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Boyland E, Maden M, Coates AE, Masterson TD, Alblas MC, Bruce AS, Roberts CA. Food and non-alcoholic beverage marketing in children and adults: A systematic review and activation likelihood estimation meta-analysis of functional magnetic resonance imaging studies. Obes Rev 2024; 25:e13643. [PMID: 37766661 DOI: 10.1111/obr.13643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 07/12/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023]
Abstract
Food marketing impacts the food behaviors of children and adults, but the underpinning neural mechanisms are poorly understood. This systematic review and meta-analysis pooled evidence from neuroimaging studies of exposure to food marketing stimuli (vs. control) on brain activations in children and adults to clarify regions associated with responding. Databases were searched for articles published to March 2022. Inclusion criteria included human functional magnetic resonance imaging (fMRI) studies employing a contrast between a food marketing stimulus and a non-food/non-exposure control, published in English in a peer-reviewed journal, reporting whole brain (not Region of Interest [ROI] only) co-ordinates. Eleven studies met inclusion criteria, of which eight were included in the quantitative synthesis (Activation Likelihood Estimation [ALE] meta-analysis). Food marketing exposures (vs. controls) produced greater activation in two clusters lying across the middle occipital gyrus, lingual gyrus, and cuneus (cluster 1), and the postcentral gyrus, precentral gyrus, and the inferior parietal lobule/supramarginal gyrus (cluster 2). Brain responses to food marketing are most consistently observed in areas relating to visual processing, attention, sensorimotor activity, and emotional processing. Subgroup analyses (e.g., adults vs. children) were not possible because of the paucity of data, and sensitivity analyses highlighted some instability in the clusters; therefore, conclusions remain tentative pending further research.
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Affiliation(s)
- Emma Boyland
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Michelle Maden
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Anna E Coates
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Travis D Masterson
- Department of Nutritional Sciences, The Pennsylvania State University, Pennsylvania, USA
| | - Monique C Alblas
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
| | - Amanda S Bruce
- Department of Pediatrics, University of Kansas Medical Center, Kansas, USA
| | - Carl A Roberts
- Department of Psychology, University of Liverpool, Liverpool, UK
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2
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Pradeep Kumar D, Zanotto T, Cozart JS, Bruce AS, Befort C, Siengsukon C, Shook R, Lynch S, Mahmoud R, Simon S, Hibbing PR, Drees B, Huebner J, Bradish T, Robichaud J, Sosnoff JJ, Bruce JM. Association between frailty and sleep quality in people living with multiple sclerosis and obesity: An observational cross-sectional study. Mult Scler Relat Disord 2024; 81:105154. [PMID: 38043367 DOI: 10.1016/j.msard.2023.105154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND A majority of the people with multiple sclerosis (pwMS) experience sleep disturbances. Frailty is also common in pwMS. The geriatric literature strongly suggests that frailty is associated with worse sleep outcomes in community-dwelling older adults, but this association has yet to be explored among pwMS. This study focused on examining the association between frailty and sleep quality in pwMS. METHODS Seventy-six people with both MS and obesity (mean age: 47.6 ± 10.9 years, 81.6 % female, mean body mass index (BMI): 37.10 ± 5.5 kg/m2, mean Patient Determined Disease Steps (PDDS): 0.82 ± 1.20) were included in this cross-sectional secondary analysis. A comprehensive frailty index (FI) based on 41 health deficits from various health domains was calculated based on standardized procedures. Sleep quality was determined by the Pittsburgh Sleep Quality Index questionnaire (PSQI). RESULTS Overall, 67.1 % of the participants were identified as non-frail (FI ≤ 0.25), and 32.9 % were identified as frail (FI > 0.25). A significant correlation was observed between FI scores and global PSQI scores (ρ = 0.43, p < 0.05). Cross-tabulation analyses revealed that frail participants had worse subjective sleep quality, sleep latency, habitual sleep efficiency, sleep disturbances, daytime dysfunction, and higher use of sleep medications compared to non-frail participants (p < 0.05). CONCLUSIONS The current study identified a significant association between frailty and sleep quality in people with both MS and obesity with minimal disability. These findings underscore the importance of untangling the relationship between frailty and sleep quality in pwMS. These results could lead to a more targeted approach for rehabilitation interventions aiming to improve frailty in MS.
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Affiliation(s)
- Danya Pradeep Kumar
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA
| | - Tobia Zanotto
- Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA; Mobility Core, University of Kansas Centre for Community Access, Rehabilitation Research, Education and Service, Kansas City, KS, USA; Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA
| | - Julia S Cozart
- Department of Biomedical and Health Informatics, University of Missouri - Kansas City School of Medicine, University of Missouri - Kansas City, Kansas City, MO, USA
| | - Amanda S Bruce
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA; Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Christie Befort
- Department of Population Health, University Kansas Medical Center, Kansas City, KS, USA
| | - Catherine Siengsukon
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA
| | - Robin Shook
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA; Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA; School of Medicine, University of Missouri-Kansas City, Kansas City, MO USA
| | - Sharon Lynch
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Rola Mahmoud
- Department of Neurology, University of Missouri, Kansas City, Saint Luke's Hospital, Kansas City, MO, USA
| | - Steve Simon
- Department of Biomedical and Health Informatics, University of Missouri - Kansas City School of Medicine, University of Missouri - Kansas City, Kansas City, MO, USA
| | - Paul R Hibbing
- Department of Kinesiology & Nutrition, University of Illinois Chicago, Chicago, IL, USA
| | - Betty Drees
- Department of Biomedical and Health Informatics, University of Missouri - Kansas City School of Medicine, University of Missouri - Kansas City, Kansas City, MO, USA; Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA; Graduate School of the Stowers Institute for Medical Research, USA
| | - Joanie Huebner
- UMKC Department of Community and Family Medicine, University Health Lakewood Medical Center, Kansas City, MO, USA
| | - Taylor Bradish
- Department of Biomedical and Health Informatics, University of Missouri - Kansas City School of Medicine, University of Missouri - Kansas City, Kansas City, MO, USA
| | - Jade Robichaud
- Department of Biomedical and Health Informatics, University of Missouri - Kansas City School of Medicine, University of Missouri - Kansas City, Kansas City, MO, USA
| | - Jacob J Sosnoff
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA; Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA; Mobility Core, University of Kansas Centre for Community Access, Rehabilitation Research, Education and Service, Kansas City, KS, USA; Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jared M Bruce
- Department of Biomedical and Health Informatics, University of Missouri - Kansas City School of Medicine, University of Missouri - Kansas City, Kansas City, MO, USA; Departments of Neurology and Psychiatry, University Health, Kansas City, MO, USA.
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Killian HJ, Bakula DM, Wallisch A, Swinburn Romine R, Fleming K, Edwards ST, Bruce AS, Chang CN, Mousa H, Davis AM. Pediatric Tube Weaning: A Meta-Analysis of Factors Contributing to Success. J Clin Psychol Med Settings 2023; 30:753-769. [PMID: 36856955 PMCID: PMC10989027 DOI: 10.1007/s10880-023-09948-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2023] [Indexed: 03/02/2023]
Abstract
Approximately 3-10% of children have severe feeding issues, and some require enteral/tube nutrition to grow and thrive. For many children, tube feeding is temporary, making efficacious interventions for tube weaning essential. We conducted a systematic review and meta-analysis of tube weaning treatments. Outcomes included percentage of participants completely weaned from the tube, and mean percentage of kilocalories consumed orally following treatment. Data were extracted from 42 studies, including cohort studies and single-subject research design studies. We evaluated moderators of treatment success, including treatment setting, use of behavioral approaches, use of hunger provocation, and use of a multidisciplinary approach. Results indicated that, after treatment, children received significantly more calories orally, and 67-69% of children were fully weaned. These analyses suggest that current interventions are generally effective; however, variability within treatments exist. Prospective randomized clinical trials are needed to understand effective components of weaning interventions.
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Affiliation(s)
- Haley J Killian
- Department of Psychology, University of Missouri-Kansas City, 5030 Cherry St, Kansas City, MO, USA.
- Division of Developmental and Behavioral Health, Children's Mercy Kansas City, 2401 Gillham Rd, Kansas City, MO, USA.
| | - Dana M Bakula
- Division of Pediatric Gastroenterology, University of Missouri-Kansas City, 2411 Holmes, Kansas City, MO, 64108, USA
- School of Medicine, University of Missouri-Kansas City, 2411 Holmes, Kansas City, MO, 64108, USA
- Center for Children's Healthy Lifestyles & Nutrition, 610 E 22nd St, Kansas City, MO, USA
| | - Anna Wallisch
- Juniper Gardens Children's Project, University of Kansas, 444 Minnesota Ave #300, Kansas City, KS, USA
| | - Rebecca Swinburn Romine
- Life Span Institute, Dole Human Development Center, University of Kansas, 1000 Sunnyside Ave, Lawrence, KS, USA
| | - Kandace Fleming
- Life Span Institute, Dole Human Development Center, University of Kansas, 1000 Sunnyside Ave, Lawrence, KS, USA
| | - Sarah T Edwards
- Division of Pediatric Gastroenterology, University of Missouri-Kansas City, 2411 Holmes, Kansas City, MO, 64108, USA
- School of Medicine, University of Missouri-Kansas City, 2411 Holmes, Kansas City, MO, 64108, USA
- Center for Children's Healthy Lifestyles & Nutrition, 610 E 22nd St, Kansas City, MO, USA
| | - Amanda S Bruce
- Center for Children's Healthy Lifestyles & Nutrition, 610 E 22nd St, Kansas City, MO, USA
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, USA
| | - Chi-Ning Chang
- Department of Foundations of Education, School of Education, Virginia Commonwealth University, 1015 W. Main Street, PO Box 842020, Richmond, VA, USA
| | - Hayat Mousa
- Division of Gastroenterology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, USA
| | - Ann M Davis
- Center for Children's Healthy Lifestyles & Nutrition, 610 E 22nd St, Kansas City, MO, USA
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, USA
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Bruce JM, Cozart JS, Shook RP, Befort C, Siengsukon CF, Simon S, Lynch SG, Mahmoud R, Drees B, Posson P, Hibbing PR, Huebner J, Bradish T, Robichaud J, Bruce AS. Modifying diet and exercise in multiple sclerosis (MoDEMS): A randomized controlled trial for behavioral weight loss in adults with multiple sclerosis and obesity. Mult Scler 2023; 29:1860-1871. [PMID: 38018409 DOI: 10.1177/13524585231213241] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
BACKGROUND Obesity is a risk factor for developing multiple sclerosis (MS) and MS-related disability. The efficacy of behavioral weight loss interventions among people with MS (pwMS) remains largely unknown. OBJECTIVE Examine whether a group-based telehealth weight loss intervention produces clinically significant weight loss in pwMS and obesity. METHODS Seventy-one pwMS were randomized to the weight loss intervention or treatment-as-usual (TAU). The 6-month program promoted established guidelines for calorie reduction and increased physical activity. Anthropometric measurements, mobility tasks, self-report questionnaires, and accelerometry were used to assess changes at follow-up. RESULTS Mean percent weight loss in the treatment group was 8.6% compared to 0.7% in the TAU group (p < .001). Sixty-five percent of participants in the intervention achieved clinically meaningful weight loss (⩾ 5%). Participants in the treatment group engaged in 46.2 minutes/week more moderate-to-vigorous physical activity than TAU participants (p = .017) and showed improvements in quality of life (p = .012). Weight loss was associated with improved mobility (p = .003) and reduced fatiguability (p = .008). CONCLUSION Findings demonstrate the efficacy of a behavioral intervention for pwMS and obesity, with clinically significant weight loss for two-thirds of participants in the treatment condition. Weight loss may also lead to improved mobility and quality of life.
