Reasons for eating 'unhealthy' snacks in overweight and obese males and females

Taste sensitivities mediate differential snack choices across BMI groups: a study with New Zealand young male individuals

OBJECTIVE

This study aimed to: 1) test for the link between snack choices and BMI using a novel sensory-based classification method; and 2) elucidate the role of gustatory sensitivity in orienting snack choices.

METHODS

The study employed a dual approach involving sensory and nutritional assessments. Ninety-eight European male individuals were tested for gustatory sensitivities to sweetness, saltiness, umami, and lipid perception. Participant food intake was measured over 4 days. A separate cohort of 327 participants categorized the recorded snacks based on taste patterns, enabling profiling of snack choices across body-weight groups.

RESULTS

Results showed clear differentiations in snack choices across the BMI groups: Individuals with a higher BMI consumed more "Sweet" and "Sweet+Fat" snacks and less "Savory" snacks compared with the lower-BMI group (p < 0.05). Mediation analyses confirmed a significant effect of gustatory sensitivity, showing that the greater choice for "Sweet" and "Sweet+Fat" snacks among those with a higher BMI was mediated by sensitivities to sweetness and lipid perception (p = 0.008-0.044).

CONCLUSIONS

Our study revealed that gustatory sensitivity can mediate the relationship between BMI and energy consumption from different snacks. These findings highlight the significance of taste perception in shaping snack choice, suggesting potential strategies for interventions aimed at addressing gustatory sensitivity to promote healthier dietary preferences.

Within- and between-person associations of time-varying determinants with snacking in older adults: an ecological momentary assessment study

Promoting healthy snacking is important in addressing malnutrition, overweight and obesity among an ageing population. However, little is known about the factors underlying snacking behaviour in older adults. The present study aimed to explore within- and between-person associations between determinants (i.e. intention, visibility of snacks, social modelling and emotions) and snacking behaviours (i.e. decision to snack, health factor of the snack and portion size) in older adults (60+). Conducting a two-part intensive longitudinal design, data were analysed from forty-eight healthy older adults consisting of (1) an event-based self-report ecological momentary assessment (EMA) diary every time they had a snack and (2) a time-based EMA questionnaire on their phone five times per day. Analysis through generalised linear mixed models indicated that higher intention to snack healthily leads to healthier snacking while higher levels of social modelling and cheerfulness promote unhealthier choices within individuals. At the between-person level, similar results were found for intention and social modelling. Visibility of a snack increased portion size at both a within- and between-person level, while the intention to eat a healthy snack only increased portion size at the between-person level. No associations were found between the decision to snack and all determinants. This is the first study to investigate both within- and between-person associations between time-varying determinants and snacking in older adults. Such information holds the potential for incorporation into just-in-time adaptive interventions, allowing for personalised tailoring, more effective promotion of healthier snacking behaviours and thus pursuing the challenge of healthy ageing.

Sensing the Snacking Experience: Bodily Sensations Linked to the Consumption of Healthy and Unhealthy Snack Foods-A Comparison between Body Mass Index Levels

The World Health Organisation (WHO) has highlighted the need for immediate action regarding the escalating global prevalence of overweight and obesity. Based on the need for long-term strategies supporting dietary behaviour changes, the concept of 'interoception' (i.e., sensing the body's internal state) has been proposed as promising for understanding and controlling food intake behaviours. As eating behaviours are motivated by the need for securing energy demands as well as the desire for pleasure, investigating the bodily sensations perceived in relation to food consumption can support our understanding of human food and eating behaviours. Here, a consumer study was conducted on 286 Danish consumers to explore the interoceptive experience of snack food consumption. This study included an investigation of the consumers' interoceptive capabilities and ability to feel pleasure, intuitive eating behaviours, snack food consumption frequency, the drivers of snack food consumption, food-related pleasure, and post-ingestive sensations linked to snack food consumption. The study was conducted on consumers with different Body Mass Index (BMI) levels to study potential differences between these groups. The study showed normal interoceptive capabilities and abilities to feel pleasure, with no differences between BMI groups. Regarding intuitive eating, the study found intuitive eating to be more prevalent among the group holding normal BMI. No significant differences between BMI groups were found in terms of snack intake frequency. However, differences between BMI groups were found in terms of: the drivers of snack consumption, the aspects bringing food-related pleasure from snack consumption, and the post-ingestive sensations felt after eating snack foods.

The effect of a mindfulness-based body scan exercise on food intake during TV watching

In some studies mindfulness is associated with reduced food consumption, but the underlying mechanisms are less well researched. One potential mechanism is that mindfulness increases attention toward feelings of fullness. Additionally, experimental research on mindfulness and food intake has primarily been conducted in constrained laboratory settings, where it may be easier for participants to notice their internal bodily signals, as opposed to the real world where individuals are often engaged in other activities while eating. The effect of mindfulness on food intake while participants are distracted remains unexplored. This study therefore aimed to examine whether a mindfulness-based body scan exercise reduced food consumption within a distracted environment by increasing attention toward feelings of fullness. Participants (n = 137) listened to a 10-minute body scan meditation, or a 10-minute visualisation (control) meditation. They were then given a bowl of crisps to consume while watching a 10-minute TV show segment. Participants also completed measures assessing proposed mediators, including state mindfulness, attention to bodily sensations and eating automaticity. The body scan manipulation increased state mindfulness but had no direct effect on the other mediators or on food intake (intervention M = 34.79g, SD = 24.06; control M = 33.16g, SD = 23.88). State mindfulness was positively correlated with attention to bodily sensations while eating. Lower eating automaticity and greater reliance on decreased food appeal and physical satisfaction to stop eating were found to be associated with lower food intake. Contrary to previous studies, we found no evidence that a mindfulness body scan reduces food consumption when participants are distracted. Future research should examine the specific conditions under and mechanisms by which mindfulness may influence food consumption.

A systematic review of ecological momentary assessment studies of appetite and affect in the experience of temptations and lapses during weight loss dieting

Dietary temptations and lapses challenge control over eating and act as barriers toward successful weight loss. These are difficult to assess in laboratory settings or with retrospective measures as they occur momentarily and driven by the current environment. A better understanding of how these experiences unfold within real-world dieting attempts could help inform strategies to increase the capacity to cope with the changes in appetitive and affective factors that surround these experiences. We performed a narrative synthesis on the empirical evidence of appetitive and affective outcomes measured using ecological momentary assessment (EMA) during dieting in individuals with obesity and their association with dietary temptations and lapses. A search of three databases (Scopus, Medline, and PsycInfo) identified 10 studies. Within-person changes in appetite and affect accompany temptations and lapses and are observable in the moments precipitating a lapse. Lapsing in response to these may be mediated through the strength of a temptation. Negative abstinence-violation effects occur following a lapse, which negatively impact self-attitudes. Engagement in coping strategies during temptations is effective for preventing lapses. These findings indicate that monitoring changes in sensations during dieting could help identify the crucial moments when coping strategies are most effective for aiding with dietary adherence.

Hunger, temptation, and dietary adherence during weight management

Preliminary evidence suggests that hunger and temptation may predict nonadherence to dietary intake goals; however, no studies have investigated the potential interaction between hunger and temptation in relation to dietary nonadherence nor have any investigated whether these associations may be different after the end of active behavioral intervention. Thus, the current study examined the week-to-week associations between hunger, temptation, and dietary adherence in 74 adults with overweight or obesity (mean ± SD age = 50.7 ± 10.4, BMI = 31.2 ± 4.5 kg/m2) enrolled in a 12-week, Internet-based weight loss program followed by a 40-week post-intervention observational maintenance period. Each week during the study, participants completed a questionnaire on which they rated their hunger, temptation, and dietary adherence on 7-point scales. Multilevel models demonstrated that higher levels of hunger and temptation were associated with lower ratings of dietary adherence during the same week, ps < 0.0001, such that 1-point higher ratings of hunger or temptation were associated with 0.2- and 0.5-point lower ratings of dietary adherence, respectively. Further, there was an interaction between hunger and temptation such that the association between temptation and dietary nonadherence was stronger when ratings of hunger were lower, p = .028. There were no differences in associations between the initial weight loss period and the maintenance period. Results suggest that hunger and temptation may serve as potential treatment targets for interventions aimed at improving adherence to dietary intake goals. Future studies should investigate whether interventions targeting hunger and temptation can improve dietary adherence and weight loss outcomes.

