Integrating Mindfulness Into Eating Behaviors

Methods to assess ambivalence towards food and diet: a scoping review

BACKGROUND

Ambivalence towards food and diet, which favours behavioural inertia, might be a barrier to adopting healthier eating behaviours. Measuring it can help researchers to better understand its relationship with behaviour change and design interventions aimed at resolving it. In this scoping review, we map and describe methods and tools employed in studies to assess, measure or classify the ambivalence of participants towards food- and diet-related attitude objects.

METHODS

In accordance with Joanna Briggs Institute guidance for conducting scoping reviews, we retrieved peer-reviewed studies from MEDLINE, CINAHL, PsycINFO, Web of Science, FSTA and Food Science Source and preprints from PsyArXiv and MedRxiv. Two independent reviewers screened the articles. We considered for inclusion peer-reviewed studies and preprints that assessed the ambivalence of participants of any age, sex or sociodemographic group towards food and diet.

RESULTS

We included 45 studies published between 1992 and 2022, which included participants from 17 countries. Eighteen methods were employed across the included studies to assess different types of ambivalence (felt, potential or cognitive-affective), the most frequent of which were the Griffin Index, the Subjective Ambivalence Questionnaire, the MouseTracker Paradigm and the Orientation to Chocolate Questionnaire.

CONCLUSION

This scoping review identified several methods and tools to assess different types of ambivalence towards food- and diet-related objects, providing an array of options for future studies.

Snack Package Size and Variety Differentially Influence Energy Intake and Food Choices in Healthy Adults

BACKGROUND

While energy and nutritional content of snacks can contribute to overconsumption, other factors within the modern food environment may also influence the amount and types of snacks consumed.

OBJECTIVES

The aim was to examine whether snack package size and variety influence free-living snacking behavior in healthy adults. The impact of intuitive eating score on snacking behavior was also examined.

METHODS

Thirty adults [age: 23.6 ± 0.8 y; BMI (kg/m2): 22.8 ± 0.5] participated in a randomized crossover-design study. Participants were provided, in randomized order, with the following isocaloric snack exposures to consume for 3 d/exposure-1) CONTROL: highly appealing/appetizing snacks (e.g., dessert snacks, candy, savory snacks, fruits and vegetables, protein snacks); 2) LARGE-PACKAGE: similar snacks as CONTROL but in larger package sizes; and 3) VARIETY: larger variety of snacks. The primary outcomes included the 3-d average ad libitum snack energy, macronutrient content, and food choices for each snack exposure. The secondary outcome was the intuitive eating score and snacking behavior.

RESULTS

LARGE-PACKAGE increased snack intake by 11.9% (1150 ± 81 kcal) compared with CONTROL (1030 ± 71 kcal, P = 0.04), whereas VARIETY snack intake (1030 ± 69 kcal) was no different from CONTROL (P = 1.0). LARGE-PACKAGE increased consumption of desserts compared with CONTROL (P = 0.03) and VARIETY (P = 0.02). Alternately, VARIETY increased consumption of fruits and vegetables compared with LARGE-PACKAGE (P = 0.01) and CONTROL (P = 0.01). Intuitive eating score was not significantly associated with snack intake or snack choice (all, P > 0.05).

CONCLUSIONS

Snack package size and variety differentially influence energy intake and food choices in healthy adults. This trial was registered atclinicaltrials.gov (NCT03940105).

Mindful Eating Proficiency and Healthy Eating Literacy among Japanese Mothers: Associations with Their Own and Their Children's Eating Behavior

Mindfulness is a process of focusing one’s attention on the present moment. Applying this concept to eating (i.e., mindful eating (ME)) is associated with regulated eating behaviors, particularly in people with obesity and who are overweight. Sustaining healthy eating habits requires both healthy eating literacy (HEL) and proficiency in ME. However, ME proficiency in Japanese people has not been sufficiently investigated. In this paper, we conduct a survey of mothers with 4- to 5-year-old children in Aomori City, Japan, to investigate their ME proficiency and HEL level and eating behavior and self-reported body mass index in both mothers and their children from August to September 2019. This study is the first to describe ME proficiency in Japanese mothers. The study sample includes 128 participants from 18 nursery schools. ME proficiency in mothers was positively correlated with both their own and their children’s eating behaviors, thereby suggesting a potential relationship, while strong relationships were not observed between the HEL level and eating behaviors of mothers and children. Improving ME skills, rather than HEL, may be an effective way to sustain healthier eating behaviors in mothers and their children. The level of evidence was Level V: Opinions of respected authorities based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Identifying behavioral types of dietary lapse from a mobile weight loss program: Preliminary investigation from a secondary data analysis

Success in behavioral weight loss (BWL) programs depends on adherence to the recommended diet to reduce caloric intake. Dietary lapses (i.e., deviations from the BWL diet) occur frequently and can adversely affect weight loss outcomes. Research indicates that lapse behavior is heterogenous; there are many eating behaviors that could constitute a dietary lapse, but they are rarely studied as distinct contributors to weight outcomes. This secondary analysis aims to evaluate six behavioral lapse types during a 10-week mobile BWL program (eating a large portion, eating when not intended, eating an off-plan food, planned lapse, being unaware of caloric content, and endorsing multiple types of lapse). Associations between weekly behavioral lapse type frequency and weekly weight loss were investigated, and predictive contextual characteristics (psychological, behavioral, and environmental triggers for lapse) and individual difference (e.g., age, gender) factors were examined across lapse types. Participants (N = 121) with overweight/obesity (M_BMI = 34.51; 84.3% female; 69.4% White) used a mobile BWL program for 10 weeks, self-weighed weekly using Bluetooth scales, completed daily ecological momentary assessment of lapse behavior and contextual characteristics, and completed a baseline demographics questionnaire. Linear mixed models revealed significant negative associations between unplanned lapses and percent weight loss. Unplanned lapses from eating a large portion, eating when not intended, and having multiple "types" were significantly negatively associated with weekly percent weight loss. A lasso regression showed that behavioral lapse types share many similar stable factors, with other factors being unique to specific lapse types. Results add to the prior literature on lapses and weight loss in BWL and provide preliminary evidence that behavioral lapse types could aid in understanding adherence behavior and developing precision medicine tools to improve dietary adherence.

A restoration ecology perspective on the treatment of inflammatory bowel disease

The human gut can be considered an ecosystem comprised of a community of microbes and nonliving components such as food metabolites and food additives. Chronic diseases are increasingly associated with disruption of this ecosystem. The science of restoration ecology was developed to restore degraded ecosystems, but its principles have not been applied widely to gut medicine, including the treatment of inflammatory bowel disease (IBD). One principle of ecological restoration is that ‘passive’ restoration, which involves removing an ecosystem disturbance, should occur before attempting additional ‘active’ interventions. We discuss evidence that poor diet is principle source of disturbance in IBD, and therefore requires better attention in its research and clinical care. Another restoration principle is that higher biodiversity may improve ecosystem behavior, but this idea has not been tested for its possible importance in donor stool during fecal microbiota transplants.

Lay summary: In patients with chronic disease the gut microbiome behaves like a disturbed ecosystem. Principles borrowed from the science of restoration ecology identify a need to better understand the influence of diet on treatment of inflammatory bowel disease and the importance of donor diversity in fecal microbiota transplants.