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Affiliation(s)
- Jared M Bruce
- Department of Biomedical and Health Informatics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
- Departments of Neurology and Psychiatry, University Health, Kansas City, MO, USA
| | - Julia S Cozart
- Department of Biomedical and Health Informatics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Robin P Shook
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
- Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Christie Befort
- Department of Population Health, University Kansas Medical Center, Kansas City, KS, USA
| | - Catherine F Siengsukon
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
| | - Stephen Simon
- Department of Biomedical and Health Informatics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Sharon G Lynch
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Rola Mahmoud
- Department of Neurology, Saint Luke's Hospital, Kansas City, MO, USA
- Department of Neurology, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Betty Drees
- Department of Biomedical and Health Informatics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
- Department of Internal Medicine, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
- Graduate School of the Stowers Institute for Medical Research, Kansas City, MO, USA
| | - Paige Posson
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
| | - Paul R Hibbing
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, USA
| | - Joanie Huebner
- Department of Community and Family Medicine, University Health Lakewood Medical Center, Kansas City, MO, USA
| | - Taylor Bradish
- Department of Biomedical and Health Informatics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Jade Robichaud
- Department of Biomedical and Health Informatics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Amanda S Bruce
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
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5
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Cozart JS, Bruce AS, Befort C, Siengsukon C, Lynch SG, Punt S, Simon S, Shook RP, Huebner J, Bradish T, Robichaud J, Bruce JM. A pilot study evaluating the prefeasibility of a behavioral weight loss program in people with multiple sclerosis. Prev Med Rep 2023; 36:102437. [PMID: 37810265 PMCID: PMC10558767 DOI: 10.1016/j.pmedr.2023.102437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 09/14/2023] [Accepted: 09/20/2023] [Indexed: 10/10/2023] Open
Abstract
Weight loss interventions seldom include individuals with neurologic disease. The aims of the present study were to: 1) develop and assess the prefeasibility of a 6-month telehealth behavioral weight loss program for people with multiple sclerosis (MS) and obesity and 2) examine changes in weight loss (primary outcome), physical activity, and fruit/vegetable consumption at follow-up. Participants with obesity and MS engaged in a 24-week weight loss program. Participants followed established diet, exercise, and self-monitoring guidelines and attended weekly online group meetings. Median percentage weight loss was 10.54 % (SD = 7.19). Participants who adhered more closely to the self-monitoring guidelines (r = 0.81, p =.02), and who averaged higher weekly active minutes (r = 0.91, p =.002) achieved greater percentage weight loss. Six of the eight pilot participants achieved clinically meaningful weight loss (>5%) after 6-months.
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Affiliation(s)
- Julia S. Cozart
- University of Missouri-Kansas City School of Medicine, Department of Biomedical and Health Informatics, 2411 Holmes St., Kansas City, MO, USA
- University of Missouri-Kansas City, Department of Psychology, 5030 Cherry St., Kansas City, MO, USA
| | - Amanda S. Bruce
- Department of Pediatrics, University of Kansas Medical Center, 2801 Olathe Blvd., Kansas City, KS, USA
- Children’s Mercy Hospital, Center for Children’s Healthy Lifestyles and Nutrition, 610 E 22 St., Kansas City, MO, USA
| | - Christie Befort
- University of Kansas Medical Center, Department of Population Health, 2060 W 39 Ave., Kansas City, KS, USA
| | - Catherine Siengsukon
- University of Kansas Medical Center, Department of Physical Therapy, Rehabilitation Science, and Athletic Training, 3901 Rainbow Blvd., Kansas City, KS, USA
| | - Sharon G. Lynch
- University of Kansas Medical Center, Department of Neurology, 3901 Rainbow Blvd., Kansas City, KS, USA
| | - Stephanie Punt
- University of Kansas, Department of Psychology, 1415 Jayhawk Blvd., Lawrence, KS, USA
- University of California, Los Angeles, Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Los Angeles, CA 90024, USA
| | - Stephen Simon
- University of Missouri-Kansas City School of Medicine, Department of Biomedical and Health Informatics, 2411 Holmes St., Kansas City, MO, USA
| | - Robin P. Shook
- Children’s Mercy Hospital, Center for Children’s Healthy Lifestyles and Nutrition, 610 E 22 St., Kansas City, MO, USA
- Department of Pediatrics, Children’s Mercy Hospital, 2401 Gillham Rd., Kansas City, MO, USA
- School of Medicine, University of Missouri-Kansas City, 2411 Holmes St., Kansas City, MO USA
| | - Joanie Huebner
- University Health Lakewood Medical Center, UMKC Department of Community and Family Medicine, 7900 Lee’s Summit Rd., Kansas City, MO, USA
| | - Taylor Bradish
- University of Missouri-Kansas City School of Medicine, Department of Biomedical and Health Informatics, 2411 Holmes St., Kansas City, MO, USA
| | - Jade Robichaud
- University of Missouri-Kansas City School of Medicine, Department of Biomedical and Health Informatics, 2411 Holmes St., Kansas City, MO, USA
| | - Jared M. Bruce
- University of Missouri-Kansas City School of Medicine, Department of Biomedical and Health Informatics, 2411 Holmes St., Kansas City, MO, USA
- Department of Neurology, University Health, 2411 Holmes St., Kansas City, MO, USA
- Department of Psychiatry, University Health, 2411 Holmes St., Kansas City, MO, USA
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Cozart JS, Bruce AS, Shook RP, Befort C, Siengsukon C, Simon S, Lynch SG, Mahmoud R, Drees B, Posson P, Hibbing PR, Huebner J, Bradish T, Robichaud J, Bruce JM. Body metrics are associated with clinical, free-living, and self-report measures of mobility in a cohort of adults with obesity and multiple sclerosis. Mult Scler Relat Disord 2023; 79:105010. [PMID: 37776827 DOI: 10.1016/j.msard.2023.105010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/29/2023] [Accepted: 09/13/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Obesity is associated with multiple sclerosis (MS) onset and may contribute to more rapid disability accumulation. Whether obesity impacts mobility in MS is uncertain. Some studies find that obesity in MS is associated with poorer mobility; other studies find no relationship. Discrepant findings may be due to differences in measurement and methodology. In the present study, we employ a comprehensive battery of anthropometric and mobility measures in a sample of people with MS and obesity. METHODS Participants with MS (N = 74) completed a battery of adiposity measurements (weight, height, waist circumference, and full body dual-energy x-ray absorptiometry [DXA] scans). They also completed validated clinical, free-living (accelerometry), and self-report measures of mobility. Spearman's Rho correlations were used to examine the associations between mobility and obesity measures with Benjamini and Hochberg correction for multiple comparisons. Multiple linear regression was used to examine if adiposity predicted mobility outcomes in people with MS when controlling for age and disease duration. RESULTS The majority of participants (n = 70) were diagnosed with relapsing-remitting MS and reported mild MS-related disability on the Patient Determined Disease Steps (M = 0.77, SD = 1.1). Median BMI was 35.8 (SD = 5.4). Higher percentage body fat (measured via DXA) was associated with poorer self-reported physical functioning (rs = -0.52, p <0.001), less moderate-to-vigorous physical activity (rs = -0.24, p = 0.04), and worse performance on the Six Minute Walk Test (6MWT; rs = -0.44, p <0.001), the Timed 25 Foot Walk (T25FW; rs = 0.45, p <0.001), and the Timed Up and Go test (TUG; rs = 0.35, p = .003). Higher BMI and waist-to-height ratio (WtHR) were associated with worse outcomes on the 6MWT (BMI; rs = -0.35, p <0.01, WtHR; rs = -0.43, p <0.001), T25FW (BMI; rs = 0.32, p <0.01, WtHR; rs = 0.38, p <0.001), and the SF-36 (BMI; rs = -0.29, p <0.005, WtHR; rs = -0.31, p <0.05). Percentage body fat accounted for an additional 17 % of the variance in the T25FW and 6MWT performance, after controlling for age and disease duration. CONCLUSION Higher BMI, WtHR, and percentage body fat were associated with lower levels of mobility (T25FW and 6MWT) in people with MS who have class I, class II, and class III obesity. Higher percentage body fat was associated with significantly worse performance on clinical, free-living, and self-report measures of mobility in people with MS even when accounting for participant age and disease duration. These findings suggest that people with MS and obesity may show improved mobility with weight loss.
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Affiliation(s)
- J S Cozart
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City, School of Medicine, Kansas City, Missouri, USA; Department of Psychology, University of Missouri-Kansas City, Kansas City, Missouri, USA.
| | - A S Bruce
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, Missouri, USA; Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - R P Shook
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, Missouri, USA; Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri, USA; School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri USA
| | - C Befort
- Department of Population Health, University Kansas Medical Center, Kansas City, Kansas, USA
| | - C Siengsukon
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - S Simon
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City, School of Medicine, Kansas City, Missouri, USA
| | - S G Lynch
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - R Mahmoud
- Department of Neurology, Saint Luke's Hospital, Kansas City, Missouri, USA; Department of Neurology, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - B Drees
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City, School of Medicine, Kansas City, Missouri, USA; Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA; Graduate School of the Stowers Institute for Medical Research, Kansas City, Missouri, USA
| | - P Posson
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, Missouri, USA
| | - P R Hibbing
- Department of Kinesiology & Nutrition, University of Illinois Chicago, Chicago, Illinois, USA
| | - J Huebner
- Department of Community and Family Medicine University Health Lakewood Medical Center, Medicine, Kansas City, Missouri, USA
| | - T Bradish
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City, School of Medicine, Kansas City, Missouri, USA
| | - J Robichaud
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City, School of Medicine, Kansas City, Missouri, USA
| | - J M Bruce
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City, School of Medicine, Kansas City, Missouri, USA; Departments of Neurology and Psychiatry, University Health, Kansas City, Missouri, USA
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7
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Lepping RJ, Hoffart CM, Bruce AS, Taylor JM, Mardis NJ, Lim SL, Wallace DP. Pediatric Neural Changes to Physical and Emotional Pain After Intensive Interdisciplinary Pain Treatment: A Pilot Study. medRxiv 2023:2023.10.03.23295921. [PMID: 37873243 PMCID: PMC10593005 DOI: 10.1101/2023.10.03.23295921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Brain areas activated during pain can contribute to enhancing or reducing the pain experience, showing a potential connection between chronic pain and the neural response to pain in adolescents and youth. This study examined changes in brain activation associated with experiencing physical pain, and the observation of physical and emotional pain in others, by using functional magnetic resonance imaging (fMRI) before and after intensive interdisciplinary pain treatment (IIPT). Eighteen youth (age 14 to 18) with widespread chronic pain completed fMRI testing before and after IIPT to assess changes in brain activation in response to physical and emotional pain. Broadly, brain activation changes were observed in frontal, somatosensory, and limbic regions. These changes suggest improvements in descending pain modulation via thalamus and caudate, and the different pattern of brain activation after treatment suggests better discrimination between physical and emotional pain. Brain activation changes were also correlated with improvements in clinical outcomes of catastrophizing (reduced activation in right caudate, right mid-cingulate, and postcentral gyrus) and pain-related disability (increased activation in precentral gyrus, left hippocampus, right middle occipital cortex, and left superior frontal gyrus). These changes support interpretation that reduced brain protective responses to pain were associated with treatment-related improvements. This pilot study highlights the need for larger trials designed to better understand the brain mechanisms involved in pediatric widespread pain treatment.