Disentangling the role of NAc D1 and D2 cells in hedonic eating

Overeating is driven by both the hedonic component ('liking') of food, and the motivation ('wanting') to eat it. The nucleus accumbens (NAc) is a key brain center implicated in these processes, but how distinct NAc cell populations encode 'liking' and 'wanting' to shape overconsumption remains unclear. Here, we probed the roles of NAc D1 and D2 cells in these processes using cell-specific recording and optogenetic manipulation in diverse behavioral paradigms that disentangle reward traits of 'liking' and 'wanting' related to food choice and overeating in healthy mice. Medial NAc shell D2 cells encoded experience-dependent development of 'liking', while D1 cells encoded innate 'liking' during the first food taste. Optogenetic control confirmed causal links of D1 and D2 cells to these aspects of 'liking'. In relation to 'wanting', D1 and D2 cells encoded and promoted distinct aspects of food approach: D1 cells interpreted food cues while D2 cells also sustained food-visit-length that facilitates consumption. Finally, at the level of food choice, D1, but not D2, cell activity was sufficient to switch food preference, programming subsequent long-lasting overconsumption. By revealing complementary roles of D1 and D2 cells in consumption, these findings assign neural bases to 'liking' and 'wanting' in a unifying framework of D1 and D2 cell activity.

Effect of mastication evaluation and intervention on body composition and biochemical indices in female patients with obesity: a randomized controlled trial

BACKGROUND

A limited number of studies have evaluated the masticatory indices of individuals with obesity who only chew their food a few times and for shorter duration or who were provided with an instructional intervention. This study aimed to examine the effects of a 6-month instructional mastication intervention on the body composition and biochemical indices in female patients with obesity.

METHODS

Female patients with obesity were randomly classified into a conventional treatment group (CTG; 12 individuals), which only received normal nutritional and exercise guidance, and a mastication intervention group (MIG; 16 individuals), which received an additional mastication guidance. The MIG received guidance on foods requiring increased number of chews and chewing duration, eating techniques, and the proper method of cutting foods.

RESULTS

Changes in the masticatory, body composition, and biochemical indices were compared before and after the 6-month intervention. The values of body composition indices decreased significantly in both groups; however, the rate of change in body mass index significantly decreased in the MIG. In addition, the values of biochemical indices were significantly decreased in the MIG compared with that in the CTG, which is attributed to the addition of mastication instruction to female patients with obesity.

CONCLUSION

Increasing the number of chews and duration of chewing times for carbohydrates, which are staple foods, possibly contributed to weight loss and improvement of glucose metabolism.

TRIAL REGISTRATION

UMIN, UMIN000025875. Registered on 27 Jan 2017.

Childhood Food Experiences and Selected Eating Styles as Determinants of Diet Quality in Adulthood-A Cross-Sectional Study

Available studies suggest that childhood food experiences (CFE) may be linked with eating behaviors in adulthood, as well as eating style (ES); thus, both CFE and ES can determine dietary intake. Little is known about the role of both of these factors in explaining the diet quality (DQ) of adults. The aim was to investigate to what extent selected ESs, i.e., intuitive (IE), restrained (ResEat), and external (ExtEat) eating, and CFE related to parental feeding practices (PFPs) will predict the DQ of women and men. Data from 708 Polish adults (477 women and 231 men) aged 18-65 were collected via the Internet from October 2022 to January 2023. Mann-Whitney's U Test was used to compare ES and CFE levels among women and men, while DQ determinants were tested with the multiple linear regression (MLR). In the total study sample, "Healthy Eating Guidance" (CFE), "Child Control" (CFE), "Body-Food Choice Congruence" (IE), and ResEat favored higher DQ scores, while "Unconditional Permission to Eat" (IE), "Eating for Physical Rather Than Emotional Reasons" (IE), and ExtEat predisposed to lower DQ scores. After the MLR was conducted separately in women and men, differences were noted in the role of "Healthy Eating Guidance" (CFE), "Pressure and Food Reward" (CFE), "Unconditional Permission to Eat" (IE), "Eating for Physical Rather Than Emotional Reasons" (IE), ExtEat, and ResEat in predicting DQ indices. Our findings suggest that childhood food experiences and selected eating styles may differently determine the DQ of women and men. Future studies conducted within representative samples are needed to confirm these results.

Eating when depressed, anxious, bored, or happy: An examination in treatment-seeking adults with overweight/obesity

Emotions that differ in valence are uniquely associated with eating. In our previous study with an online sample of adults with overweight/obesity, eating in response to depression was the type of emotional eating most closely associated with negative psychosocial correlates (Braden et al., 2018). The current study extended this research by examining associations between emotional eating types (eating in response to depression, anxiety, boredom, happiness) and psychological correlates among treatment-seeking adults. The present study was a secondary analysis of adults (N = 63; 96.8% female) with overweight/obesity and self-identified emotional eating who completed a baseline assessment for a behavioral weight loss intervention. Emotional eating in response to depression (EE-depression), anxiety/anger (EE-anxiety/anger), and boredom (EE-boredom) were assessed with the revised Emotional Eating Scale (EES-R), and positive emotional eating (EE-positive) was assessed with the positive emotions subscale of the Emotional Appetite Questionnaire (EMAQ). The Eating Disorder Examination Questionnaire (EDE-Q), Binge Eating Scale (BES), Difficulties in Emotion Regulation Scale (DERS), and Patient Health Questionnaire-9 (PHQ-9; depressive symptoms) were also administered. Frequencies showed the most endorsed emotional eating type was EE-depression (44.4%; n = 28). Four multiple regression analyses examined associations between emotional eating (EE-depression, EE-anxiety/anger, EE-boredom, and EE-positive) and dependent variables (EDE-Q, BES, DERS, and PHQ-9). Results showed that depression was the emotional eating type most closely related to disordered eating, binge eating, and depressive symptoms. Eating in response to anxiety was closely related to emotion regulation difficulties. Positive emotional eating was related to less depressive symptoms. Exploratory analyses showed that lower levels of positive emotional eating were related to higher depressive symptoms among adults with greater emotion regulation difficulties. Researchers and clinicians may consider tailoring weight loss treatment based on unique emotions that trigger eating.

Snacking behavior is associated with snack quality, overall diet quality, and body weight among US college students

Snacking behavior may affect snack quality, overall diet quality, and body weight; however, the associations between these variables have not been studied among college students. The objective of this study was to associate snacking behaviors with snack quality, diet quality, and weight status among college students with overweight and obesity. We hypothesized that a higher snacking frequency, accessibility and availability of unhealthy snacks, and lack of knowledge would be associated with lower snack and diet quality, and higher weight. Participants (n = 140) completed a snack behavior questionnaire, three 24-hour dietary recalls to assess diet quality using Healthy Eating Index 2015 (HEI-2015), and snack score using an algorithm based on the US DA Smart Snack guidelines and reported weight and height to calculate body mass index (BMI). Analysis of variance and Pearson correlation was used in the analyses. After adjusting for confounders, snack frequency was not associated with snack score, HEI-2015 score, or BMI, but evening snacks had a significantly lower snack score compared with late afternoon snacks (P = .017). Also, those with more accessibility and availability of unhealthy snacks had a lower snack score (P = .001), lower HEI-2015 score (P = .006), and higher BMI (P = .019). Snacking for pleasure was significantly associated with a lower snack score (P = .037). Snack score was positively correlated with HEI-2015 score but not with BMI. In conclusion, late snacking, unhealthy snack environment, and snacking for pleasure were associated with lower snack and diet quality. These findings could be used in future intervention strategies to improve snacking behaviors and the food environment.

