Associating a prototypical forbidden food item with guilt or celebration: Relationships with indicators of (un)healthy eating and the moderating role of stress and depressive symptoms

The underlying role of food guilt in adolescent food choice: A potential conceptual model for adolescent food choice negotiations under circumstances of conscious internal conflict

Food choice decisions are challenging to conceptualise, and literature is lacking specific to adolescent food choice decisions. Understanding adolescent nutrition and food choice is becoming increasingly important. This research aims to understand what influences the food choices of Irish adolescents, and the mental negotiations occurring in food-based decisions. Additionally, it aims to develop a holistic conceptual model of food choice, specific to adolescents. A qualitative study was conducted in N = 47 Irish adolescents, via focus group discussions using vignettes to introduce discussion topics around food and eating habits. Data were analysed using reflexive thematic analysis, involving both semantic and latent analysis. Thirteen distinct factors related to adolescent food choices were discussed, forming one main theme and three inter-linking subthemes. The main theme relates to food choice being multi-factorial in nature, needing a balance of priorities through internal negotiations for food choice with the aim of reducing food guilt. This can change depending on the social setting. Social concerns and food guilt appear to play a strong role in adolescent food choice, with adolescents feeling guilty for eating unhealthy food, wasting food, or spending/wasting money on food. A conceptual model for food choice in adolescents was developed, named a "Food Choice Funnel", incorporating a specific "Food Guilt Matrix". While we should encourage healthy eating and a healthy lifestyle, it is important to understand the value placed on the social component to eating among adolescents, since they have increasing social interactions and occasions where choosing health-promoting foods may be more challenging. Healthy eating messages should be designed in a balanced manner to support healthy growth and development, while limiting the potential to induce feelings of guilt among adolescents.

Perspectives on Healthy Eating of Adult Populations in High-Income Countries: A Qualitative Evidence Synthesis

BACKGROUND

Understanding how individuals currently perceive healthy eating is essential for developing food policies and dietary recommendations that improve the health and well-being of populations. The purpose of this qualitative evidence synthesis was to systematically outline the views and understandings of healthy eating, focusing on how foods are classified as healthy and unhealthy and what meanings are attached to food and eating by the general adult population in high-income countries.

METHODS

A systematic search of four electronic databases was conducted and yielded 24 relevant primary qualitative studies of generally healthy, community-dwelling adults.

RESULTS

Thematic synthesis of the included studies identified three analytic themes: constructions of healthy and unhealthy eating, considerations on dietary recommendations, and meanings attached to food and eating. Study participants generally understood what constitutes a healthy and unhealthy diet which was in line with dietary recommendations, but those of lower socioeconomic status exhibited gaps in nutrition knowledge. Participants expressed diverse opinions on dietary recommendations, including skepticism and a lack of trust. Food and eating were associated with various meanings, including pleasure, stress relief, and feelings of guilt. Moral, health, and sociocultural considerations also played a role in dietary behaviors.

CONCLUSIONS

The findings suggest that improving population diet requires considering how dietary recommendations are phrased and communicated to ensure that healthy eating is associated with pleasure and immediate well-being. This review provides valuable insights for developing consumer-oriented, practicable, and acceptable food policies and dietary recommendations that effectively improve population health and well-being.

Timing of chocolate intake affects hunger, substrate oxidation, and microbiota: A randomized controlled trial

Eating chocolate in the morning or in the evening/at night, may differentially affect energy balance and impact body weight due to changes in energy intake, substrate oxidation, microbiota (composition/function), and circadian-related variables. In a randomized controlled trial, postmenopausal females (n = 19) had 100 g of chocolate in the morning (MC), in the evening/at night (EC), or no chocolate (N) for 2 weeks and ate any other food ad libitum. Our results show that 14 days of chocolate intake did not increase body weight. Chocolate consumption decreased hunger and desire for sweets (P < .005), and reduced ad libitum energy intake by ~300 kcal/day during MC and ~150 kcal/day during EC (P = .01), but did not fully compensate for the extra energy contribution of chocolate (542 kcal/day). EC increased physical activity by +6.9%, heat dissipation after meals +1.3%, and carbohydrate oxidation by +35.3% (P < .05). MC reduced fasting glucose (4.4%) and waist circumference (-1.7%) and increased lipid oxidation (+25.6%). Principal component analyses showed that both timings of chocolate intake resulted in differential microbiota profiles and function (P < .05). Heat map of wrist temperature and sleep records showed that EC induced more regular timing of sleep episodes with lower variability of sleep onset among days than MC (60 min vs 78 min; P = .028). In conclusion, having chocolate in the morning or in the evening/night results in differential effects on hunger and appetite, substrate oxidation, fasting glucose, microbiota (composition and function), and sleep and temperature rhythms. Results highlight that the "when" we eat is a relevant factor to consider in energy balance and metabolism.