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Affiliation(s)
- Rebecca J Lepping
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
- Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Cara M Hoffart
- Pain Management, Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO, USA; Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, USA; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Amanda S Bruce
- Pediatrics, University of Kansas Medical Center, USA; Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
| | - Jasmine M Taylor
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
- Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Neil J Mardis
- Pediatric Radiology, Children's Mercy, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Seung-Lark Lim
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Dustin P Wallace
- Pain Management, Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO, USA; Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, USA; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
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8
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Stancil SL, Yeh HW, Brucks MG, Bruce AS, Voss M, Abdel-Rahman S, Brooks WM, Martin LE. Potential biomarker of brain response to opioid antagonism in adolescents with eating disorders: a pilot study. Front Psychiatry 2023; 14:1161032. [PMID: 37492067 PMCID: PMC10363723 DOI: 10.3389/fpsyt.2023.1161032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/30/2023] [Indexed: 07/27/2023] Open
Abstract
Background Eating Disorders (ED) affect up to 5% of youth and are associated with reward system alterations and compulsive behaviors. Naltrexone, an opioid antagonist, is used to treat ED behaviors such as binge eating and/or purging. The presumed mechanism of action is blockade of reward activation; however, not all patients respond, and the optimal dose is unknown. Developing a tool to detect objective drug response in the brain will facilitate drug development and therapeutic optimization. This pilot study evaluated neuroimaging as a pharmacodynamic biomarker of opioid antagonism in adolescents with ED. Methods Youth aged 13-21 with binge/purge ED completed functional magnetic resonance imaging (fMRI) pre- and post-oral naltrexone. fMRI detected blood oxygenation-level dependent (BOLD) signal at rest and during two reward probes (monetary incentive delay, MID, and passive food view, PFV) in predefined regions of interest associated with reward and inhibitory control. Effect sizes for Δ%BOLD (post-naltrexone vs. baseline) were estimated using linear mixed effects modeling. Results In 12 youth (16-21 years, 92% female), BOLD signal changes were detected following naltrexone in the nucleus accumbens during PFV (Δ%BOLD -0.08 ± 0.03; Cohen's d -1.06, p = 0.048) and anterior cingulate cortex during MID (Δ%BOLD 0.06 ± 0.03; Cohen's d 1.25, p = 0.086). Conclusion fMRI detected acute reward pathway modulation in this small sample of adolescents with binge/purge ED. If validated in future, larger trials, task-based Δ%BOLD detected by fMRI may serve as a pharmacodynamic biomarker of opioid antagonism to facilitate the development of novel therapeutics targeting the reward pathway, enable quantitative pharmacology trials, and inform drug dosing. Clinical trial registration https://clinicaltrials.gov/ct2/show/NCT04935931, NCT#04935931.
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Affiliation(s)
- Stephani L. Stancil
- Divisions of Adolescent Medicine and Clinical Pharmacology, Toxicology and Therapeutic Innovation, Children’s Mercy Kansas City, Kansas City, MO, United States
- Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States
- Department of Pediatrics, University of Kansas Medical Center School of Medicine, Kansas City, KS, United States
| | - Hung-Wen Yeh
- Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States
- Division of Health Services and Outcomes Research, Children’s Mercy Research Institute, Kansas City, MO, United States
| | - Morgan G. Brucks
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States
| | - Amanda S. Bruce
- Department of Pediatrics, University of Kansas Medical Center School of Medicine, Kansas City, KS, United States
- Center for Children’s Healthy Lifestyles and Nutrition, Kansas City, MO, United States
| | - Michaela Voss
- Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States
| | - Susan Abdel-Rahman
- Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States
| | - William M. Brooks
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States
- Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, United States
| | - Laura E. Martin
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States
- Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, United States
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9
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Lim SL, Bruce AS, Shook RP. Neurocomputational mechanisms of food and physical activity decision-making in male adolescents. Sci Rep 2023; 13:6145. [PMID: 37061558 PMCID: PMC10105706 DOI: 10.1038/s41598-023-32823-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 04/03/2023] [Indexed: 04/17/2023] Open
Abstract
We examined the neurocomputational mechanisms in which male adolescents make food and physical activity decisions and how those processes are influenced by body weight and physical activity levels. After physical activity and dietary assessments, thirty-eight males ages 14-18 completed the behavioral rating and fMRI decision tasks for food and physical activity items. The food and physical activity self-control decisions were significantly correlated with each other. In both, taste- or enjoyment-oriented processes were negatively associated with successful self-control decisions, while health-oriented processes were positively associated. The correlation between taste/enjoyment and healthy attribute ratings predicted actual laboratory food intake and physical activities (2-week activity monitoring). fMRI data showed the decision values of both food and activity are encoded in the ventromedial prefrontal cortex, suggesting both decisions share common reward value-related circuits at the time of choice. Compared to the group with overweight/obese, the group with normal weight showed stronger brain activations in the cognitive control, multisensory integration, and motor control regions during physical activity decisions. For both food and physical activity, self-controlled decisions utilize similar computational and neurobiological mechanisms, which may provide insights into how to promote healthy food and physical activity decisions.
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Affiliation(s)
- Seung-Lark Lim
- Department of Psychology, University of Missouri-Kansas City, 5030 Cherry St, Kansas City, MO, 64110, USA.
| | - Amanda S Bruce
- Center for Children's Healthy Lifestyles & Nutrition, Department of Pediatrics, Children's Mercy, 610 E. 2nd St, Kansas City, MO, 66108, USA
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Robin P Shook
- Center for Children's Healthy Lifestyles & Nutrition, Department of Pediatrics, Children's Mercy, 610 E. 2nd St, Kansas City, MO, 66108, USA
- School of Medicine, University of Missouri-Kansas City, 2411 Holmes, Kansas City, MO, 64108, USA
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10
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Jarmolowicz DP, Schneider TD, Strickland JC, Bruce AS, Reed DD, Bruce JM. Reinforcer pathology, probabilistic choice, and medication adherence in patients with multiple sclerosis. J Exp Anal Behav 2023; 119:275-285. [PMID: 36710645 DOI: 10.1002/jeab.830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 04/11/2022] [Accepted: 12/17/2022] [Indexed: 01/31/2023]
Abstract
The reinforcer pathology model posits that core behavioral economic mechanisms, including delay discounting and behavioral economic demand, underlie adverse health decisions and related clinical disorders. Extensions beyond substance use disorder and obesity, however, are limited. Using a reinforcer pathology framework, this study evaluates medical adherence decisions in patients with multiple sclerosis. Participants completed behavioral economic measures, including delay discounting, probability discounting, and a medication purchase task. A medical decision-making task was also used to evaluate how sensitivity to mild side effect risk and efficacy contributed to the likelihood of taking a hypothetical disease-modifying therapy. Less steep delay discounting and more intense (greater) medication demand were independently associated with greater adherence to the medication decision-making procedure. More generally, the pattern of interrelations between the medication-specific and general behavioral economic metrics was consistent with and contributes to the reinforcer pathology model. Additional research is warranted to expand these models to different populations and health behaviors, including those of a positive health orientation (i.e., medication adherence).
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Affiliation(s)
- David P Jarmolowicz
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA
- Cofrin-Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
- Healthcare Institute for Innovations in Quality, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Tadd D Schneider
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA
- Cofrin-Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
| | - Justin C Strickland
- Behavioral Pharmacology Research Unit, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Amanda S Bruce
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Derek D Reed
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA
- Cofrin-Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
| | - Jared M Bruce
- Department(s) of Biomedical and Health Informatics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
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11
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Wallisch A, Little LM, Bruce AS, Salley B. Oral Sensory Sensitivity Influences Attentional Bias to Food Logo Images in Children: A Preliminary Investigation. Front Psychol 2022; 13:895516. [PMID: 35814143 PMCID: PMC9257076 DOI: 10.3389/fpsyg.2022.895516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 05/26/2022] [Indexed: 11/24/2022] Open
Abstract
Background Children's sensory processing patterns are linked with their eating habits; children with increased sensory sensitivity are often picky eaters. Research suggests that children's eating habits are also partially influenced by attention to food and beverage advertising. However, the extent to which sensory processing influences children's attention to food cues remains unknown. Therefore, we examined the attentional bias patterns to food vs. non-food logos among children 4-12 years with and without increased oral sensory sensitivity. Design Children were categorized into high (n = 8) vs. typical (n = 36) oral sensory sensitivity by the Sensory Profile-2. We used eye-tracking to examine orientation and attentional bias to food vs. non-food logos among children with high vs. typical oral sensory sensitivity. We used a mixed model regression to test the influence of oral sensory sensitivity to attentional biases to food vs. non-food logos among children. Results Results showed that children with high oral sensory sensitivity showed attentional biases toward non-food logos; specifically, children with high oral sensory sensitivity oriented more quickly to non-food logos as compared to food logos (p < 0.05), as well as spent more time looking at non-food logos as compared to food logos (p < 0.05). Findings were in the opposite direction for children with typical oral sensory sensitivity. Conclusion Sensory sensitivity may be an individual characteristic that serves as a protective mechanism against susceptibility to food and beverage advertising in young children.
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Affiliation(s)
- Anna Wallisch
- Juniper Gardens Children’s Project, University of Kansas, Kansas City, KS, United States
| | - Lauren M. Little
- Department of Occupational Therapy, Rush University, Chicago, IL, United States
| | - Amanda S. Bruce
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, United States
- Center for Children’s Healthy Lifestyles and Nutrition, Kansas City, MO, United States
| | - Brenda Salley
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, United States
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12
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Ha OR, Lim SL, Bruce AS, Masterson TD, Luo S. Editorial: Eating Behavior and Food Decision Making in Children and Adolescents. Front Psychol 2022; 12:818078. [PMID: 35111114 PMCID: PMC8801582 DOI: 10.3389/fpsyg.2021.818078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 12/10/2021] [Indexed: 12/03/2022] Open
Affiliation(s)
- Oh-Ryeong Ha
- Department of Psychology, University of Missouri – Kansas City, Kansas City, MO, United States
- *Correspondence: Oh-Ryeong Ha
| | - Seung-Lark Lim
- Department of Psychology, University of Missouri – Kansas City, Kansas City, MO, United States
| | - Amanda S. Bruce
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, United States
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, United States
| | - Travis D. Masterson
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States
| | - Shan Luo
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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13
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Ha OR, Bruce AS, Killian HJ, Davis AM, Lim SL. Shared Dynamics of Food Decision-Making in Mother-Child Dyads. Front Psychol 2021; 12:695388. [PMID: 34456810 PMCID: PMC8387796 DOI: 10.3389/fpsyg.2021.695388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/12/2021] [Indexed: 12/01/2022] Open
Abstract
This study explored risk parameters of obesity in food decision-making in mother-child dyads. We tested 45 children between 8–12 years and their biological mothers to measure the decision weights of food health attributes, the decision weights of food taste attributes, self-regulated food decisions, and self-reported self-control scores. Maternal body mass index (BMI), and children's BMI-percentiles-for-age were also measured. We found a positive correlation between children's and their mothers' decision weights of taste attributes in food decision-making. We also found a positive correlation between children's BMI %iles and their mothers' BMIs. Children with overweight/obesity demonstrated lower correlations between health and taste ratings and a lower percentage of self-regulated food decisions (i.e., resisting to eat tasty but unhealthy foods or choosing to eat not-tasty but healthy foods) than children with healthy weight. Our findings suggested that the decision weights of taste attributes and weight status shared similar patterns in mother-child dyads. Also, the findings suggested that establishing dynamics of unhealthy food-decision making may increase the risk of childhood obesity. Helping children to develop the dynamics of healthy food-decision making by increasing the importance of health while decreasing the importance of taste may promote resilience to susceptibility to unhealthy eating and weight gain.
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Affiliation(s)
- Oh-Ryeong Ha
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Amanda S Bruce
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, United States.,Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, United States
| | - Haley J Killian
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Ann M Davis
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, United States.,Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, United States
| | - Seung-Lark Lim
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
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14
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Bruce JM, Cozart JS, Shook RP, Ruppen S, Siengsukon C, Simon S, Befort C, Lynch S, Mahmoud R, Drees B, Norouzinia AN, Bradish T, Posson P, Hibbing PR, Bruce AS. Modifying Diet and Exercise in MS (MoDEMS): Study design and protocol for a telehealth weight loss intervention for adults with obesity & Multiple Sclerosis. Contemp Clin Trials 2021; 107:106495. [PMID: 34216814 DOI: 10.1016/j.cct.2021.106495] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 10/21/2022]
Abstract
Weight loss improves overall health, and reduces inflammation, risk of stroke, heart attack, diabetes, certain cancers, and death among individuals with obesity. Weight loss also improves mobility, increases stamina, and elevates mood. Between 25 and 33% of people with Multiple Sclerosis (pwMS) have obesity. Multiple Sclerosis (MS) and obesity are independently associated with reduced mobility, increased fatigue, and depression. Most behavioral weight loss trials exclude individuals with neurologic disease. Consequently, few studies have examined the effects of weight loss on symptom presentation and health outcomes among pwMS and obesity. This is the first study examining the efficacy of a comprehensive behavioral weight loss intervention designed specifically for pwMS. The purpose of this study is to develop and assess the efficacy of a telehealth administered weight loss intervention tailored for pwMS. Additionally, we aim to determine if weight loss reduces physical and emotional symptoms in individuals with obesity and MS. We will enroll 70 pwMS in a wait-list crossover trial to examine the efficacy of our intervention. If successful, findings will help determine whether we can help participants lose clinically significant weight - and whether weight loss among pwMS and overweight/obesity reduces fatigue, and improves mobility, mood, and quality of life.