Snacking Behavior and Association with Metabolic Risk Factors in Adults from North and South India

BACKGROUND

Snacks are increasingly contributing to daily diets around the world. Studies from high-income countries have demonstrated the link between snack consumption and metabolic risk factors, but there are very few studies from low- and middle-income countries.

OBJECTIVES

The objective of this study was to assess snack behavior and its associations with metabolic risk factors in Indian adults.

METHODS

Adults from the UDAY study (October 2018-February 2019, n = 8762) from rural and urban Sonipat (North) and Vizag (South) India were studied for snack consumption (food frequency questionnaire), demographic factors, including age, sex, etc. and metabolic risk factors, including BMI, waist circumference, fat percentage, plasma glucose, and blood pressure. We compared snack consumption by categories of sociodemographic factors (Mann-Whitney U test, Kruskal-Wallis test) and studied the likelihood for metabolic risk (logistic regression analysis).

RESULTS

Half of the study participants were women and resided in rural locations. Savory snacks were the most preferred; 50% of the participants consumed them 3-5 times/wk. Participants preferred to purchase out-of-home prepared snacks and eat them at home (86.6%) while watching television (69.4%) or with family/friends (49.3%). The reasons for snacking were hunger, craving, liking, and availability. Snack consumption was higher in Vizag (56.6%) than in Sonipat (43.4%), among women (55.5%) than men (44.5%), and the wealthiest; it was similar in rural-urban locations. Frequent consumers of snacks had 2 times higher likelihood for having obesity (OR: 2.22; 95% CI: 1.51, 3.27) central obesity (OR: 2.35; 95% CI: 1.60, 3.45), and higher fat percentage (OR: 1.92; 95% CI: 1.31, 2.82) and higher fasting glucose levels (r=0.12 (0.07-0.18) than consumers who consumed snacks rarely (all P ≤ 0.05).

CONCLUSIONS

Snack (savory and sweet) consumption was high among adults from sexes in both urban and rural locations of north and south India. This was associated with higher risk of obesity. There is a need to improve the food environment by promoting policies for ensuring healthier food options to reduce snacking and associated metabolic risk.

Snacking for a reason: detangling effects of socio-economic position and stress on snacking behaviour

BACKGROUND

As snacking can be considered a cornerstone of an unhealthy diet, investigating psychological drivers of snacking behaviour is urgent, and therefore the purpose of this study. Socio-economic position (SEP) and stress are known to affect many behaviours and outcomes, and were therefore focal points in the study.

METHODS

In a cross-sectional survey study, we examined whether Socio-economic position (SEP) would amplify associations between heightened stress levels and self-reported negative-affect related reasons for snacking. Next, we investigated whether Socio-economic position (SEP) predicted frequency of snacking behaviour, and how stress and other reasons for snacking could explain this association. Outcome measures were reasons people indicated for snacking, and frequency of snacking behaviour.

RESULTS

Analyses revealed that people seem to find more reasons to snack when they are stressed, and that this association was more pronounced for people with a high compared to low socio-economic position. Furthermore, a higher socio-economic position was associated with a higher frequency of snacking, and both snacking to reward oneself and snacking because of the opportunity to do so remained significant mediators.

CONCLUSION

Whereas low socio-economic position was associated with higher stress levels, this did not translate into increased snacking. Contrarily, those with higher socio-economic position could be more prone to using 'reasons to snack', which may result in justification of unhealthy snacking behaviour.

A Comparison of Emotional Triggers for Eating in Men and Women with Obesity

OBJECTIVE

Emotional eating (EE) is prevalent in people seeking obesity treatment and is a contributor to poor weight loss outcomes. We aimed to delineate the emotions most associated with this type of eating, and whether they differ by sex in people undergoing obesity treatment.

METHODS

A cross-sectional study recruiting 387 adults from a hospital obesity management service. Emotional eating was measured using the Emotional Eating Scale (EES). Separate analyses included all participants, and those undergoing lifestyle interventions alone or in combination with obesity medication and/or bariatric surgery.

RESULTS

A total of 387 people (71% women) participated in the study (n = 187 receiving lifestyle modification alone; n = 200 in combination with additional treatments). Feeling 'bored' was most commonly and most strongly associated with the urge to eat, regardless of sex or treatment. Women had higher scores for total EES, for subscales of depression and anger, and individual feelings of 'blue', 'sad' and 'upset' compared to men.

CONCLUSIONS

Understanding why certain emotions differentially trigger an urge to eat in men and women, and finding strategies to break the link between boredom and eating may enable better personalisation of lifestyle interventions for people with obesity.

Noor N, Mat Ludin AF, Shahar S, Abdul Manaf MR. The Challenges and Strategies towards Healthy Eating during COVID-19 Home Confinement Period among Working Adults with BMI ≥ 25 kg/m2 Enrolled in a Weight Loss Program: Qualitative Findings

The COVID-19 pandemic has been affecting our lifestyles, such as work, living, and health. In Malaysia, the Restriction of Movement Order (RMO) was first announced in March 2020 to curb the spread of the virus. Since then, many Malaysians have been confined to their own home. This new lifestyle can cause a change of eating habits where healthy eating may be a challenge. Hence, our qualitative study explored the challenges and strategies for healthy eating during the first wave of the COVID-19 home confinement period among working adults overweight and obese in Malaysia. Eleven participants were individually interviewed through phone calls. The interviews were audio-recorded, transcribed verbatim, and then coded with NVIVO 12 based on thematic analysis. We found that social pressure, changes in the social setting, more free time to access food, and extra stock of unhealthy foods at home were among the challenges to healthy eating. Some participants countered these perceived challenges by reducing unhealthy food stock, limiting kitchen visits, and utilizing self-monitoring apps to monitor their calorie intake. Social media was not consistently perceived to influence their eating behavior during this period. We conclude that COVID-19 home confinement has created challenges to healthy eating habits among overweight and obese adults with overweight and obesity. Our study provides evidence that vulnerable groups such as overweight and obese individuals require specific nutritional support during pandemic-related confinement to enhance eating self-efficacy.

Olfactory and Gustatory Supra-Threshold Sensitivities Are Linked to Ad Libitum Snack Choice

Snacking is a common eating habit in the modern food environment. Individual snack choices vary substantially, with sweet versus savoury snacks linked to differential health outcomes. The role of olfactory and gustatory sensitivities in snack choices and consumption is yet to be tested. A total of 70 Caucasian young males (age: 21−39 years; BMI: 20.5−40.5 kg∙m−2) were tested for their supra-threshold sensitivities to sweet and savoury associated odours and tastants (vanillin, methional; sucrose, NaCl). The participants also attended an ad libitum task in which their intakes of sweet and savoury snacks were recorded and analysed. Univariate and multivariate analyses were used to test for relationships between odour/taste sensitivities and sweet versus savoury snack intake. Results indicated that individual sensitivities to sweet-associated stimuli (e.g., vanillin, sucrose) were negatively linked with intake of the congruent (e.g., sweet) snacks and positively linked with incongruent (e.g., savoury) snacks (p < 0.05). These differences were reflected by energy intake rather than consumption weight (p > 0.05). This study outlines the fundamental roles of olfactory and gustatory sensitivities in snack choices and offers novel insights into inter-individual variability in snack consumption.

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.

