Exploring Strategies to Optimise the Impact of Food-Specific Inhibition Training on Children's Food Choices

The effectiveness of Go/No-Go and Stop-Signal training in reducing food consumption and choice: A systematic review and meta-analysis

The Go/No-Go and Stop-Signal tasks have been used to reduce excess food intake via repeated pairing of food cues with response inhibition. A meta analysis of 32 studies was conducted to determine whether, and under which conditions, the Go/No-Go and Stop-Signal training tasks are effective in reducing food consumption or choice. Moderators included task parameters (e.g., number of sessions, stop signal), sample differences (e.g., age, weight), and the measure of food consumption or choice. Overall, there was a small effect for Go/No-Go and Stop-Signal training in reducing food consumption or choice, g = -0.21, CI95 = [-0.31, -0.11], p < .001, with this holding individually only for a single session of the Go/No-Go Task, g = -0.31, CI95 = [-0.45, -0.18], p < .001. Comprehensive investigation of the impact of varying moderators indicated that the effect for Go/No-Go training was robust. Nevertheless, there was significant variation in the specific parameters of the task. Overall, the present meta-analysis extends previous findings by providing comprehensive evidence that the Go/No-Go Task is effective in reducing food consumption and choice, as well as providing optimal parameter recommendations for the task.

Can smartphone-based response inhibition training elicit sustained changes in appetite, preference, and cravings for energy-dense foods? A free-living randomized controlled trial

BACKGROUND

Food-specific response inhibition training has been implemented as a strategy to modify food choices and reward-related eating behaviours, but short-term studies have produced equivocal findings.

OBJECTIVE

To longitudinally assess the effect of a smartphone-based response inhibition intervention on food reward, hedonic eating drive, and cravings in a free-living setting.

METHODS

84 adults (Mage  = 30.49, SDage  = 13.01, 52 female) with high responsivity to food cues or overweight/obesity were randomly assigned to a response inhibition training intervention (n = 45) or a control game (n = 39) at home during a training week, followed by a week with no training. Primary analyses compared groups on measures of explicit liking and implicit wanting for food of different energy densities, food cravings, and reward-related eating throughout this two-week period.

RESULTS

A reduction was observed in explicit liking and implicit wanting for energy-dense foods from baseline to post-training independent of condition (ps < .001). These changes from baseline were sustained after a 1-week latency period, also independent of condition (ps < .001). These effects coincided with similar observations of hedonic eating drive, tonic cravings, and control over cravings during the observation period (ps < .01).

CONCLUSIONS

Although significant reductions in reward-related appetite were observed, free-living response inhibition training did not offer additional benefit over a control activity. Future intervention studies with observable food intake are needed to investigate which appetitive mechanisms most reliably predict eating behaviour over time.

TRIAL REGISTRATION

Retrospectively registered with ANZCTR [ACTRN12622001502729].

Evaluating Eating Behaviour, Energy Homeostasis, and Obesity in Childhood-Onset Craniopharyngioma: A Feasibility Study

INTRODUCTION

Craniopharyngiomas are rare brain tumours (incidence 1.1-1.7 cases/million/year). Although non-malignant, craniopharyngioma causes major endocrine and visual morbidities including hypothalamic obesity, yet mechanisms leading to obesity are poorly understood. This study investigated the feasibility and acceptability of eating behaviour measures in patients with craniopharyngioma to inform the design of future trials.

METHODS

Patients with childhood-onset craniopharyngioma and controls matched for sex, pubertal stage, and age were recruited. After an overnight fast, participants received the following measures: body composition, resting metabolic rate, oral glucose tolerance test including magnetic resonance imaging (patients only), appetite ratings, eating behaviour, and quality of life questionnaires, ad libitum lunch, and an acceptability questionnaire. Data are reported as median ± IQR, with effect size measure (Cliff's delta) and Kendall's tau for correlations, due to the small sample size.

RESULTS

Eleven patients (median age = 14 years; 5 F/6 M) and matched controls (median age = 12 years; 5 F/6 M) were recruited. All patients had received surgery, and 9/11 also received radiotherapy. Hypothalamic damage post-surgery was graded (Paris grading): grade 2 n = 6; grade 1 n = 1; grade 0 n = 2. The included measures were deemed highly tolerable by participants and their parent/carers. Preliminary data suggest a difference in hyperphagia between patients and controls (d = 0.5), and a relationship between hyperphagia with body mass index standard deviation score (BMISDS) in patients (τ = 0.46).

DISCUSSION

These findings demonstrate that eating behaviour research is feasible and acceptable to craniopharyngioma patients and there is an association between BMISDS and hyperphagia in patients. Thus, food approach and avoidance behaviours may be useful targets for interventions to manage obesity in this patient group.