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Affiliation(s)
- Jared M Bruce
- Department of Biomedical and Health Informatics, University of Missouri- Kansas City School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA.
| | - Julia S Cozart
- Department of Biomedical and Health Informatics, University of Missouri- Kansas City School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA; Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Robin P Shook
- Center for Healthy Lifestyle and Nutrition, Children's Mercy Hospitals, Kansas City, MO, USA
| | - Stephanie Ruppen
- Department of Biomedical and Health Informatics, University of Missouri- Kansas City School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA; Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Catherine Siengsukon
- Department of Physical Therapy and Rehab Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Steve Simon
- Department of Biomedical and Health Informatics, University of Missouri- Kansas City School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Christie Befort
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Sharon Lynch
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Rola Mahmoud
- Department of Neurology, Saint Luke's Hospital, Kansas City, MO, USA
| | - Betty Drees
- Department of Biomedical and Health Informatics, University of Missouri- Kansas City School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA; Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | | | - Taylor Bradish
- Department of Biomedical and Health Informatics, University of Missouri- Kansas City School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Paige Posson
- Center for Healthy Lifestyle and Nutrition, Children's Mercy Hospitals, Kansas City, MO, USA
| | - Paul R Hibbing
- Center for Healthy Lifestyle and Nutrition, Children's Mercy Hospitals, Kansas City, MO, USA
| | - Amanda S Bruce
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
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15
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Abstract
PURPOSE OF REVIEW The goal of the current paper is to review the literature on the neural and behavioral factors involved in food decision-making in youth. RECENT FINDINGS Recent neuroimaging studies that employ passive viewing paradigms have found that exposure to food-related cues activate reward, motor planning, and attentional salience signals in children. Greater activations of reward signals and/or lower activations of control signals are associated with overeating and weight gain. Neuroimaging studies with decision-making paradigms have found the reward network in the brain activates during food choices, while control network activates less strongly. Findings suggest that exposure to food cues activates reward/valuation network, but activation of control network tends to be relatively weaker in children. Hedonic aspects of foods are predominantly considered in children's food choices, and their dietary self-control is not matured yet. The increased activation in reward network and the decreased activation in control network are associated with risk of developing obesity.
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Affiliation(s)
- Oh-Ryeong Ha
- Department of Psychology, University of Missouri-Kansas City, 5030 Cherry St, Kansas City, MO, 64110, USA
| | - Seung-Lark Lim
- Department of Psychology, University of Missouri-Kansas City, 5030 Cherry St, Kansas City, MO, 64110, USA
| | - Amanda S Bruce
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA.
- Center for Children's Healthy Lifestyles and Nutrition; Children's Mercy Hospital, Kansas City, MO, USA.
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16
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Ha OR, Killian HJ, Davis AM, Lim SL, Bruce JM, Sotos JJ, Nelson SC, Bruce AS. Promoting Resilience to Food Commercials Decreases Susceptibility to Unhealthy Food Decision-Making. Front Psychol 2020; 11:599663. [PMID: 33343472 PMCID: PMC7738621 DOI: 10.3389/fpsyg.2020.599663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/10/2020] [Indexed: 01/01/2023] Open
Abstract
Children are vulnerable to adverse effects of food advertising. Food commercials are known to increase hedonic, taste-oriented, and unhealthy food decisions. The current study examined how promoting resilience to food commercials impacted susceptibility to unhealthy food decision-making in children. To promote resilience to food commercials, we utilized the food advertising literacy intervention intended to enhance cognitive skepticism and critical thinking, and decrease positive attitudes toward commercials. Thirty-six children aged 8–12 years were randomly assigned to the food advertising literacy intervention or the control condition. Eighteen children received four brief intervention sessions via video over 1 week period. In each session, children watched six food commercials with interspersed embedded intervention narratives. While watching food commercials and narratives, children were encouraged to speak their thoughts out loud spontaneously (“think-aloud”), which provided children's attitudes toward commercials. Eighteen children in the control condition had four control sessions over 1 week, and watched the same food commercials without intervention narratives while thinking aloud. The first and last sessions were held in the laboratory, and the second and third sessions were held at the children's homes. Susceptibility to unhealthy food decision-making was indicated by the decision weights of taste attributes, taste perception, food choices, ad libitum snacking, and cognitive and affective attitudes toward food commercials. As hypothesized, the intervention successfully decreased susceptibility to unhealthy food decision-making evidenced by reduced decision weights of the taste in food decisions, decreased tasty perception of unhealthy foods, and increased cognitive skepticism and critical thinking toward food commercials. In addition, as children's opinions assimilated to intervention narratives, their cognitive skepticism and critical thinking toward commercials increased. The aforementioned results were not shown in the control condition. However, this brief intervention was not enough to change actual food choices or food consumption. Results of this study suggest that promoting resilience to food commercials by enhancing cognitive skepticism and critical thinking effectively reduced children's susceptibility to unhealthy food-decision making.
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Affiliation(s)
- Oh-Ryeong Ha
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Haley J Killian
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Ann M Davis
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, United States.,Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, United States
| | - Seung-Lark Lim
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Jared M Bruce
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Jarrod J Sotos
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Samuel C Nelson
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Amanda S Bruce
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, United States.,Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, United States
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17
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Jarmolowicz DP, Reed DD, Schneider TD, Smith J, Thelen J, Lynch S, Bruce AS, Bruce JM. Behavioral economic demand for medications and its relation to clinical measures in multiple sclerosis. Exp Clin Psychopharmacol 2020; 28:258-264. [PMID: 31556674 DOI: 10.1037/pha0000322] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Multiple sclerosis (MS) is a neurodegenerative disorder that causes a wide range of symptoms, which, if left untreated, worsen over time. Despite the availability of effective medications, however, many MS patients fail to take their medications. One possibility is that these patients fail to follow through on treatment recommendations because they do not value these treatments-despite their effectiveness. Prior studies have used principles of microeconomic demand to quantify subjects' valuation of commodities such as alcohol and cigarettes. The current study examined MS patients' microeconomic demand for effective treatments. Patients' willingness to purchase this effective medication was well described by behavioral economic models and was significantly related to MS knowledge and select components of adherence determination. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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18
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Lundquist E, Austen M, Bermudez M, Rubin C, Bruce AS, Masterson TD, Keller KL. Time spent looking at food during a delay of gratification task is positively associated with children's consumption at ad libitum laboratory meals. Appetite 2019; 141:104341. [PMID: 31276712 DOI: 10.1016/j.appet.2019.104341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/28/2019] [Accepted: 06/29/2019] [Indexed: 01/10/2023]
Abstract
Greater ability to delay gratification for an immediate food reward may protect against the development of obesity. However, it is not known if the behaviors children exhibit during a delay of gratification task are related to overeating in other contexts. The purpose of this analysis was to assess the relationship between observed child coping strategies during a delay of gratification task and laboratory intake from ad libitum test-meals. The sample consisted of 40, 7-9 year old children (40% (N = 16 with overweight/obesity). Across 5 laboratory visits, children consumed 3 identical test-meals presented after varying exposure conditions (i.e., no exposure, exposure to food commercials, exposure to toy commercials). On the first visit, children were recorded during a delay of gratification task which was coded for three behavioral themes: looking at vs. away from food, talking vs. staying silent, and fidgeting vs. sitting still. Pearson correlations and multiple regressions were run to look at the relationships between coping strategies and test-meal intake. Time spent looking away from food was negatively associated with ad libitum food consumption at the meals. Conversely, greater time spent looking at food was positively associated with ad libitum food consumption. These relationships were independent of covariates likely to influence intake (e.g., sex, age, weight status, parent income) and were more robust following food rather than toy commercial exposure. Children who spent more time looking at food and less time looking away during a delay of gratification task may be vulnerable to overeating in other contexts. Upon replication in larger samples, these behaviors could serve as modifiable targets in the development of childhood obesity prevention programs.
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Affiliation(s)
- Ella Lundquist
- Nutritional Sciences, The Pennsylvania State University, United states
| | - Marielle Austen
- Nutritional Sciences, The Pennsylvania State University, United states
| | - Maria Bermudez
- Nutritional Sciences, The Pennsylvania State University, United states
| | - Carter Rubin
- Nutritional Sciences, The Pennsylvania State University, United states
| | - Amanda S Bruce
- Pediatrics, University of Kansas Medical Center, United states; Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, United States
| | | | - Kathleen L Keller
- Nutritional Sciences, The Pennsylvania State University, United states; Food Science, The Pennsylvania State University, United states.
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19
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Jarmolowicz DP, Reed DD, Bruce AS, Bruce JM. On the behavioral economics of medication choice: A research story. Behav Processes 2019; 165:66-77. [PMID: 31181266 DOI: 10.1016/j.beproc.2019.05.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 10/26/2022]
Abstract
Behavioral economics has been consistently useful in describing a wide range of clinical phenomena, particularly in reference to behavioral excesses such as substance abuse, problematic gambling and obesity/overeating. Given an opportunity to explore these processes as they relate to treatment adherence in patients with multiple sclerosis (MS), our central thesis was that behavioral economic tools/processes that have been helpful in other areas of application (e.g., substance abuse, obesity) could be leveraged to help understand treatment non-adherence and hopefully lead to efforts to combat it. The current paper tells a story of how an interdisciplinary set of researchers came to combine their separate expertise in MS and behavioral economics to yield novel insights into the failures of treatment adherence often experienced in this clinical population.
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Affiliation(s)
- David P Jarmolowicz
- University of Kansas, Department of Applied Behavior Science, United States; University of Kansas, Cofrin Logan Center for Addiction Research and Treatment, United States.
| | - Derek D Reed
- University of Kansas, Department of Applied Behavior Science, United States; University of Kansas, Cofrin Logan Center for Addiction Research and Treatment, United States
| | - Amanda S Bruce
- University of Kansas Medical Center, Department of Pediatrics, United States; Children's Mercy Hospital, Center for Children's Healthy Lifestyles, United States
| | - Jared M Bruce
- University of Missouri - Kansas City, Department of Psychology, United States; University of Missouri - Kansas City. Department of Biological and Health Informatics, United States
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Ha OR, Lim SL, Bruce JM, Bruce AS. Unhealthy foods taste better among children with lower self-control. Appetite 2019; 139:84-89. [PMID: 31026492 DOI: 10.1016/j.appet.2019.04.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 02/16/2019] [Accepted: 04/22/2019] [Indexed: 01/05/2023]
Abstract
Self-control is important for healthy eating. Achieving and maintaining healthy eating behaviors can be challenging for children. Susceptibility to palatable unhealthy foods with high sugar, fat, and/or salt is a biologically predisposed, dominant response that can hinder healthy eating decisions. Self-control can help adults to build automatized strategies for resisting susceptibility to unhealthy foods. Likewise, if self-control helps children to learn strategies for resisting susceptibility to unhealthy foods, susceptibility to unhealthy foods would be demonstrated in children with low self-control. Specifically, the association between unhealthiness and tastiness (i.e., unhealthy foods taste better) is one of the important mechanisms underlying susceptibility to unhealthy foods. We expected susceptibility to unhealthy foods to be indicated by the association between unhealthiness and tastiness, as well as better taste perception of unhealthy foods and unhealthy food preferences. In our study, fifty-nine children aged 8-13 years reported their perceived self-control, and completed computerized food rating tasks measuring their healthiness, taste, and preference ratings on 30 healthy and 30 unhealthy foods. Results showed that children with lower self-control demonstrated heightened susceptibility to unhealthy foods, but children with higher self-control did not. Our findings suggested that higher levels of self-control would help children to develop healthy eating strategies for regulating dispositional susceptibility to unhealthy foods.