Added value of physical food products as a stimulus during interviewing

Semi-structured interviews are an often-used method for researching consumer perceptions of food products. However, understanding detailed and in-depth how consumers perceive food products is challenging for researchers because it could be difficult for consumers to express their motives and perceptions. In our previous studies using semi-structured interviews, this difficulty to express perceptions was also recognized, especially when concepts like naturalness, sustainability and healthiness were discussed. However, in both studies physical food products were used as stimuli and there was an indication that there might be differences in the number and type of answers given before and after the use of these stimuli products. Therefore, the current research aimed at showing effects and the possible value of using physical food stimuli products during semi-structured interviews. Two different studies were used to reach this aim, one study about the health perception of mothers and the other study about the naturalness, sustainability and healthiness perception of adolescents, both using snack products as physical stimuli. In both studies, the use of physical stimuli products appeared to be effective and useful. The comparison of the answers with and without stimuli products showed that using stimuli products provides more, and more detailed answers on the perception of the products. Therefore, the results of this study could serve as a guideline on the use of food stimuli products during semi-structured interviews.

Self-compassion in weight management: A systematic review

OBJECTIVE

Self-compassion - the tendency or ability to treat oneself kindly in times of failure or distress - may be a natural fit to support individuals who struggle with weight management. However, while self-compassion shows promise with improving health behaviours, the associations self-compassion has on weight management outcomes are unclear. The objective of this systematic review was three-fold: (1) to evaluate whether self-compassion interventions can increase individual self-compassion in the context of weight management, (2) to investigate if self-compassion interventions can improve weight management outcomes, defined as healthier eating, increased physical activity, or reduced weight and finally, (3) to explore whether these benefits can be sustained over the longer term.

METHODS

Following PRISMA guidelines, Scopus, PsycINFO, Medline, PubMed and Embase databases were searched. Studies including a measure of self-compassion and a self-compassion intervention reporting weight management outcomes were included. Studies in populations living with an eating disorder were excluded. The Quality Criteria Checklist from the American Dietetic Association was used to assess study quality. Prospero Registration #CRD42019146707.

RESULTS

Of the 9082 records screened, a total of 20 studies met inclusion criteria. Seventeen studies reported significant increases in self-compassion post-intervention. Improvements were also found for eating behaviours (15 of 18), physical activity behaviours (6 of 9), and weight loss (6 of 11). The majority of improvements were maintained at follow-up, except for physical activity behaviours (1 of 7).

CONCLUSION

Self-compassion interventions tailored to weight management outcomes demonstrate efficacy with increasing self-compassion post-intervention. Methodological weaknesses and questions about the maintenance of any improvements in weight management outcomes limit our ability to make strong conclusions. However, there is promise and clear relevance for including self-compassion interventions to enhance weight management outcomes; directions for improved intervention and study design are given.

Development and validity of semi-quantitative food frequency questionnaire as a new research tool for sugar intake assessment among Indonesian adolescents

Robust evidence has shown that sugar is a major contributor to obesity and Non-Communicable Diseases (NCDs). However, there have not been sufficient tools to estimate sugar intakes. Therefore, developing a new and valid tool to assess sugar intake, based on cultural eating habits, is crucial. The study was done in two phases; the first focused on the development of Semi-quantitative Food Frequency Questionnaire (SFFQ), and the second focused on researching the validity of the questionnaire. Food items in the SFFQ were selected from the latest national survey review, exploratory survey, and food market observation. Forty-nine food items were included in the final SFFQ with five open-ended questions for fruit groups. One hundred and six adolescents aged 15-17 years participated in the study. The total sugar intake among the adolescents was 58.80 g/day (52.7 g sucrose; 1.47 g fructose; 1.49 glucose) which contributed to 11.6% of the total energy intake per day. The reliability analysis showed a good agreement between the two administered SFFQs in a one-month interval. The relative validity results, using 6-days food diaries as a reference method, demonstrated a superior ability to rank individuals into the same and adjacent classification and only <10% gross misclassification in all sugar intakes. The developed SFFQ in turn has been proven to have moderate to good validity and be applicable for a larger epidemiological study.

Snacking patterns throughout the life span: potential implications on health

Eating outside the three main meals - in other words, snacking - is a part of the dietary pattern of individuals in all stages of life. The quality and pattern of snacking have an impact on health during the life span. Thus, the aim of this review was to evaluate various patterns and health outcomes of the snacking habits of different demographical groups, from children to the elderly, throughout their life span. We discuss the snacking pattern among children and adolescents, which is characterized by consuming high energy foods with low nutrient value, and which is associated with increased risk of obesity. During university years, study stress and lack of time were obstacles to a healthy dietary pattern involving nutritious snacks, although awareness of the importance of healthy snacks was higher in this group than among younger age groups. Employment status and skipping regular meals were important factors affecting snacking quality and patterns in adulthood. Unhealthy snacks, high in energy, sugar, and salt and low in nutrients, were demonstrated to have a negative impact on individuals' health, such as oral health, blood pressure, obesity, and diabetes. In conclusion, encouraging individuals to consume healthy snacks that are high in nutrients through education to help them plan for their snacks is important to enhance health and reduce disease risk.

Within-Day Variability in Negative Affect Moderates Cue Responsiveness in High-Calorie Snacking

Background

Many discretionary foods (“snacks”) contribute both to individual health risks and to global issues, in particular through high carbon footprints and water scarcity. Snacking is influenced by the presence of snacking cues such as food availability, observing others eating, and negative affect. However, less is known about the mechanisms underlying the effects of negative affect. This study examines whether the individual odds of consuming high-calorie snacks as a consequence to being exposed to known snacking cues were moderated by experiencing (i) higher or lower total negative affect per day or (ii) higher or lower negative affect variability per day.

Methods

Secondary analysis of an ecological momentary assessment study of 60 participants over 14 days with food logs and randomly timed assessments of known snacking cues. High total daily negative affect levels (daily within-participant means) and negative affect variability (daily within-participant SDs) were examined as moderators to predict high-calorie snacking in three-level hierarchical random effects logistic regressions.

Results

Consistent with previous studies, the odds of snacking increased when food was available (OR = 5.05, 95% CI 3.32, 7.66), when others were eating (OR = 5.11, 95% CI = 3.73, 6.99), and when participants experienced more negative affect (OR = 1.02, 95% CI = 1.01, 1.03). Associations for food availability (OR = 0.92, 95% CI 0.86, 0.99) and others eating (OR = 0.95, 95% CI 0.91, 0.99) were significantly moderated by negative affect variability such that associations between cues and high-calorie snacking were weaker on days with higher negative affect variability, but not negative affect levels.

Conclusion

The relationship between cues to high-calorie snacking and snacking behavior varies with variability in negative affect, suggesting a complex relationship between affect and high-calorie snacking. Clearer conceptualizations on the relation between affect and eating are needed.

Networks of stress, affect and eating behaviour: anticipated stress coping predicts goal-congruent eating in young adults

BACKGROUND

Many people aim to eat healthily. Yet, affluent food environments encourage consumption of energy dense and nutrient-poor foods, making it difficult to accomplish individual goals such as maintaining a healthy diet and weight. Moreover, goal-congruent eating might be influenced by affects, stress and intense food cravings and might also impinge on these in turn. Directionality and interrelations of these variables are currently unclear, which impedes targeted intervention. Psychological network models offer an exploratory approach that might be helpful to identify unique associations between numerous variables as well as their directionality when based on longitudinal time-series data.

METHODS

Across 14 days, 84 diet-interested participants (age range: 18-38 years, 85.7% female, mostly recruited via universities) reported their momentary states as well as retrospective eating episodes four times a day. We used multilevel vector autoregressive network models based on ecological momentary assessment data of momentary affects, perceived stress and stress coping, hunger, food craving as well as goal-congruent eating behaviour.

RESULTS

Neither of the momentary measures of stress (experience of stress or stress coping), momentary affects or craving uniquely predicted goal-congruent eating. Yet, temporal effects indicated that higher anticipated stress coping predicted subsequent goal-congruent eating. Thus, the more confident participants were in their coping with upcoming challenges, the more they ate in line with their goals.