Think positive! Emotional response to assertiveness in positive and negative language promoting preventive health behaviors

OBJECTIVE

There is insufficient evidence for the effectiveness of various tones of communication in modifying health behaviours. We examine the moderating role of assertiveness in the effect of positive/negative language on emotional responses (optimism, self-efficacy, and guilt), and resulting preventive health behaviours.

DESIGN

Three experiments were employed. An online experiment tests the relationship between positive/negative language and assertiveness when people communicate about healthful eating. Next, a field study examines the moderating effect of assertiveness in positive and negative language encouraging using sunscreen among street passers-by. Third, an online study explores whether the effect of assertiveness in positive and negative messages on hand-washing intentions is mediated by increased optimism and self-efficacy, and decreased guilt, respectively.

RESULTS

Positive language increases compliance when expressed assertively because the assertive tone emphasises optimism and self-efficacy. Conversely, negative communication is more effective when expressed non-assertively, because of the replenishing effect of the gentler tone on the guilt evoked by the negative communication.

CONCLUSION

Assertiveness serves as an intensifier of what is being communicated. When considering whether to employ positive or negative language in health messaging, assertiveness should be considered as part of the design of effective health communication strategies leading to health promoting behaviour change.

Low-calorie sweeteners in the human diet: scientific evidence, recommendations, challenges and future needs. A symposium report from the FENS 2019 conference

Overconsumption of free sugars, particularly from sugar-sweetened beverages (SSB), has potential negative health impacts. Implementation of a range of public health strategies is needed to reduce intakes of free sugars, including reducing portion sizes, promoting healthier dietary choices and reformulating foods and beverages. Although low-calorie sweeteners (LCS) are a useful tool for reducing energy intake and control glucose response when consuming sweet foods and drinks, several opinions persist about the adverse health effects of LCS, many of which are based on poor, little or no scientific evidence. This symposium report summarises key messages of the presentations and related discussions delivered at a scientific symposium at the 13th European Nutrition Conference (FENS 2019). These presentations considered the scientific evidence and current recommendations about the use and potential benefits of LCS for human health, with a particular focus on current evidence in relation to body weight and glycaemic control. Many of the studies to date on LCS have focused on low-calorie sweetened beverages (LCSB); however, the psychological and behavioural factors influencing consumer beliefs and consumption of LCSB need to be further explored. Current recommendations for LCS use are described, including the conclusions from a recent expert consensus report identifying the challenges that remain with LCS research. Finally, existing knowledge gaps and future actions are described, as well as two large ongoing research projects: SWITCH and SWEET.

Investigating the Efficacy of Genetic, Environmental, and Multifactorial Risk Information When Communicating Obesity Risk to Parents of Young Children

BACKGROUND

Effectively communicating with parents about children's obesity risk is of critical importance for preventive medicine and public health.

PURPOSE

The current study investigates the efficacy of communications focused on two primary causes of obesity: genes and environment.

METHODS

We compared parental feeding responses to messages focused on (i) genetics alone, (ii) family environment alone, (iii) genetics-family environment interaction (G × FE), and (iv) no causal message. We also examined whether parental guilt mediates the effect of message type on feeding. Our sample consisted of 190 parents, half mothers and half fathers, of children 3-7 years old. After receiving one of the four types of messages, parents chose foods for their child using the Virtual Reality Buffet measure. Parents responded to questionnaires in the lab and at 1-week follow-up.