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Affiliation(s)
- Oh-Ryeong Ha
- Department of Psychology, University of Missouri, Kansas City, USA.
| | - Seung-Lark Lim
- Department of Psychology, University of Missouri, Kansas City, USA
| | - Jared M Bruce
- Department of Psychology, University of Missouri, Kansas City, USA; Department of Biomedical and Health Informatics, University of Missouri, Kansas City, USA
| | - Amanda S Bruce
- Department of Pediatrics, University of Kansas Medical Center, USA; Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, USA
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Jarmolowicz DP, Reed DD, Bruce AS, Lynch S, Smith J, Bruce JM. Modeling effects of side-effect probability, side-effect severity, and medication efficacy on patients with multiple sclerosis medication choice. Exp Clin Psychopharmacol 2018; 26:599-607. [PMID: 30148403 DOI: 10.1037/pha0000220] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Multiple sclerosis (MS) is an autoimmune disease that causes a range of problematic symptoms. These symptoms tend to get worse over time, causing substantial impairment in patient quality of life. Although many effective disease-modifying therapies (DMTs) exist that slow the course of MS, patients often do not choose to take them, which may be because these medications carry substantial risks of side effects, varying from mild to severe, while only decreasing the probability of future symptoms. In the current study, we examined MS patients' self-reported likelihood of taking medications with a range of efficacies (11 values, ranging from 0.1% to 99.9%), side-effect probabilities (11 values, ranging from 0.1% to 99.9%), and side-effect severities (mild, moderate, or severe). These data were well-described by a three-dimensional probability-discounting model that isolated patients' undiscounted likelihood of taking DMTs, as well as their discounting and psychophysical scaling/weighting of side-effect probabilities and efficacy. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Bruce JM, Bruce AS, Lynch S, Thelen J, Lim SL, Smith J, Catley D, Reed DD, Jarmolowicz DP. Probability discounting of treatment decisions in multiple sclerosis: associations with disease knowledge, neuropsychiatric status, and adherence. Psychopharmacology (Berl) 2018; 235:3303-3313. [PMID: 30244284 DOI: 10.1007/s00213-018-5037-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 09/11/2018] [Indexed: 11/27/2022]
Abstract
RATIONALE Patients weigh risks and benefits when making treatment decisions. Despite this, relatively few studies examine the behavioral patterns underpinning these decisions. Moreover, individual differences in these patterns remain largely unexplored. OBJECTIVES The purpose of this study was to test a probability discounting model to explain the independent influences of risks and benefits when patients make hypothetical treatment decisions. Furthermore, we examine how individual differences in this probability discounting function are associated with patient demographics, clinical characteristics, disease knowledge, neuropsychiatric status, and adherence. METHODS Two hundred eight participants with relapsing-remitting multiple sclerosis (MS) indicated their likelihood (0-100%) of taking a hypothetical medication as the probability of mild side effects (11 values from .1 to 99.9%) and reported medication efficacies (11 values from .1 to 99.9%) varied systematically. They also completed a series of questionnaires and cognitive tests. RESULTS Individual components of medication treatment decision making were successfully described with a probability discounting model. High rates of discounting based on risks were associated with poor treatment adherence and less disease-specific knowledge. In contrast, high rates of discounting of benefits was associated with poorer cognitive functioning. Regression models indicated that risk discounting predicted unique variance in treatment adherence. CONCLUSIONS Insights gained from the present study represent an important early step in understanding individual differences associated with medical decision making in MS. Future research may wish to use this knowledge to inform the development of empirically supported adherence interventions.
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Affiliation(s)
- Jared M Bruce
- Department of Psychology, University of Missouri - Kansas City, 5030 Cherry Hall, Kansas City, MO, 64110, USA.
- Department of Biomedical and Health Informatics, University of Missouri - Kansas City, Kansas City, MO, USA.
| | - Amanda S Bruce
- Center for Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Sharon Lynch
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Joanie Thelen
- Department of Psychology, University of Missouri - Kansas City, 5030 Cherry Hall, Kansas City, MO, 64110, USA
| | - Seung-Lark Lim
- Department of Psychology, University of Missouri - Kansas City, 5030 Cherry Hall, Kansas City, MO, 64110, USA
| | - Julia Smith
- Department of Psychology, University of Missouri - Kansas City, 5030 Cherry Hall, Kansas City, MO, 64110, USA
| | - Delwyn Catley
- Center for Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
| | - Derek D Reed
- Department of Applied Behavior Science, University of Kansas, Lawrence, KS, USA
- Cofrin-Logan Center for Addiction Research and Treatment, Lawrence, KS, USA
| | - David P Jarmolowicz
- Department of Applied Behavior Science, University of Kansas, Lawrence, KS, USA
- Cofrin-Logan Center for Addiction Research and Treatment, Lawrence, KS, USA
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Ha OR, Killian H, Bruce JM, Lim SL, Bruce AS. Food Advertising Literacy Training Reduces the Importance of Taste in Children's Food Decision-Making: A Pilot Study. Front Psychol 2018; 9:1293. [PMID: 30100889 PMCID: PMC6072865 DOI: 10.3389/fpsyg.2018.01293] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 07/05/2018] [Indexed: 01/20/2023] Open
Abstract
Television food advertising influences children’s food choices. The attribute of “taste” drives children’s food choices, and exposure to food commercials can increase the importance of “taste” when children make food decisions. The current pilot study explored whether food advertising literacy training influences children’s food choices. In particular, whether the training would change the way children weigh the importance of taste attributes in their food decisions. Thirty-nine children ages 8–13 were recruited. Twenty-three of those children had four sessions of food advertising literacy training (1 week): children watched four videos of food commercials embedded with factual narratives (i.e., building cognitive defenses; e.g., “commercials want to sell products”) and evaluative narratives (i.e., changing affective responses toward commercials; e.g., “these foods don’t make you happy”). The first and last sessions were held in the laboratory, and the second and third sessions were at home. During the training, children were encouraged to think aloud while watching commercials and provided narratives to encourage active information processing. At baseline and post-training, children made binary eating choices for 60 foods and rated each food item on health and taste. We fitted linear regression models to examine whether taste and health attributes predicted unique variance in each child’s food choices. The results showed that taste attributes in children’s food choices was significantly decreased after completing the training. This finding suggested that improving food advertising literacy could be helpful for reducing the influence of taste attributes in the food decision-making process. Also, the cognitive literacy training increased children’s critical thoughts toward commercials during thinking aloud. These findings suggest that food advertising literacy training was helpful for reducing the importance of “taste” in children’s food decisions. In contrast, 16 children in the control condition (i.e., watching four videos of food commercials without narratives in 1 week) did not show any significant change in their food choices. Future research should investigate the utility of food advertising literacy training for the promotion of healthy eating and the prevention of childhood obesity.
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Affiliation(s)
- Oh-Ryeong Ha
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Haley Killian
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Jared M Bruce
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States.,Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Seung-Lark Lim
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Amanda S Bruce
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, United States.,Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, United States
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Bruce JM, Jarmolowicz DP, Lynch S, Thelen J, Lim SL, Smith J, Catley D, Bruce AS. How patients with multiple sclerosis weigh treatment risks and benefits. Health Psychol 2018; 37:680-690. [DOI: 10.1037/hea0000626] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Jarmolowicz DP, Reed DD, Francisco AJ, Bruce JM, Lemley SM, Bruce AS. Modeling effects of risk and social distance on vaccination choice. J Exp Anal Behav 2018; 110:39-53. [DOI: 10.1002/jeab.438] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 04/20/2018] [Indexed: 11/08/2022]
Affiliation(s)
| | | | | | | | | | - Amanda S. Bruce
- University of Kansas Medical Center and Children's Mercy Hospital
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26
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Smith J, Bruce AS, Glusman M, Thelen J, Lynch S, Bruce JM. Determining reliable change on the modified fatigue impact scale (5-item version). Mult Scler Relat Disord 2018; 20:22-24. [DOI: 10.1016/j.msard.2017.12.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/20/2017] [Accepted: 12/13/2017] [Indexed: 10/18/2022]
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Lim SL, Penrod MT, Ha OR, Bruce JM, Bruce AS. Calorie Labeling Promotes Dietary Self-Control by Shifting the Temporal Dynamics of Health- and Taste-Attribute Integration in Overweight Individuals. Psychol Sci 2018; 29:447-462. [DOI: 10.1177/0956797617737871] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Understanding why people make unhealthy food choices and how to promote healthier choices is critical to prevent obesity. Unhealthy food choices may occur when individuals fail to consider health attributes as quickly as taste attributes in their decisions, and this bias may be modifiable by health-related external cues. One hundred seventy-eight participants performed a mouse-tracking food-choice task with and without calorie information. With the addition of calorie information, participants made healthier choices. Without calorie information, the initial integration of health attributes in overweight individuals’ decisions was about 230 ms delayed relative to the taste attributes, but calorie labeling promoted healthier choices by speeding up the integration of health attributes during a food-choice task. Our study suggests that obesogenic choices are related to the relative speed with which taste and health attributes are integrated into the decision process and that this bias is modifiable by external health-related cues.
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Affiliation(s)
- Seung-Lark Lim
- Department of Psychology, University of Missouri–Kansas City
| | - Molly T. Penrod
- Department of Psychology, University of Missouri–Kansas City
| | - Oh-Ryeong Ha
- Department of Psychology, University of Missouri–Kansas City
| | - Jared M. Bruce
- Department of Psychology, University of Missouri–Kansas City
| | - Amanda S. Bruce
- Department of Pediatrics, University of Kansas Medical Center and Center for Children’s Healthy Lifestyles and Nutrition, Children’s Mercy Hospital
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Jarmolowicz DP, Bruce AS, Glusman M, Lim SL, Lynch S, Thelen J, Catley D, Zieber N, Reed DD, Bruce JM. On how patients with multiple sclerosis weigh side effect severity and treatment efficacy when making treatment decisions. Exp Clin Psychopharmacol 2017; 25:479-484. [PMID: 29251977 DOI: 10.1037/pha0000152] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although effective disease-modifying treatments (DMTs) are available for individuals suffering from multiple sclerosis (MS), many patients fail to take their recommended medications. Unlike medications that provide immediate relief from existing symptoms, DMTs decrease the probability of future symptoms (i.e., a probabilistic benefit) while concurrently carrying an appreciable risk of immediate side effects (i.e., a probabilistic cost). Prior research has shown that both the probability of reducing disease progression and the probability of experiencing side effects impact patients' likelihood of taking a hypothetical DMT. The role that side effect severity plays in treatment decisions remains unexplored. The present study examined how probability of medication efficacy and side effect severity impact patients' likelihood of taking hypothetical DMTs. Patients' likelihood of taking a DMT systematically decreased as medication efficacy decreased and side effect severity increased. Because side effect severity appears to impact decision-making processes in unique ways, the present results suggest that providers should present information on severe (which are typically rare) and mild to moderate side effects (which are more common) separately. (PsycINFO Database Record
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Affiliation(s)
- David P Jarmolowicz
- Department of Applied Behavioral Science and Problem Gambling Research and Education Support System
| | - Amanda S Bruce
- Department of Pediatrics, University of Kansas Medical Center
| | - Morgan Glusman
- Department of Psychology, University of Missouri-Kansas City
| | - Seung-Lark Lim
- Department of Psychology, University of Missouri-Kansas City
| | - Sharon Lynch
- Department of Neurology, University of Kansas Medical Center
| | - Joanie Thelen
- Department of Psychology, University of Missouri-Kansas City
| | | | - Nicole Zieber
- Department of Psychology, University of Missouri-Kansas City
| | - Derek D Reed
- Department of Applied Behavioral Science, University of Kansas
| | - Jared M Bruce
- Department of Psychology, University of Missouri-Kansas City
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Lim SL, Cherry JBC, Davis AM, Balakrishnan SN, Ha OR, Bruce JM, Bruce AS. Correction: Corrigendum: The child brain computes and utilizes internalized maternal choices. Nat Commun 2016; 7:12127. [PMID: 27336219 PMCID: PMC4931020 DOI: 10.1038/ncomms12127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Jarmolowicz DP, Reed DD, Bruce AS, Catley D, Lynch S, Goggin K, Lim SL, Strober L, Glusman M, Norouzinia AN, Bruce JM. Using EP50 to forecast treatment adherence in individuals with multiple sclerosis. Behav Processes 2016; 132:94-99. [PMID: 27702587 DOI: 10.1016/j.beproc.2016.09.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 09/09/2016] [Accepted: 09/15/2016] [Indexed: 11/29/2022]
Abstract
Much like delay discounting, probability discounting may be related to a host of pro-health behaviors. In a recent report, a Medical Decision Making Questionnaire (MDMQ) was developed that leveraged this insights of probability discounting to both describe ways that multiple sclerosis (MS) patients weigh costs and benefits when making adherence choices, and predicted their self-reported treatment adherence. The current re-analysis of those data use a novel EP50 measure as a framework of a model that predicted the cost/benefit ratios necessary for the choices of typically non-adherent patients to become indistinguishable from those of typically adherent patients (and vice versa). These analytic tools may aid in the development/evaluation of both novel therapeutics and treatment adherence strategies for chronic conditions.