CONCLUSION

Most eating behaviour interventions focus on hunger and craving alongside negative and positive affect, thereby overlooking additional important variables like stress coping. Furthermore, self-regulation of eating behaviours seems to be represented by how much someone perceives a particular eating episode as matching their individual eating goal. To conclude, stress coping might be a potential novel intervention target for eating related Just-In-Time Adaptive Interventions in the context of intensive longitudinal assessment.

Comfort eating: An observational study of affect in the hours immediately before, and after, snacking

OBJECTIVE

'Comfort eating' has been used to explain real-world food choices, suggesting that individuals are drawn to energy-dense ('unhealthy') snacks when experiencing negative affect. However, this concept has rarely been studied, particularly in real-world settings. Similarly, the effects of snacking on subsequent affect are also poorly understood. The present study aimed to examine the association between affect and snacking in daily life.

METHODS

One hundred and forty-one adults recorded their food intake in real time for ~14 days using a study issued mobile phone. Participants also responded to randomly timed assessments. During both types of assessments, participants indicated their current level of affect. By anchoring off snacking events, the trajectory of affect in the hours leading up to - and following - snacking was explored.

RESULTS

In the three hours leading up to a healthy snack, affect was stable. In contrast, affect fell during the hours leading up to an unhealthy snack. The interaction between snack type and time was significant. A similar, but opposite, pattern was seen following snacking: where affect decreased after unhealthy snacking, affect increased following healthy snack intake.

CONCLUSION

The findings are consistent with the hypothesis of comfort eating, with unhealthy snacking being preceded by worsening affect. Unhealthy snacking did not, however, lead to affect improvements afterwards, which questions the 'effectiveness' of comfort eating. The intake of healthy snacks however was associated with positive affective experiences. These findings could function as a component of interventions aiming at improving dietary behaviours.

Perceived daily tension and food cravings and consumption: A within- and between-person investigation

Previous research examining the relationship between negative states such as tension/anxiety and food intake has typically overlooked the naturally occurring variability of day-to-day experiences and the subsequent consequences for eating behavior. In this study, the relationship of within- and between-person perceived daily tension with food cravings and consumption was assessed. One hundred and forty-two men and women (M_age=21.3, SD_age=5.3) completed a survey daily for 7 consecutive days. Levels of perceived daily tension, food cravings, and consumption were assessed. Linear and logistic mixed effect regression models were used to examine associations between tension and food cravings and consumption variables, respectively. Individuals reported greater cravings (for sweets, OR 95% CI 1.05-1.26; carbohydrates/starches, OR 95% CI 1.02-1.26; and fast foods, OR 95% CI 1.01-1.19) and consuming more carbohydrates/starches (b 95% CI 0.05-0.79) on days when they felt more tension. Individuals with higher tension had more cravings (total OR 95% CI 1.09-1.71; and specifically for sweets, OR 95% CI 1.04-1.42; and fast foods, OR 95% CI 1.15-1.54) and reported consuming more sweet (b 95% CI 0.21-1.10) and fast foods (b 95% CI 0.55-1.66). These findings suggest that greater perceived tension (both within and between individuals) is associated with increased food cravings and consumption.

The Relationship Between Food Craving, Appetite-Related Hormones and Clinical Parameters in Bipolar Disorder

Obesity and weight gain in bipolar disorder (BD) have multifactorial underlying causes such as medication side effects, atypical depressive symptomatology, genetic variants, and disturbances in the neuro-endocrinal system. Therefore, we aim to explore the associations between food craving (FC), clinical parameters, psychotropic medication, and appetite-related hormones. In this cross-sectional investigation, 139 individuals with BD and 93 healthy controls (HC) completed the food craving inventory (FCI). In addition, blood samples (including leptin and acylated ghrelin) were analyzed and sociodemographic and anthropometric data were collected. Individuals with BD reported higher frequencies of total FC as well as craving for fat and fast food than HC. Additionally, we found a significant negative correlation between FC and ghrelin levels in BD. Smokers with BD reported significantly more craving for high fat foods than non-smokers. Age was significantly associated with FC independent of group. Individuals with BD taking olanzapine and quetiapine reported higher frequencies of craving for sweet food, while patients currently taking lithium reported less total FC compared to those without lithium therapy. Likewise, patients currently taking valproate reported less total FC and less craving for sweets than those not taking valproate. FC appears to be of clinical relevance in individuals with BD. Contrary to previous data, this does not seem to be a female phenomenon only and might encompass more than the specific craving for carbohydrates. Although due to the cross sectional design, causality cannot be determined, the association between depressive symptomatology and fast food craving warrants further research.

Snack foods and lead ingestion risks for school aged children: A comparative evaluation of potentially toxic metals and children's exposure response of blood lead, copper and zinc levels

Snack foods are common and highly advertised to children and serve their natural predispositions for sweet and salty tastes. However, the risk issues of low-cost snacks eaten by 0-6 aged children are lack of more concern. To better understand the issue of low-cost snacks this study considered potentially toxic metals (PTMs) impact on children's health risk, measured PTMs in a collection of 570 collected low-cost snacks contributed by 1342 voluntary participants children aged 0-6 years involved in Xi'an city are conducted. Nine priority PTMs and amounts ranked as Mn > Zn > Cu > Cr > Sb > Pb > Ni > Cd > Co. The Estimated Weekly Intake of PTMs in snacks for children accounted for a proportion of the Provisional Tolerance Weekly Intake. Children's daily snack ingestion of Cr, Cd and Pb were especially concerning. It was noted that all PTMs in flour products contribute to the total Target Hazard Quotient (THQ>1) were observed having a non-carcinogenic risk compared to the single metals Cr, Co and Cd with carcinogenic risk. The correlations between Cu, Pb, Zn in low-cost snacks and children's bloods reflected PTMs especially for Pb that transfers into children's bodies mostly through low-cost foodstuffs ingestion. Also, the elevated blood lead levels (BLLs) depended on readily available, low-quality snacks accessible for children. Therefore, multi-initiatives aimed at improving the quality, increasing awareness, and a PTM monitoring program for low-cost snack food market to young children should be undertaken.

Brain Activity Associated With Regulating Food Cravings Predicts Changes in Self-Reported Food Craving and Consumption Over Time

Neural patterns associated with viewing energy-dense foods can predict changes in eating-related outcomes. However, most research on this topic is limited to one follow-up time point, and single outcome measures. The present study seeks to add to that literature by employing a more refined assessment of food craving and consumption outcomes along with a more detailed neurobiological model of behavior change over several time points. Here, a community sample of 88 individuals (age: M = 39.17, SD = 3.47; baseline BMI: M = 31.5, SD = 3.9, range 24–42) with higher body mass index (BMI) performed a food craving reactivity and regulation task while undergoing functional magnetic resonance imaging. At that time—and 1, 3, and 6 months later—participants reported craving for and consumption of healthy and unhealthy foods via the Food Craving Inventory (FCI) and ASA24 (N at 6 months = 52–55 depending on the measure). A priori hypotheses that brain activity associated with both viewing and regulating personally desired unhealthy, energy-dense foods would be associated with self-reported craving for and consumption of unhealthy foods at baseline were not supported by the data. Instead, regression models controlling for age, sex, and BMI demonstrated that brain activity across several regions measured while individuals were regulating their desires for unhealthy food was associated with the self-reported craving for and consumption of healthy food. The hypothesis that vmPFC activity would predict patterns of healthier eating was also not supported. Instead, linear mixed models controlling for baseline age and sex, as well as changes in BMI, revealed that more regulation-related activity in the dlPFC, dACC, IFG, and vmPFC at baseline predicted decreases in the craving for and consumption of healthy foods over the course of 6 months.

Explaining the dimensions of social support for breakfast and healthy snacks in students: a qualitative study

BACKGROUND

breakfast elimination as well as consumption of low-value snacks is ever increasing among adolescents. This study sought to explain the dimensions of social support for breakfast and healthy snacks among students.