RESULTS

In the VR Buffet, parents did not feed their children differently in message provision conditions versus control. There were, however, differences among message provision conditions wherein mothers who received any genetic information chose higher-calorie meals in the VR Buffet. At 1-week follow-up, parents who received information about genetics alone reported feeding their child more junk food and fatty meat on self-report food frequency assessments; there were no such differences for sugary beverages, sugary foods, or fast foods. Parental guilt was typically higher for participants who received family environment information alone but did not mediate the relation between information provision and feeding outcomes.

CONCLUSIONS

While none of the messages improved feeding above the control condition, GxFE messages were associated with a better overall profile of outcomes. As such, it may be beneficial for messaging for parents about children's obesity risk to include content that reflects the complexity of genetic and environmental contributions to obesity risk.

Barriers and Facilitators to Healthy Eating among Adult Food Bank Users

Healthy eating relates to improved health, yet adult food bank users report difficulty accessing healthy foods. Registered nurses can promote healthy eating for food bank recipients by understanding perceived obstacles and facilitators. Urban food bank users completed a survey, and qualitative content analysis was used to analyze four open-ended questions regarding perceptions of healthy eating. In total, 196 adults were included in analysis. Two main categories were identified as perceived facilitators and barriers to healthy eating. Themes from the facilitator category included internal resources and external resources. Themes from the barrier category were personal challenges and environmental issues. Healthy eating is a complex behavior that requires personal motivation, skills, and social/environmental supports to be successfully executed among food bank recipients. Nurses should advocate to leverage food bank resources for healthier eating by offering nurtition counseling at events, optimizing access to fresh fruits and vegetables, and decreasing unhealthy food options.

Understanding the food-family relationship: A qualitative research in a Chilean low socioeconomic context

Our life is comprised of, among other things, many food and eating decisions. Therefore, we are in a constant relationship with food. Although many health providers and researchers have recommended having a positive relationship with food for better health and well-being, what the human relationship with food entails is still unclear. The aim of this study is to explore the relationship with food among families in Chile, a country that has the highest rate of obesity among OECD countries. In this qualitative study, we conducted eight focus groups in three regions of Chile (North, Center, and South). We recruited women living with their partners and children who represented the family point of view. For data analysis, we used the Atlas.ti program and conducted a thematic analysis. We found that the family relationship with food had five dimensions: (1) An identity dimension that allowed families to describe themselves or some of their family members; (2) an emotional dimension in which family expressed feelings and emotions through food; (3) a social dimension in which family members got together through food; (4) a health dimension in which family related to food to obtain benefits from it or to avoid enemy food; (5) a practical dimension in which families were organized around food tasks. Our findings show that the relationship that Chilean families have with food is a complex phenomenon. All the dimensions should be taken in consideration to create or improve interventions that seek to improve eating habits or prevent nutrition-related diseases from a family perspective.

You won't regret it (or love it) as much as you think: impact biases for everyday health behavior outcomes

When predicting the future, people tend to overestimate the intensity of their emotions, a phenomenon known as the impact bias. Design: In two studies, we examined the impact bias for health outcomes. In Study 1, participants were randomized to think about a negative health outcome in the future or one in the past. In Study 2, participants came to the laboratory and were asked to predict and report their emotions surrounding an actual health outcome (consuming an unhealthy food). Results: In both studies, an impact bias emerged. In Study 1, participants thinking about an outcome in the future estimated more negative emotion than those thinking about an outcome in the past. In Study 2, when facing an actual health outcome, participants anticipated more negative and positive emotion than they experienced. Impact biases were also associated with behavioral motivation - desire to change the outcome (Study 1) and increased preventive intentions (Study 2). Additional analyses revealed that regret was a particularly important emotion. Conclusion: Although research has highlighted an impact bias for severe health outcomes like disease, these studies provide evidence of an impact bias for health outcomes generally. They also suggest that the bias may have implications for behavior intentions.

Association of parental guilt with harmful versus healthful eating and feeding from a virtual reality buffet

OBJECTIVE

Parents often report guilt about what they feed their child, but no studies have examined how this guilt might affect their child-feeding or own eating behavior. Some studies suggest that guilt motivates healthy behaviors, yet others show that guilt impairs the self-control needed to abstain from unhealthy behaviors.