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Affiliation(s)
- David P Jarmolowicz
- Department of Applied Behavioral Science, University of Kansas, 4050 Dole Developmental Center, 1000 Sunnyside Ave., Lawrence, KS 66045, USA.
| | - Derek D Reed
- Department of Applied Behavioral Science, University of Kansas, 4050 Dole Developmental Center, 1000 Sunnyside Ave., Lawrence, KS 66045, USA.
| | - Amanda S Bruce
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Hospital, 610 E. 22nd St., Kansas City, MO, 64108, USA.
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Hospital, 610 E. 22nd St., Kansas City, MO, 64108, USA.
| | - Sharon Lynch
- Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA.
| | - Kathy Goggin
- Health Services and Outcomes Research, Children's Mercy Hospital and Clinics, University of Missouri - Kansas City, 2401 Gillham Road 610, Kansas City, MO, 64108, USA.
| | - Seung-Lark Lim
- Department of Psychology, University of Missouri, 5030 Cherry St., Kansas City, MO 64110, USA.
| | | | - Morgan Glusman
- Department of Psychology, University of Missouri, 5030 Cherry St., Kansas City, MO 64110, USA.
| | - Abigail N Norouzinia
- Department of Psychology, University of Missouri, 5030 Cherry St., Kansas City, MO 64110, USA.
| | - Jared M Bruce
- Department of Psychology, University of Missouri, 5030 Cherry St., Kansas City, MO 64110, USA.
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Lim SL, Cherry JBC, Davis AM, Balakrishnan SN, Ha OR, Bruce JM, Bruce AS. The child brain computes and utilizes internalized maternal choices. Nat Commun 2016; 7:11700. [PMID: 27218420 PMCID: PMC4890300 DOI: 10.1038/ncomms11700] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 04/19/2016] [Indexed: 11/09/2022] Open
Abstract
As children grow, they gradually learn how to make decisions independently. However, decisions like choosing healthy but less-tasty foods can be challenging for children whose self-regulation and executive cognitive functions are still maturing. We propose a computational decision-making process in which children estimate their mother's choices for them as well as their individual food preferences. By employing functional magnetic resonance imaging during real food choices, we find that the ventromedial prefrontal cortex (vmPFC) encodes children's own preferences and the left dorsolateral prefrontal cortex (dlPFC) encodes the projected mom's choices for them at the time of children's choice. Also, the left dlPFC region shows an inhibitory functional connectivity with the vmPFC at the time of children's own choice. Our study suggests that in part, children utilize their perceived caregiver's choices when making choices for themselves, which may serve as an external regulator of decision-making, leading to optimal healthy decisions. Mothers advocate eating healthy foods while children like to eat tasty foods. Lim and colleagues demonstrate that children incorporate their mothers' food choices while deciding what to eat as well as provide the neural correlates of this decision making process.
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Affiliation(s)
- Seung-Lark Lim
- Department of Psychology, University of Missouri-Kansas City, 5030 Cherry Street, Kansas City, Missouri 64110, USA
| | - J Bradley C Cherry
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, Kanas 66160, USA
| | - Ann M Davis
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, Kanas 66160, USA.,Center for Children's Healthy Lifestyles &Nutrition, 610 East 2nd Street, Kansas City, Missouri 66108, USA
| | - S N Balakrishnan
- Department of Mechanical and Aerospace Engineering, Missouri University of Science and Technology, 194 Toomey Hall, Rolla, Missouri 65409, USA.,School of Engineering and Computer Science, Shiv Nadar University, NH91, Tehsil Dadri, Gautam Buddha Nagar, Uttar Pradesh 201314
| | - Oh-Ryeong Ha
- Department of Psychology, University of Missouri-Kansas City, 5030 Cherry Street, Kansas City, Missouri 64110, USA.,Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, Kanas 66160, USA
| | - Jared M Bruce
- Department of Psychology, University of Missouri-Kansas City, 5030 Cherry Street, Kansas City, Missouri 64110, USA
| | - Amanda S Bruce
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, Kanas 66160, USA.,Center for Children's Healthy Lifestyles &Nutrition, 610 East 2nd Street, Kansas City, Missouri 66108, USA
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Lepping RJ, Bruce AS, Francisco A, Yeh HW, Martin LE, Powell JN, Hancock L, Patrician TM, Breslin FJ, Selim N, Donnelly JE, Brooks WM, Savage CR, Simmons WK, Bruce JM. Resting-state brain connectivity after surgical and behavioral weight loss. Obesity (Silver Spring) 2015; 23:1422-8. [PMID: 26053145 PMCID: PMC4483156 DOI: 10.1002/oby.21119] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 03/23/2015] [Accepted: 03/24/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Changes in food-cue neural reactivity associated with behavioral and surgical weight loss interventions have been reported. Resting functional connectivity represents tonic neural activity that may contribute to weight loss success. This study explores whether intervention type is associated with differences in functional connectivity after weight loss. METHODS Fifteen participants with obesity were recruited prior to adjustable gastric banding surgery. Thirteen demographically matched participants with obesity were selected from a separate behavioral diet intervention. Resting-state functional magnetic resonance imaging was collected 3 months after surgery/behavioral intervention. ANOVA was used to examine post-weight loss differences between the two groups in connectivity to seed regions previously identified as showing differential cue-reactivity after weight loss. RESULTS Following weight loss, behavioral dieters exhibited increased connectivity between left precuneus/superior parietal lobule (SPL) and bilateral insula pre- to postmeal and bariatric patients exhibited decreased connectivity between these regions pre- to postmeal (P(corrected) <0.05). CONCLUSIONS Behavioral dieters showed increased connectivity pre- to postmeal between a region associated with processing of self-referent information (precuneus/SPL) and a region associated with interoception (insula) whereas bariatric patients showed decreased connectivity between these regions. This may reflect increased attention to hunger signals following surgical procedures and increased attention to satiety signals following behavioral diet interventions.
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Affiliation(s)
| | - Amanda S. Bruce
- Department of Pediatrics, University of Kansas Medical Center and Children’s Mercy Hospital
| | - Alex Francisco
- Department of Psychology, University of Missouri-Kansas City
| | - Hung-Wen Yeh
- Department of Biostatistics, University of Kansas Medical Center
| | - Laura E. Martin
- Hoglund Brain Imaging Center, University of Kansas Medical Center
- Department of Preventive Medicine, University of Kansas Medical Center
| | - Joshua N. Powell
- Center for Health Behavior Neuroscience, University of Kansas Medical Center
| | - Laura Hancock
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University
| | | | - Florence J. Breslin
- Center for Health Behavior Neuroscience, University of Kansas Medical Center
| | - Niazy Selim
- Department of Surgery-General, University of Kansas Medical Center
| | - Joseph E. Donnelly
- Center for Physical Activity and Weight Management, University of Kansas Medical Center
- Department of Medicine-Cardiology, University of Kansas Medical Center
| | - William M. Brooks
- Hoglund Brain Imaging Center, University of Kansas Medical Center
- Department of Neurology, University of Kansas Medical Center
| | - Cary R. Savage
- Center for Health Behavior Neuroscience, University of Kansas Medical Center
- Department of Psychiatry, University of Kansas Medical Center
| | - W. Kyle Simmons
- Laureate Institute for Brain Research
- Faculty of Community Medicine, The University of Tulsa
| | - Jared M. Bruce
- Department of Psychology, University of Missouri-Kansas City
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McFadden BR, Lusk JL, Crespi JM, Cherry JBC, Martin LE, Aupperle RL, Bruce AS. Can neural activation in dorsolateral prefrontal cortex predict responsiveness to information? An application to egg production systems and campaign advertising. PLoS One 2015; 10:e0125243. [PMID: 26018592 PMCID: PMC4446318 DOI: 10.1371/journal.pone.0125243] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 03/23/2015] [Indexed: 11/18/2022] Open
Abstract
Consumers prefer to pay low prices and increase animal welfare; however consumers are typically forced to make tradeoffs between price and animal welfare. Campaign advertising (i.e., advertising used during the 2008 vote on Proposition 2 in California) may affect how consumers make tradeoffs between price and animal welfare. Neuroimaging data was used to determine the effects of brain activation in dorsolateral prefrontal cortex (dlPFC) on choices making a tradeoff between price and animal welfare and responsiveness to campaign advertising. Results indicated that activation in the dlPFC was greater when making choices that forced a tradeoff between price and animal welfare, compared to choices that varied only by price or animal welfare. Furthermore, greater activation differences in right dlPFC between choices that forced a tradeoff and choices that did not, indicated greater responsiveness to campaign advertising.
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Affiliation(s)
- Brandon R. McFadden
- Department of Food and Resource Economics, University of Florida, Gainesville, Florida, United States of America
- * E-mail:
| | - Jayson L. Lusk
- Department of Agricultural Economics, Oklahoma State University, Stillwater, Oklahoma, United States of America
| | - John M. Crespi
- Department of Agricultural Economics, Kansas State University, Manhattan, Kansas, United States of America
| | - J. Bradley C. Cherry
- Department of Behavioral Pediatrics at the University of Kansas Medical Center, Kansas City, Kansas, United States of America
| | - Laura E. Martin
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas, United States of America
| | - Robin L. Aupperle
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, Oklahoma, United States of America
| | - Amanda S. Bruce
- Department of Behavioral Pediatrics at the University of Kansas Medical Center, Kansas City, Kansas, United States of America
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Lim SL, Bruce AS. Prospect theory and body mass: characterizing psychological parameters for weight-related risk attitudes and weight-gain aversion. Front Psychol 2015; 6:330. [PMID: 25852628 PMCID: PMC4371555 DOI: 10.3389/fpsyg.2015.00330] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 03/07/2015] [Indexed: 11/13/2022] Open
Abstract
We developed a novel decision-making paradigm that allows us to apply prospect theory in behavioral economics to body mass. 67 healthy young adults completed self-report measures and two decision-making tasks for weight-loss, as well as for monetary rewards. We estimated risk-related preference and loss aversion parameters for each individual, separately for weight-loss and monetary rewards choice data. Risk-seeking tendency for weight-loss was positively correlated with body mass index in individuals who desired to lose body weight, whereas the risk-seeking for momentary rewards was not. Risk-seeking for weight-loss was correlated to excessive body shape preoccupations, while aversion to weight-gain was correlated with self-reports of behavioral involvement for successful weight-loss. We demonstrated that prospect theory can be useful in explaining the decision-making process related to body mass. Applying prospect theory is expected to advance our understanding of decision-making mechanisms in obesity, which might prove helpful for improving healthy choices.