METHODS

A qualitative research was conducted in Isfahan, Tehran, and Khorramabad, Iran high schools in 2017-18. Data were obtained from five focus group discussions and 35 in-depth interviews as well as semi-structured interviews with students of both sex, parents and school authorities. The data simultaneously analyzed using conventional content analysis in three stages including preparation, organization, and reporting. Prolonged engagement, maximum variation of sampling and member check were the enrichment factors of the research.

RESULTS

Three main categories emerged. First, family supports with sub- categories of family in the school programs as well as mother-sponsored support and family life patterns. Second, school supports with sub- categories of instrumental and informational support. And third, support of other community organizations with sub- categories of intra-department coordination and mass media.

CONCLUSION

The concepts emerging in the present study develop multilevel ecological strategies to promote nutritional health including family, school, and community organizations such as school renovations, municipalities, police, education, and mass media to promote healthy breakfast and snack behavior are applicable for students.

Body Mass Index and stimulus control: Results from a real-world study of eating behaviour

BACKGROUND

Evidence suggests decisions about when, what, and how much to eat can be influenced by external (location, food outlet presence, food availability) and internal (affect) cues. Although the relationship between stimulus control and obesity is debated, it is suggested that individuals with higher BMIs are more driven by cues to eating than individuals in the healthy-weight range (HWR). This study investigates the influence of stimulus control on real-world food intake, and whether stimulus control differs by BMI. It was hypothesised that, compared to those in the HWR, eating among individuals with higher BMIs would be under greater stimulus control.

METHOD

74 participants (n = 34 BMI < 24.9, n = 40 BMI > 24.9) recorded food intake for 14 days using Ecological Momentary Assessment. Participants also responded to 4-5 randomly-timed assessments per day. Known external and internal eating cues were assessed during both assessment types. Within-person logistic regression analyses were used to predict eating vs. non-eating occasions from stimulus control domains.

FINDINGS

Results support the hypothesis that eating was influenced by stimulus control: food availability, affect, time of day, and location significantly distinguished between eating and non-eating instances (AUC-ROC = 0.56-0.69, all p's < 0.001). The presence of food outlets was significantly better at distinguishing between eating and non-eating instances for those with higher BMIs (compared to individuals in the HWR).

DISCUSSION

Results support the notion of stimulus control in shaping eating decisions. Differences in levels of stimulus control between participants in the HWR compared to those with a high BMI suggest that dietary improvement interventions may be more effective when they are tailored to the individual and consider environmental influences on eating behaviour.

A Laboratory-Based Study of the Priming Effects of Food Cues and Stress on Hunger and Food Intake in Individuals with Obesity

OBJECTIVE

This study aimed to assess the effects of exposures to food cues and stress on hunger and food intake and examine whether cue responses differ by weight status.

METHODS

In a laboratory-based experimental study, participants (n = 138) were exposed to stress, neutral, and food cues delivered using an individualized script-driven imagery task on three separate days. After each cue exposure, participants ate high- and low-calorie snack foods ad libitum (Food Snack Test). Hunger was measured by visual analog scales.

RESULTS

Food cues elicited significantly greater increases in hunger compared with neutral and stress stimuli. Cue-induced hunger did not differ by weight status. Participants consumed a similar number of total calories across stimuli. In response to food cue provocation, participants with obesity consumed [mean (SE)] 81.0% (4.0%) of calories from high-calorie foods, which was significantly greater than participants with normal weight (63.5%  [3.6%]; P = 0.001). After the stress cue, participants with obesity consumed 81.4% (4.0%) of calories from high-calorie foods, which was significantly more than participants with normal weight (70.2% [3.6%]; P = 0.04). Energy intake from high-calorie foods did not differ by weight status after the neutral cue.

CONCLUSIONS

Among individuals with obesity, exposure to food and stress cues shifted consumption to high-calorie snack foods within a well-controlled experimental setting.

Using pre-prandial blood glucose to assess eating in the absence of hunger in free-living individuals

Our ability to understand and intervene on eating in the absence of hunger (EAH) as it occurs in peoples' natural environments is hindered by biased methods that lack ecological validity. One promising indicator of EAH that does not rely on self-report and is easily assessed in free-living individuals is glucose. Here, we hypothesize that elevated pre-prandial blood glucose concentrations (PPBG), which reflect a source of readily-available, short-term energy, are a biological indicator of EAH. This was a 7-day observational study of N = 41, 18-24 year old men and women with BMI < 25 kg/m² (60%) or BMI ≥ 25 kg/m² (40%). We collected data using ecological momentary assessment from people in their natural environments. We defined EAH by self-report (perceived EAH) and by PPBG thresholds using two methods (standardized, PPBG < 85 mg/dl; personalized, PPBG < individual fasting levels). Multilevel modeling was used to analyze the data. N = 963 eating events were reported. There were significantly (p < .05) fewer perceived EAH events (25%) as compared to standardized (62%) and personalized PPBG-defined EAH events (51%). Consistent with published literature, perceived EAH was more likely to occur at a higher PPBG (p < .01), particularly among participants with a BMI ≥ 25 kg/m² (p_int < .01). Additionally, discordance between perceived EAH and PPBG-defined EAH, indicating a perception of hunger at an eating event when PPBS was elevated, was less likely among participants with a BMI < 25 kg/m² vs. those with a BMI ≥ 25 kg/m² (p_int < .01) as well as at snacks vs. meals (p_int < .01). These findings provide preliminary support for using PPBG as a biological indicator of EAH in free-living individuals.

Does stress eat away at you or make you eat? EMA measures of stress predict day to day food craving and perceived food intake as a function of trait stress-eating

Eating behaviour can be driven by non-homeostatic factors like stress. Both increased and decreased food intake in response to stress has been documented, but it has remained difficult to identify a trait that predicts who shows either pattern. Thus, we collected naturalistic data from Ecological Momentary Assessment in combination with the trait-level Salzburg Stress Eating Scale (SSES). In study 1, 97 individuals completed the SSES and 6 daily reports about stress, food craving and perceived food intake across 8 days, whereas in study 2, 83 diet-interested participants completed the same measures at 4 daily prompts across 14 days. Consistent across both studies, multilevel modelling revealed that participants with high SSES-scores showed relatively more positive intra-day stress-craving relationships than those with low SSES-scores. On the day level, stress also predicted perceived food intake as a function of SSES-scores. Controlling for negative affect did not alter results. Results support an individual difference model of stress-eating where decrease vs increase of eating depends on SSES-scores. In affected individuals stress influences simultaneous food craving but might exhibit cumulative or delayed effects on food intake. Furthermore, the SSES provides a valid instrument for identifying at risk individuals and for tailoring interventions.

Association of Video Game Use With Body Mass Index and Other Energy-Balance Behaviors in Children

Importance

Childhood obesity is one of the biggest public health threats facing the UK, and video game use is considered a risk behavior for obesity among children. However, few studies have explored the prospective association between video game use and body mass index (BMI) or the potential mediators of this association.

Objectives

To investigate whether a longer-term association exists between video game use at a young age and BMI SD score in later years, independent of television use, and to ascertain whether this association is mediated by other energy-balance behaviors.

Design, Setting, and Participants

This cohort study is a secondary analysis of data from the Millennium Cohort Study, a nationally representative sample of children who were born in the UK between September 1, 2000, and January 31, 2002, that focused on data collected when the children were aged 5, 7, 11, and 14 years. Data for all variables, except BMI, were provided by parental or caregiver reporting if the children were younger than 14 years of age. At age 14 years, the children self-reported their own behavior. Initial data analysis was conducted between September 18, 2018, and September 28, 2018, with supplementary analyses conducted from October 7, 2019, to November 22, 2019.

Main Outcomes and Measures

The main outcome variable was BMI SD scores, with video game use as the exposure variable of interest. Physical activity, bedtime regularity, sugar-sweetened beverage consumption, and high-calorie food consumption were included as potential mediating behaviors.