Efficacy of a food response and attention training treatment for obesity: A randomized placebo controlled trial

Elevated brain reward and attention region response, and weaker inhibitory region response to high-calorie foods has predicted future weight gain, suggesting that an intervention that reduces reward and attention region response and increases inhibitory region response to such foods might reduce overeating. We conducted a randomized controlled trial to test whether a multi-faceted food response and attention training protocol with personalized high- and low-calorie food images would reduce body fat and valuation and reward region response to high-calorie foods compared to a placebo control training protocol with non-food images in an effort to replicate findings from two past trials. Participants were community-recruited adults with overweight/obesity (N = 179; M age = 27.7 ± 7.0) who completed assessments at pretest, posttest, 3-month, 6-month, and 12-month follow-ups. Participants randomized to the food response inhibition and attention training showed significantly greater increases in palatability ratings of low-calorie foods than controls (d = 0.27) at posttest, but did not show body fat loss, reductions in palatability ratings and monetary valuation, or reward region response, to high-calorie foods. The lack of expected effects appears to be related to weaker learning compared to the learning in past trials, potentially because we used more heterogenous high-calorie and low-calorie food images in the present training.

Efficacy of a combined food-response inhibition and attention training for weight loss

This Current Opinion in Behavioral Sciences article reviews trials that evaluated an obesity treatment that combines response-inhibition training with high-calorie foods and training designed to reduce attention for high-calorie foods. Two randomized controlled trials suggest that food-response inhibition and attention training produced significant body-fat loss, along with a reduction in valuation of, and reward-region response to, high-calorie foods. However, these effects did not emerge in a third trial, potentially because this trial used more heterogeneous food images, which reduced inhibition learning and attentional learning. Collectively, results suggest that food-response inhibition and attention training can devalue high-calorie foods and result in weight loss, but only if a homogeneous set of high-calorie and low-calorie food images is used.

The role of attention control in complex real-world tasks

Working memory capacity is an important psychological construct, and many real-world phenomena are strongly associated with individual differences in working memory functioning. Although working memory and attention are intertwined, several studies have recently shown that individual differences in the general ability to control attention is more strongly predictive of human behavior than working memory capacity. In this review, we argue that researchers would therefore generally be better suited to studying the role of attention control rather than memory-based abilities in explaining real-world behavior and performance in humans. The review begins with a discussion of relevant literature on the nature and measurement of both working memory capacity and attention control, including recent developments in the study of individual differences of attention control. We then selectively review existing literature on the role of both working memory and attention in various applied settings and explain, in each case, why a switch in emphasis to attention control is warranted. Topics covered include psychological testing, cognitive training, education, sports, police decision-making, human factors, and disorders within clinical psychology. The review concludes with general recommendations and best practices for researchers interested in conducting studies of individual differences in attention control.

Exploring acute and non-specific effects of mobile app-based response inhibition training on food evaluation and intake

Previous studies have demonstrated that response inhibition training can modify the appeal of palatable and energy-dense foods, thus serving as a potential intervention for weight management, via changes in food selection and intake. However, empirical findings of efficacy have been inconsistent across studies due to heterogenous approaches to measuring salient appetitive outcomes, training implementation strategies, and sample recruitment. Systematic assessment of both affective and motivational components of food reward may help characterise to what extent devaluation can be generalised to nutritionally similar foods post-training. In this mixed factorial experiment, a non-clinical, adult sample completed time-matched single sessions with mobile app-based response inhibition training and control tasks of short (12 min; n = 27) or long (20 min; n = 25) duration. Participants were assessed on two discrete facets of food reward pre- and post-training: pleasure (i.e., explicit liking) and desire (i.e., implicit wanting) for non-specific (i.e., novel) food stimuli differing in energy-density. Consumption of snacks categorised by energy density was also assessed in a laboratory ad libitum taste test post-training. No significant differences were found between intervention and control sessions on explicit liking or implicit wanting for non-specific energy-dense foods. Moreover, participants ate a similar volume of snack foods during both sessions. Training duration did not significantly moderate differences between intervention and control sessions in primary outcomes. Variance between intervention and control sessions in chocolate intake and frequency of choice for energy-dense foods, but not explicit liking, was associated with a higher BMI. Methodological and theoretical implications for appropriate intervention implementation and underlying mechanisms, respectively, are discussed.

Food-Specific Inhibition Training for Food Devaluation: A Meta-Analysis

Theories have suggested that food-specific inhibition training could lead to food devaluation which, in turn, may help people to regulate their eating behavior. In this review, we have synthesized the current literature on this topic by conducting a meta-analysis of studies investigating the effects of food-specific inhibition training on food evaluation. We identified 24 studies-with 36 independent samples, 77 effect sizes, and 3032 participants-that met our inclusion criteria. Effect sizes were analyzed using the robust variance estimation in random effects meta-regression technique. The results indicate that food-specific inhibition training can lead to statistically significant reductions in food evaluation. More specifically, it was observed that the effects of training on participants' food evaluation differed according to the type of evaluation; food-specific inhibition training significantly decreased participants' explicit food evaluation, but not their implicit food evaluation. However, because most of the included studies focused on trained food items and short-term outcomes in normal-weight samples, more research is needed on the continuance of the training effects, as well as on the extent to which effects can be generalized to untrained food items or different populations (e.g., overweight or obese individuals).