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Affiliation(s)
- Seung-Lark Lim
- Department of Psychology, University of Missouri - Kansas City Kansas City, MO, USA
| | - Amanda S Bruce
- Department of Pediatrics and Center for Children's Healthy Lifestyles and Nutrition, University of Kansas Medical Center and Children's Mercy Hospital Kansas City, KS, USA
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Lusk JL, Crespi JM, Cherry JBC, McFadden BR, Martin LE, Bruce AS. An fMRI investigation of consumer choice regarding controversial food technologies. Food Qual Prefer 2015. [DOI: 10.1016/j.foodqual.2014.10.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hancock LM, Bruce JM, Bruce AS, Lynch SG. Processing speed and working memory training in multiple sclerosis: A double-blind randomized controlled pilot study. J Clin Exp Neuropsychol 2015; 37:113-27. [DOI: 10.1080/13803395.2014.989818] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Lim SL, Bruce AS. Can't wait to lose weight? Characterizing temporal discounting parameters for weight-loss. Appetite 2014; 85:8-13. [PMID: 25450897 DOI: 10.1016/j.appet.2014.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 10/16/2014] [Accepted: 11/02/2014] [Indexed: 02/07/2023]
Abstract
Obesity is often related to steeper temporal discounting, that is, higher decision impulsivity for immediate rewards over delayed rewards. However, previous studies have measured temporal discounting parameters through monetary rewards. The aim of this study was to develop a temporal discounting measure based on weight-loss rewards, which may help to understand decision-making mechanisms more closely related to body weight regulation. After having their heights and weights measured, healthy young adults completed the Monetary Choice Questionnaire (MCQ), and an adapted version of the MCQ, with weight-loss as a reward. Participants also completed self-reports that measure obesity-related cognitive variables. For 42 participants who expressed a desire to lose weight, weight-loss rewards were discounted over time and had a positive correlation with temporal discounting for monetary rewards. Higher temporal discounting for weight loss rewards (i.e., preference for immediate weight loss) showed correlations with beliefs that obesity is under obese persons' control and largely due to lack of willpower, while temporal discounting parameters for monetary rewards did not. Taken together, our weight loss temporal discounting measure demonstrated both convergent and divergent validity, which can be utilized for future obesity research and interventions.
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Affiliation(s)
- Seung-Lark Lim
- Department of Psychology, University of Missouri - Kansas City, 5030 Cherry Street, Kansas City, MO 64110, USA.
| | - Amanda S Bruce
- Department of Pediatrics, University of Kansas Medical Center, USA; Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, USA
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Black WR, Lepping RJ, Bruce AS, Powell JN, Bruce JM, Martin LE, Davis AM, Brooks WM, Savage CR, Simmons WK. Tonic hyper-connectivity of reward neurocircuitry in obese children. Obesity (Silver Spring) 2014; 22:1590-3. [PMID: 24634397 PMCID: PMC4077951 DOI: 10.1002/oby.20741] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 03/07/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Obese children demonstrate less activation in prefrontal regions associated with self-control and inhibition when presented with food cues and advertisements. This study evaluates the differences between obese and healthy weight children in resting-state functional connectivity to these brain regions. METHODS Seed regions in bilateral middle frontal gyri were chosen based on previous task-based analysis showing differences between obese and healthy weight children's responses to food-associated stimuli. Functional connectivity to these seed regions was measured in resting-state scans collected in obese and lean children undergoing fMRI. RESULTS Obese children exhibited greater resting-state functional connectivity than healthy weight children between the left middle frontal gyrus and reward-related regions in the left ventromedial prefrontal cortex, as well as the left lateral OFC. CONCLUSION Previously published results demonstrated that obese children exhibit less activity in brain regions associated with self-control when viewing motivationally salient food advertisements. Here, it is shown that the obese children also have tonically greater input to these self-control regions from reward neurocircuitry. The greater functional connectivity between reward and self-control regions, in conjunction with weaker activation of self-control neurocircuitry, may render these children more susceptible to food advertisements, placing them at elevated risk for over-feeding and obesity.
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Affiliation(s)
| | | | - Amanda S. Bruce
- Department of Psychology, University of Missouri-Kansas City
- Center for Children’s Healthy Lifestyles & Nutrition, Children’s Mercy Hospital
| | - Joshua N. Powell
- Center for Health Behavior Neuroscience – University of Kansas Medical Center
| | - Jared M. Bruce
- Department of Psychology, University of Missouri-Kansas City
| | - Laura E. Martin
- Hoglund Brain Imaging Center – University of Kansas Medical Center
- Department of Preventive Medicine—University of Kansas Medical Center
| | - Ann M. Davis
- Center for Children’s Healthy Lifestyles & Nutrition, Children’s Mercy Hospital
- Department of Pediatrics—University of Kansas Medical Center
| | - William M. Brooks
- Hoglund Brain Imaging Center – University of Kansas Medical Center
- Department of Neurology—University of Kansas Medical Center
| | - Cary R. Savage
- Center for Health Behavior Neuroscience – University of Kansas Medical Center
- Department of Psychiatry—University of Kansas Medical Center
| | - W. Kyle Simmons
- Laureate Institute for Brain Research
- Faculty of Community Medicine – The University of Tulsa
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Thelen JM, Lynch SG, Bruce AS, Hancock LM, Bruce JM. Polypharmacy in multiple sclerosis: relationship with fatigue, perceived cognition, and objective cognitive performance. J Psychosom Res 2014; 76:400-4. [PMID: 24745782 DOI: 10.1016/j.jpsychores.2014.02.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 02/21/2014] [Accepted: 02/28/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Patients with multiple sclerosis (MS) commonly use a variety of medications to slow disease progression, alleviate symptoms, and treat comorbid conditions. Polypharmacy has been linked to adverse outcomes in other patient groups, but has not been studied extensively in MS. We investigated the impact of polypharmacy on fatigue, objective neuropsychological performance, and subjective cognitive impairment in a sample of patients with MS. METHODS MS patients (n=85) completed a medication inventory, self-report questionnaires, and a battery of neurocognitive tests. MS patients with polypharmacy were compared to MS patients without polypharmacy, using multivariate analysis of covariance (MANCOVA). RESULTS After controlling for disease characteristics, MS patients with polypharmacy (n=28) exhibited prospective memory deficits and reported significantly more fatigue and subjective cognitive problems than MS patients without polypharmacy. CONCLUSION Clinicians and patients should carefully weigh the costs and benefits of prescribing multiple medications, as these may contribute to iatrogenic fatigue and cognitive problems in MS. Moreover, researchers should account for polypharmacy when conducting studies examining fatigue and cognition in MS.
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Affiliation(s)
- Joanie M Thelen
- Department of Psychology, University of Missouri - Kansas City, Kansas City, MO, United States
| | - Sharon G Lynch
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, United States
| | - Amanda S Bruce
- Department of Psychology, University of Missouri - Kansas City, Kansas City, MO, United States
| | - Laura M Hancock
- Alpert Medical School of Brown University, Providence, RI, United States
| | - Jared M Bruce
- Department of Psychology, University of Missouri - Kansas City, Kansas City, MO, United States.
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Jarmolowicz DP, Cherry JBC, Reed DD, Bruce JM, Crespi JM, Lusk JL, Bruce AS. Robust relation between temporal discounting rates and body mass. Appetite 2014; 78:63-7. [PMID: 24650831 DOI: 10.1016/j.appet.2014.02.013] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 02/18/2014] [Accepted: 02/22/2014] [Indexed: 01/25/2023]
Abstract
When given the choice between $100 today and $110 in 1 week, certain people are more likely to choose the immediate, yet smaller reward. The present study examined the relations between temporal discounting rate and body mass while accounting for important demographic variables, depressive symptoms, and behavioral inhibition and approach. After having their heights and weights measured, 100 healthy adults completed the Monetary Choice Questionnaire, the Beck Depression Inventory-II, and the Behavioral Inhibition Scale/Behavioral Approach Scale. Overweight and obese participants exhibited higher temporal discounting rates than underweight and healthy weight participants. Temporal discounting rates decreased as the magnitude of the delayed reward increased, even when other variables known to impact temporal discounting rate (i.e., age, education level, and annual household income) were used as covariates. A higher body mass was strongly related to choosing a more immediate monetary reward. Additional research is needed to determine whether consideration-of-future-consequences interventions, or perhaps cognitive control interventions, could be effective in obesity intervention or prevention programs.
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Affiliation(s)
- David P Jarmolowicz
- Department of Applied Behavioral Science, The University of Kansas, 4001 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, Kansas 66045-7555
| | - J Bradley C Cherry
- Department of Psychology, University of Missouri-Kansas City, 324 Cherry Hall, 5030 Cherry Street, Kansas City, Missouri 64110
| | - Derek D Reed
- Department of Applied Behavioral Science, The University of Kansas, 4001 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, Kansas 66045-7555
| | - Jared M Bruce
- Department of Psychology, University of Missouri-Kansas City, 324 Cherry Hall, 5030 Cherry Street, Kansas City, Missouri 64110
| | - John M Crespi
- Department of Agricultural Economics, Kansas State University, 342 Waters Hall, Kansas State University, Manhattan, KS 66506-4011
| | - Jayson L Lusk
- Department of Agricultural Economics, Oklahoma State University, 308 Agricultural Hall, Oklahoma State University, Stillwater, Oklahoma 74078
| | - Amanda S Bruce
- Department of Psychology, University of Missouri-Kansas City, 324 Cherry Hall, 5030 Cherry Street, Kansas City, Missouri 64110.
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Bruce AS, Bruce JM, Ness AR, Lepping RJ, Malley S, Hancock L, Powell J, Patrician TM, Breslin FJ, Martin LE, Donnelly JE, Brooks WM, Savage CR. A comparison of functional brain changes associated with surgical versus behavioral weight loss. Obesity (Silver Spring) 2014; 22:337-43. [PMID: 24115765 PMCID: PMC3946492 DOI: 10.1002/oby.20630] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 09/16/2013] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Few studies have examined brain changes in response to effective weight loss; none have compared different methods of weight-loss intervention. Functional brain changes associated with a behavioral weight loss intervention to those associated with bariatric surgery were compared. DESIGN AND METHODS Fifteen obese participants were recruited prior to adjustable gastric banding surgery and 16 obese participants were recruited prior to a behavioral diet intervention. Groups were matched for demographics and amount of weight lost. Functional magnetic resonance imaging scans (visual food motivation paradigm while hungry and following a meal) were conducted before and 12 weeks after surgery/behavioral intervention. RESULTS When compared to bariatric patients in the premeal analyses, behavioral dieters showed increased activation to food images in right medial prefrontal cortex (PFC) and left precuneus following weight loss. When compared to behavioral dieters, bariatric patients showed increased activation in bilateral temporal cortex following weight loss. CONCLUSIONS Behavioral dieters showed increased responses to food cues in medial PFC-a region associated with valuation and processing of self-referent information-when compared to bariatric patients. Bariatric patients showed increased responses to food cues in brain regions associated with higher level perception-when compared to behavioral dieters. The method of weight loss determines unique changes in brain function.