Results

The full sample comprised 16 376 children and had a nearly equal number of boys (8393 [51.3%]) and girls (7983 [48.7%]). Every 1 SD increase in the number of hours of video game use at age 5 years was associated with a β = 0.018 higher BMI SD score at age 14 years (95% CI, 0.004-0.032). A small partial mediation of this association was found (direct association: β = 0.017 [95% CI, 0.003-0.031]; indirect association: β = 0.0011 [95% CI, 0.0003-0.0019]), suggesting that irregular bedtimes and higher consumption of sugar-sweetened beverages were mediators. The mediation model accounted for 36.7% (95% CI, 35.5-37.8) of the variance of the BMI SD score at age 14 years.

Conclusions and Relevance

Results of this study suggest a small (and not clinically meaningful) association between video game use in early childhood and higher BMI in later years, which may be mediated by irregular bedtimes and higher consumption of sugar-sweetened beverages. Future interventions to prevent childhood obesity should incorporate health promotion in mainstream video games to target children most at risk because of their high level of video game use.

Emotional eating in healthy individuals and patients with an eating disorder: evidence from psychometric, experimental and naturalistic studies

Emotional eating has traditionally been defined as (over)eating in response to negative emotions. Such overeating can impact general health because of excess energy intake and mental health, due to the risks of developing binge eating. Yet, there is still significant controversy on the validity of the emotional eating concept and several theories compete in explaining its mechanisms. The present paper examines the emotional eating construct by reviewing and integrating recent evidence from psychometric, experimental and naturalistic research. Several psychometric questionnaires are available and some suggest that emotions differ fundamentally in how they affect eating (i.e. overeating, undereating). However, the general validity of such questionnaires in predicting actual food intake in experimental studies is questioned and other eating styles such as restrained eating seem to be better predictors of increased food intake under negative emotions. Also, naturalistic studies, involving the repeated assessment of momentary emotions and eating behaviour in daily life, are split between studies supporting and studies contradicting emotional eating in healthy individuals. Individuals with clinical forms of overeating (i.e. binge eating) consistently show positive relationships between negative emotions and eating in daily life. We will conclude with a summary of the controversies around the emotional eating construct and provide recommendations for future research and treatment development.

Does Eating Addiction Favor a More Varied Diet or Contribute to Obesity?-The Case of Polish Adults

The rapidly increasing prevalence of overweight and obesity indicates a need to search for their main causes. Addictive-like eating and associated eating patterns might result in overconsumption, leading to weight gain. The aim of the study was to identify the main determinants of food intake variety (FIV) within eating addiction (EA), other lifestyle components, and sociodemographic characteristics. The data for the study were collected from a sample of 898 Polish adults through a cross-sectional survey in 2019. The questionnaire used in the study included Food Intake Variety Questionnaire (FIVeQ), Eating Preoccupation Scale (EPS), and questions regarding lifestyle and sociodemographic factors. High eating addiction was found in more than half of the people with obesity (54.2%). In the study sample, physical activity at leisure time explained FIV in the greatest manner, followed by the EPS factor: eating to provide pleasure and mood improvement. In the group of people with obesity, the score for this EPS factor was the best predictor of FIV, in that a higher score was conducive to a greater variety of food intake. Sociodemographic characteristics differentiated FIV only within groups with normal body weight (age) and with overweight (education). In conclusion, food intake variety (FIV) was associated with physical activity at leisure time, and then with EPS factor “Eating to provide pleasure and mood improvement”, whereas sociodemographic characteristics were predictors of FIV only within groups identified by body mass index (BMI). Nevertheless, our observations regarding the eating to provide pleasure and mood improvement factor and its associations with food intake variety indicate a need for further research in this area. Future studies should also use other tools to explicitly explain this correlation.

Visual stimulation with food pictures in the regulation of hunger hormones and nutrient deposition, a potential contributor to the obesity crisis

Food cues affect hunger and nutritional choices. Omnipresent stimulation with palatable food contributes to the epidemics of obesity. The objective of the study was to investigate the impact of food cues on appetite-related hormones and to assess the functionality of the secreted hormones on macronutrient uptake in healthy subjects. Additionally, we aimed at verifying differences in the response of total and active ghrelin to stimulation with food pictures and to a meal followed by the stimulation. We were also interested in the identification of factors contributing to response to food cues. We recruited healthy, non-obese participants for two independent cross-over studies. During the first study, the subjects were presented random non-food pictures on the first day and pictures of foods on the second day of the study. Throughout the second study, following the picture session, the participants were additionally asked to drink a milkshake. Concentrations of blood glucose, triglycerides and hunger-related hormones were measured. The results showed that concentrations of several hormones measured in the blood are interdependent. In the case of ghrelin and gastric inhibitory peptide (GIP) as well as ghrelin and glucagon-like peptide-1 (GLP-1), this co-occurrence relies on the visual cues. Regulation of total ghrelin concentration following food stimulation is highly individual and responders showed upregulated total ghrelin, while the concentration of active ghrelin decreases following a meal. Protein content and colour intensity of food pictures reversely correlated with participants’ rating of the pictures. We conclude that observation of food pictures influences the concentration of several appetite-related hormones. The close link of visual clues to physiological responses is likely of clinical relevance. Additionally, the protein content of displayed foods and green colour intensity in pictures may serve as a predictor of subjective attractiveness of the presented meal.

Inter-goal conflict and facilitation as predictors of adherence to dieting goals: an ecological momentary assessment study

Objectives: To examine dieting goals within a system of individual goals, and the patterns by personally-relevant goals might interfere or facilitate each other.Design: 94 dieters completed an assessment of goals using Little's personal project analysis. Participants identified 7 goals; one of which was pre-defined as adhering to diet. Over the beginning 14 days of their diet, participants completed an Ecological Momentary Assessment study recording their food intake in real-time. Every evening, participants reported their goal engagement and which goals conflicted or facilitated with each other.Main outcome measures/results: Over the study duration, 1452 days of food intake and goal conflict/facilitation were recorded. Participants completed an average of 1.54 (SD = 0.85) snacks, an average of 0.94 (SD = 1.81) goal conflicts, and 4.16 (SD = 4.70) goal facilitations per day. Inter-goal conflict was associated with a significant but small improvement on individuals' mood, but was not associated with daily dietary intake or long-term weight-loss. Similarly, inter-goal facilitation was not associated with daily dietary intake or long-term weight-loss. Daily food intake was a significant predictor of long-term weight-loss.Conclusions: The results of this study suggest the impact of inter-goal conflict and facilitation on dieting is not via overall snack or food consumption.

Factors behind healthy snack consumption at school among high-school students: a qualitative study

BACKGROUND

The prevalence of consuming fast foods and non-nutritious snacks is progressively increasing among adolescents. This study aimed to explore factors behind snack consumption at school among Iranian high-school students.

METHODS

This descriptive qualitative study was conducted in 2017 in four boys' and four girls' high-schools located in Isfahan, Khorramabad, and Tehran, Iran. Data were collected through 42 in-depth semi-structured interviews and four focus groups with male and female students, their parents, and their school teachers and administrators. The conventional content analysis approach was used for data analysis. Trustworthiness was applied to the study through prolonged engagement, maximum variation sampling, and member checking techniques.

RESULTS

Factors behind students' snack consumption came into two main groups, namely influential behaviors, and influential emotions and perceptions. Influential behaviors included the behaviors of students, their family members, peers, school administrators, and snack sellers. Moreover, influential emotions and perceptions included positive and negative feelings towards healthy snacks, fear over the consequences of unhealthy snacks, and perceived positive outcomes of healthy snacks.

CONCLUSIONS

Students' snack consumption at school is affected not only by their own behaviors, emotions, and perceptions, but also by significant others' behaviors and environmental factors. School administrators need to make environmental modifications to turn school environment into a pleasant place for healthy snack consumption and make healthy snack consumption a pleasurable experience for students.

