine, Mount Sinai Morningside Hospital, New York, NY, USA.
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Pink AE, Cheon BK. Development of a Simplified Portion Size Selection Task. Foods 2021; 10:foods10051121. [PMID: 34070072 PMCID: PMC8158092 DOI: 10.3390/foods10051121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 12/19/2022] Open
Abstract
Portion size is an important determinant of energy intake and the development of easy to use and valid tools for measuring portion size are required. Standard measures, such as ad libitum designs and currently available computerized portion selection tasks (PSTs), have several limitations including only being able to capture responses to a limited number of foods, requiring participants’ physical presence and logistical/technical demands. The objective of the current study was to develop and test robust and valid measures of portion size that can be readily prepared by researchers and be reliably utilized for remote online data collection. We developed and tested two simplified PSTs that could be utilized online: (1) portion size images presented simultaneously along a horizontal continuum slider and (2) multiple-choice images presented vertically. One hundred and fifty participants (M = 21.35 years old) completed both simplified PSTs, a standard computerized PST and a series of questionnaires of variables associated with portion size (e.g., hunger, food item characteristics, Three Factor Eating Questionnaire). We found average liking of foods was a significant predictor of all three tasks and cognitive restraint also predicted the two simplified PSTs. We also found significant agreement between the standard PST and estimated portion sizes derived from the simplified PSTs when accounting for average liking. Overall, we show that simplified versions of the standard PST can be used online as an analogue of estimating ideal portion size.
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Affiliation(s)
- Aimee E. Pink
- School of Social Sciences, Nanyang Technological University, Singapore 639818, Singapore;
- Department of Psychology, Swansea University, Swansea SA2 8PP, UK
| | - Bobby K. Cheon
- School of Social Sciences, Nanyang Technological University, Singapore 639818, Singapore;
- Singapore Institute for Clinical Sciences, A*STAR, Singapore 117599, Singapore
- Correspondence: ; Tel.: +65-6592-1570
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