METHOD

One hundred ninety parents reported how guilty they felt about their current child-feeding habits. Parents then chose food for their child in a virtual reality buffet and reported their intentions to improve child-feeding and own eating behavior in the future. Finally, parents were offered candy while they completed an unrelated survey.

RESULTS

Parents with greater guilt reported stronger intentions to improve both feeding (b = .27, p = .010) and eating (b = .21, p = .019) in the future. However, among parents with higher (but not lower) BMI, those who reported greater guilt served more unhealthy foods for their child in the buffet (b = .32, p = .010) and were more likely to eat candy at the end of the study (b = .92, p = .004). Further analyses revealed that guilt only predicted greater feeding intentions when parents had served relatively more unhealthy foods in the buffet (b = .43, p < .001).

CONCLUSIONS

Findings echo the mixed conceptualization of guilt shown in previous literature on health behavior. More research is necessary to understand the long-term influence of guilt on eating and feeding behavior and the circumstances under which guilt is associated with detrimental versus healthy behavior. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Do low-calorie sweetened beverages help to control food cravings? Two experimental studies

Low-calorie sweetened (LCS) beverages may help consumers to satisfy hedonic food cravings without violating dieting goals, however this remains unexplored. The present research investigated the effect of priming hedonic eating motivations on ad libitum energy intake in frequent and non-consumers of LCS beverages. It was hypothesised that energy intake would be greater after the hedonic eating prime relative to a control prime in non-consumers, but that frequent LCS beverage consumers would be protected from this effect. In Study 1 (N = 120), frequent and non-consumers were exposed to either chocolate or neutral cues (craving vs. control condition) and then completed a beverage-related visual probe task with concurrent eye-tracking. Ad libitum energy intake from sweet and savoury snacks and beverages (including LCS) was then assessed. Study 2 followed a similar protocol, but included only frequent consumers (N = 172) and manipulated the availability of LCS beverages in the ad libitum eating context (available vs. unavailable). Measures of guilt and perceived behavioural control were also included. In Study 1, as hypothesised, non-consumers showed greater energy intake in the craving condition relative to the control condition, but frequent consumers had similar energy intake in both conditions. Frequent consumers (but not non-consumers) also demonstrated an attentional bias for LCS beverage stimuli compared to both sugar and water stimuli. In contrast, in Study 2 frequent consumers showed greater energy intake in the craving condition relative to the control condition; however, overall energy intake was significantly greater when LCS beverages were unavailable compared to when they were available. Ratings of guilt were higher and perceived control was lower in the LCS-unavailable condition relative to the LCS-available condition. Conclusions: LCS beverages did not consistently protect consumers from craving-induced increases in energy intake. However, frequent consumers consumed fewer calories overall when LCS beverages were available (relative to unavailable), as well as perceiving more control over their food intake and feeling less guilty.

A Meta-Analysis of the Effectiveness of Guilt on Health-Related Attitudes and Intentions

Guilt appeals are successful in encouraging healthy behaviors as proved by many studies. However, there has been no previous systematic review of guilt research in health domain. Thus, a meta-analysis of eight studies (2,061 subjects) was conducted to examine the effectiveness of guilt on health-related attitudes and intentions. The result revealed a strong positive overall effect of guilt (r = .49, 95% CI 0.31-0.64) despite the heterogeneity. Guilt had a stronger power in changing attitudes/intentions when paired with text-only messages than text-picture mixed messages. For studies using a college sample, the percentage of females marginally moderated the effect of guilt. Whether a message was self focused or other focused did not significantly moderate the effect of guilt. Future directions and practical implications are provided.

Food addiction: an evolving nonlinear science

The purpose of this review is to familiarize readers with the role that addiction plays in the formation and treatment of obesity, type 2 diabetes and disorders of eating. We will outline several useful models that integrate metabolism, addiction, and human relationship adaptations to eating. A special effort will be made to demonstrate how the use of simple and straightforward nonlinear models can and are being used to improve our knowledge and treatment of patients suffering from nutritional pathology. Moving forward, the reader should be able to incorporate some of the findings in this review into their own practice, research, teaching efforts or other interests in the fields of nutrition, diabetes, and/or bariatric (weight) management.