Tracking snacking in real time: Time to look at individualised patterns of behaviour

BACKGROUND

Identifying when and where people overeat is important for intervention design, yet little is known about how unhealthy behaviours unfold in real life.

AIM

To track the activities, social contexts and locations that co-occur with unhealthy snacking.

METHODS

Sixty-four adults (49F, mean age = 38.6 years) used electronic diaries to record snacking, location, social context and current activity every waking hour over 7 days. The proportion of snacking episodes that co-occurred with each location/activity/context was calculated by group and individual.

RESULTS

Over the group, snacking was most frequent whilst socialising (19.9% of hours spent socialising) or using the TV/computer (19.7%), when with friends (16.7%) and when at home (15.3%). All intra-class correlation statistics for cued behaviour were low, indicating the importance of within-person variability. There were marked individual differences between people in what constituted a 'typical' context for snacking.

CONCLUSIONS

People show substantial differences in the contexts in which they snack. Tailoring interventions to these individual patterns of behaviour may improve intervention efficacy.

Negative affect is associated with increased stress-eating for women with high perceived life stress

Perceived life stress (PLS) and cognitive restraint are associated with increased comfort food intake under stress and lead to weight gain and obesity, but the mechanisms by which they do so remain unclear. Stress and negative affect (NA) are associated with increased reward-driven comfort food intake as a means to 'feel better', particularly for individuals with higher PLS and cognitive restraint. Thus, we propose that PLS and cognitive restraint increase stress-eating by strengthening the relationship between stress-induced NA and comfort food intake. Upon comfort eating, individuals with higher PLS show greater reductions in the negative consequences of stress (e.g. NA). The rewarding effects of this 'emotional relief' may promote future stress-induced comfort eating, but this has yet to be examined. Thus, we investigate the pathways by which PLS or cognitive restraint increase snack intake under stress by proposing that 1) stress-induced NA is a stronger predictor of increased snack intake for women with greater PLS and cognitive restraint, and 2) greater PLS will be associated with greater reductions in NA upon snacking under stress (i.e. emotional relief). Forty-three healthy women were given snacks (chips, golden oreos, and M&Ms) to eat after a Trier Social Stress Test or rest period on separate days in counterbalanced order. Following linear regression analyses, we determined that stress-induced NA predicted more snack intake for women with higher PLS, and that higher PLS was associated with heightened emotional relief upon snacking under stress. Future studies are needed to directly assess whether greater emotional relief following stress-eating reinforces the learned association between stress-induced NA and intake, and ultimately explains greater stress-eating and obesity in women with higher PLS. This work may lead clinicians to focus on NA in the treatment of obesity-and stress-related illnesses for women with higher PLS.

Healthy eating and restaurants. A review of recent evidence in the literature

Food environments influence food consumption and population health. This study sought to establish the outstanding themes in recent scientific literature about healthy eating and restaurants. Studies about the topic published from 2011 to 2016 in seven recognized databases were reviewed systematically. From 999 titles, 20 articles were selected. Content analysis through an inductive method by two independent investigators was performed using Nvivo 10.0. Three dominant subjects were identified: Food supply modifications, promotion of healthy choices and barriers against healthy eating promotion. The findings describe research opportunities in the area, particularly in the Latin American context. It is necessary to make interventions that result in healthy food environments given the impact on collective health.

Mood and appetite: Their relationship with discretionary and total daily energy intake

BACKGROUND

Negative affect is shown consistently to promote unhealthy food choices and dietary intake in laboratory studies. However, this relationship in naturalistic settings is less clear and previous research is limited by dietary assessment methodology and neglects to account for several important moderating variables. This observational study aimed to examine the association of negative affect and other psychological factors associated with eating behaviour simultaneously with discretionary energy intake and total energy intake, and whether these were moderated by emotional eating predisposition or age, sex and weight status.

METHODS

One hundred adults completed a four-day food diary, a concurrent end-of-day questionnaire that assessed daily affect and experience of appetite, and the Three Factor Eating Questionnaire to assess trait eating behaviour. Food diaries provided data on participants' daily intake of total energy and of "discretionary items" (specific energy-dense and nutrient poor foods and beverages as defined by the Australian Guide to Healthy Eating). Stepwise random effects models were used to estimate the association of end-of-day ratings, trait eating behaviour and personal factors, and their interactions, with discretionary and total energy intake.

RESULTS

Daily rated negative affect and appetite were significantly and positively associated with discretionary intake, such that a one unit increase in each scale was associated with eating 139 kJ/d [SE 61] and 194 kJ/d [SE 68] more discretionary energy, respectively. Negative affect and its interaction with emotional eating were consistently, positively associated with discretionary energy intake. This relationship was strongest in younger participants (β = -4.9 [SE 2.2], p < .05). There was no interaction with sex or weight status. Total energy intake was not associated with negative affect nor its interaction with emotional eating but was consistently associated with appetite.

CONCLUSION

When personal factors (age, sex, BMI), trait eating behaviours and daily rated negative affect and appetite are considered simultaneously, daily discretionary intake is associated most strongly with negative affect. Individuals, particularly young adults, may be more likely to overeat discretionary energy on days that negative affect is rated more highly. However, this may not necessarily translate into greater total energy intake which was most consistently associated with daily rated appetite.

Implicit evaluation of chocolate and motivational need states interact in predicting chocolate intake in everyday life

Snack food consumption has a high relevance for health and is partially controlled by implicit, motivational processes that make self-control difficult at certain times. Specifically, research suggests that individuals with a more positive implicit food evaluation consume more snack foods in the laboratory under conditions of high motivational needs (e.g., hunger and food craving). Yet, no study investigated if and under which circumstances implicit evaluation of food predicts snack food intake in real life. In the present study, 60 female undergraduate students (mean age: 22.3 ± 2.34 years) at the University of Salzburg, Austria, completed a chocolate-related Single Category Implicit Association Test in the laboratory and then reported snack food intake during seven days of signal-contingent Ecological Momentary Assessment. Results showed that a more positive implicit evaluation of chocolate was associated with a higher likelihood of consuming chocolate in states of high hunger and high momentary chocolate craving, whereas no such modulatory pattern was found in states of low hunger or low chocolate craving. Therefore, interventions targeting daily chocolate craving and consumption may be particularly beneficial in specific situations (i.e., in states of high hunger and craving) and also in vulnerable populations (e.g., those with a more positive implicit food evaluation).

Preliminary Validation of the Exercise-Snacking Licensing Scale: Rewarding Exercise with Unhealthy Snack Foods and Drinks

There is evidence that individuals’ compensatory health beliefs may be an important psychological driver of health behavior. Only recently, however, have researchers begun to develop and seek to validate instruments that are suited to measuring specific pairings of the diverse compensatory health beliefs that exist. The aim of this study was to provide support for key aspects of validity associated with the Exercise-Snacking Licensing Scale (ESLS), an instrument that was designed to assess individuals’ endorsement (or licensing) of unhealthy snacking behaviors around exercise. Participants (N = 1095) responded to a version of the ESLS that was designed to assess their licensing responses following either “light” or “tiring” physical activity, and completed additional instruments assessing dispositional, exercise-related, and diet-related constructs. Analyses indicated that scores derived from both versions of the ESLS (“light” and “tiring” physical activity) displayed a relatively consistent factor structure, favorable alpha coefficients, and meaningful correlations with variables that are theoretically aligned with licensing. Factor analytic procedures did, however, indicate that researchers may wish, in future, to consider the use (or not) of reverse-scored items within the ESLS. Together, these findings provide important insight into the structural, external, and generalizability aspects of validity for scores derived from the ESLS, and indicate that the ESLS may be a valuable instrument for the brief assessment of unhealthy licensing beliefs around exercise. Further use of the ESLS is encouraged to determine if and how these licensing beliefs actually influence subsequent snacking behaviors, and the potential downstream effects these beliefs may have in shaping health outcomes associated with exercise participation.