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Affiliation(s)
- Amanda S. Bruce
- Department of Psychology, University of Missouri-Kansas City
| | - Jared M. Bruce
- Department of Psychology, University of Missouri-Kansas City
| | - Abigail R. Ness
- Department of Psychology, University of Missouri-Kansas City
| | | | | | - Laura Hancock
- Department of Psychology, University of Missouri-Kansas City
| | - Josh Powell
- Center for Health Behavior Neuroscience, University of Kansas Medical Center
| | - Trisha M. Patrician
- Center for Health Behavior Neuroscience, University of Kansas Medical Center
| | - Florence J. Breslin
- Center for Health Behavior Neuroscience, University of Kansas Medical Center
| | - Laura E. Martin
- Hoglund Brain Imaging Center, University of Kansas Medical Center
- Department of Preventive Medicine & Public Health, University of Kansas Medical Center
| | - Joseph E. Donnelly
- Center for Physical Activity and Weight Management, University of Kansas Medical Center
| | - William M. Brooks
- Hoglund Brain Imaging Center, University of Kansas Medical Center
- Department of Neurology, University of Kansas Medical Center
| | - Cary R. Savage
- Center for Health Behavior Neuroscience, University of Kansas Medical Center
- Department of Psychiatry & Behavioral Sciences, University of Kansas Medical Center
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Bruce AS, Bruce JM, Black WR, Lepping RJ, Henry JM, Cherry JBC, Martin LE, Papa VB, Davis AM, Brooks WM, Savage CR. Branding and a child's brain: an fMRI study of neural responses to logos. Soc Cogn Affect Neurosci 2012; 9:118-22. [PMID: 22997054 PMCID: PMC3871732 DOI: 10.1093/scan/nss109] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Branding and advertising have a powerful effect on both familiarity and preference for products, yet no neuroimaging studies have examined neural response to logos in children. Food advertising is particularly pervasive and effective in manipulating choices in children. The purpose of this study was to examine how healthy children’s brains respond to common food and other logos. A pilot validation study was first conducted with 32 children to select the most culturally familiar logos, and to match food and non-food logos on valence and intensity. A new sample of 17 healthy weight children were then scanned using functional magnetic resonance imaging. Food logos compared to baseline were associated with increased activation in orbitofrontal cortex and inferior prefrontal cortex. Compared to non-food logos, food logos elicited increased activation in posterior cingulate cortex. Results confirmed that food logos activate some brain regions in children known to be associated with motivation. This marks the first study in children to examine brain responses to culturally familiar logos. Considering the pervasiveness of advertising, research should further investigate how children respond at the neural level to marketing.
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Affiliation(s)
- Amanda S Bruce
- Department of Psychology, The University of Missouri-Kansas City, 5030 Cherry Street, 307 Cherry Hall, Kansas City, MO 64110, USA.
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Holsen LM, Savage CR, Martin LE, Bruce AS, Lepping RJ, Ko E, Brooks WM, Butler MG, Zarcone JR, Goldstein JM. Importance of reward and prefrontal circuitry in hunger and satiety: Prader-Willi syndrome vs simple obesity. Int J Obes (Lond) 2011; 36:638-47. [PMID: 22024642 PMCID: PMC3270121 DOI: 10.1038/ijo.2011.204] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background The majority of research on obesity has focused primarily on clinical features (eating behavior, adiposity measures), or peripheral appetite-regulatory peptides (leptin, ghrelin). However, recent functional neuroimaging studies have demonstrated that some reward circuitry regions which are associated with appetite-regulatory hormones are also involved in the development and maintenance of obesity. Prader-Willi syndrome (PWS), characterized by hyperphagia and hyperghrelinemia reflecting multi-system dysfunction in inhibitory and satiety mechanisms, serves as an extreme model of genetic obesity. Simple (non-PWS) obesity (OB) represents an obesity control state. Objective This study investigated subcortical food motivation circuitry and prefrontal inhibitory circuitry functioning in response to food stimuli before and after eating in individuals with PWS compared with OB. We hypothesized that groups would differ in limbic regions (i.e., hypothalamus, amygdala) and prefrontal regions associated with cognitive control [i.e., dorsolateral prefrontal cortex (DLPFC), orbitofrontal cortex (OFC)] after eating. Design and Participants Fourteen individuals with PWS, 14 BMI- and age-matched individuals with OB, and 15 age-matched healthy-weight controls (HWC) viewed food and non-food images while undergoing functional MRI before (pre-meal) and after (post-meal) eating. Using SPM8, group contrasts were tested for hypothesized regions: hypothalamus, nucleus accumbens (NAc), amygdala, hippocampus, OFC, medial PFC, and DLPFC. Results Compared with OB and HWC, PWS demonstrated higher activity in reward/limbic regions (NAc, amygdala) and lower activity in hypothalamus and hippocampus, in response to food (vs. non-food) images pre-meal. Post-meal, PWS exhibited higher subcortical activation (hypothalamus, amygdala, hippocampus) compared to OB and HWC. OB showed significantly higher activity versus PWS and HWC in cortical regions (DLPFC, OFC) associated with inhibitory control. Conclusion In PWS compared with obesity per se, results suggest hyperactivations in subcortical reward circuitry and hypoactivations in cortical inhibitory regions after eating, which provides evidence of neural substrates associated with variable abnormal food motivation phenotypes in PWS and simple obesity.
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Affiliation(s)
- L M Holsen
- Departments of Psychiatry and Medicine, Harvard Medical School, Boston, MA, USA.
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Abstract
OBJECTIVE Childhood obesity rates have increased over the last 40 years and have a detrimental impact on public health. While the causes of the obesity epidemic are complex, obesity ultimately arises from chronic imbalances between energy intake and expenditure. An emerging area of research in obesity has focused on the role of the brain in evaluating the rewarding properties of food and making decisions about what and how much to eat. METHOD This article reviews recent scientific literature regarding the brain's role in pediatric food motivation and childhood obesity. RESULTS The article will begin by reviewing some of the recent literature discussing challenges associated with neuroimaging in children and the relevant developmental brain changes that occur in childhood and adolescence. The article will then review studies regarding neural mechanisms of food motivation and the ability to delay gratification in children and how these responses differ in obese compared to healthy weight children. CONCLUSION Increasing our understanding about how brain function and behavior may differ in children will inform future research, obesity prevention, and interventions targeting childhood obesity.
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Affiliation(s)
- Amanda S Bruce
- Department of Psychology, University of Missouri-Kansas City, USA.
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Abstract
Delay of gratification tasks require an individual to forgo an immediate reward and wait for a more desirable delayed reward. This study used an ecologically valid measure of delayed gratification to test the hypothesis that preadolescents with higher BMI would be less likely to delay gratification. Healthy Hawks is a 12-week educational/behavioral obesity intervention at the University of Kansas Medical Center. Each week, children earn a point if they complete their goals worksheet. They can spend that point immediately on a small toy prize or save points to use on a larger prize. We retrospectively calculated the percentage of points saved over the 12 weeks for 59 children (28 females) ages 8-12 years old (mean = 10.29 ± 1.39). Spearman correlation revealed that higher BMI percentile was associated with reduced point savings (r = 0.33, P = 0.01). Similarly, obese preadolescents saved significantly fewer points than healthy weight (HW) and overweight preadolescents (t (57) = 3.14, P < 0.01). Results from our ecologically valid measure support the theory that obese children are less likely to delay gratification than overweight and HW children. Even for nonfood rewards, preadolescent children with higher BMIs prefer the immediate reward over a delayed, larger reward. This has implications for developing specific strategies within obesity treatments aimed at improving delayed gratification.
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Affiliation(s)
- Amanda S Bruce
- Department of Psychology, University of Missouri-Kansas City, Kansas City, Missouri, USA.
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Bruce AS, Holsen LM, Chambers RJ, Martin LE, Brooks WM, Zarcone JR, Butler MG, Savage CR. Obese children show hyperactivation to food pictures in brain networks linked to motivation, reward and cognitive control. Int J Obes (Lond) 2010; 34:1494-500. [PMID: 20440296 DOI: 10.1038/ijo.2010.84] [Citation(s) in RCA: 192] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate the neural mechanisms of food motivation in children and adolescents, and examine brain activation differences between healthy weight (HW) and obese participants. SUBJECTS Ten HW children (ages 11-16; BMI < 85%ile) and 10 obese children (ages 10-17; BMI >95%ile) matched for age, gender and years of education. MEASUREMENTS Functional magnetic resonance imaging (fMRI) scans were conducted twice: when participants were hungry (pre-meal) and immediately after a standardized meal (post-meal). During the fMRI scans, the participants passively viewed blocked images of food, non-food (animals) and blurred baseline control. RESULTS Both groups of children showed brain activation to food images in the limbic and paralimbic regions (PFC/OFC). The obese group showed significantly greater activation to food pictures in the PFC (pre-meal) and OFC (post-meal) than the HW group. In addition, the obese group showed less post-meal reduction of activation (vs pre-meal) in the PFC, limbic and the reward-processing regions, including the nucleus accumbens. CONCLUSION Limbic and paralimbic activation in high food motivation states was noted in both groups of participants. However, obese children were hyper-responsive to food stimuli as compared with HW children. In addition, unlike HW children, brain activations in response to food stimuli in obese children failed to diminish significantly after eating. This study provides initial evidence that obesity, even among children, is associated with abnormalities in neural networks involved in food motivation, and that the origins of neural circuitry dysfunction associated with obesity may begin early in life.
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Affiliation(s)
- A S Bruce
- Department of Preventive Medicine, Hoglund Brain Imaging Center, The University of Kansas Medical Center, Kansas City, KS, USA
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Martin LE, Holsen LM, Chambers RJ, Bruce AS, Brooks WM, Zarcone JR, Butler MG, Savage CR. Neural mechanisms associated with food motivation in obese and healthy weight adults. Obesity (Silver Spring) 2010; 18:254-60. [PMID: 19629052 DOI: 10.1038/oby.2009.220] [Citation(s) in RCA: 215] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
One out of three adults in the United States is clinically obese. Excess food intake is associated with food motivation, which has been found to be higher in obese compared to healthy weight (HW) individuals. Little is known, however, regarding the neural mechanisms associated with food motivation in obese compared to HW adults. The current study used functional magnetic resonance imaging (fMRI) to examine changes in the hemodynamic response in obese and HW adults while they viewed food and nonfood images in premeal and postmeal states. During the premeal condition, obese participants showed increased activation, compared to HW participants, in anterior cingulate cortex (ACC) and medial prefrontal cortex (MPFC). Moreover, in the obese group, self-report measures of disinhibition were negatively correlated with premeal ACC activations and self-report measures of hunger were positively correlated with premeal MPFC activations. During the postmeal condition, obese participants also showed greater activation than HW participants in the MPFC. These results indicate that brain function associated with food motivation differs in obese and HW adults and may have implications for understanding brain mechanisms contributing to overeating and obesity, and variability in response to diet interventions.
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Affiliation(s)
- Laura E Martin
- Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, Kansas, USA
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Bruce JM, Bruce AS, Hancock L, Lynch S. Self-reported Memory Problems in Multiple Sclerosis: Influence of Psychiatric Status and Normative Dissociative Experiences. Arch Clin Neuropsychol 2009; 25:39-48. [DOI: 10.1093/arclin/acp092] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Affiliation(s)
| | - Amanda S. Bruce
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI
| | - Molly Zimmerman
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI
| | - Lawrence H. Sweet
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI
| | - Richard P. Millman
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Brown Medical School, Providence, RI
| | - Mark S. Aloia
- Department of Medicine, National Jewish Medical and Research Center, Denver, CO
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Felver-Gant JC, Bruce AS, Zimmerman M, Sweet LH, Millman RP, Aloia MS. Working memory in obstructive sleep apnea: construct validity and treatment effects. J Clin Sleep Med 2007; 3:589-594. [PMID: 17993040 PMCID: PMC2045718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
STUDY OBJECTIVE To better understand the effects of obstructive sleep apnea (OSA) on working memory performance. We first examined the construct validity of a working memory task (the 2-Back task) and its relationship to other tests of cognitive functioning, and then determined the effects of positive airway pressure (PAP) treatment on measures of both working memory and its related component processes. METHODS Fifty-six participants with OSA were administered cognitive tests of working memory and related subordinate cognitive processes prior to initiation of PAP treatment and at a 3-month follow-up visit. Objective monitors were employed to measure PAP treatment adherence. Statistical analyses were conducted to examine treatment adherence and cognitive performance over time. RESULTS Performance on the 2-Back task was statistically correlated with both a second working memory task (PASAT) and all subordinate cognitive measures. Participants were separated into high and low PAP adherence groups using a median split of 4 hours of PAP use per night. Repeated measures ANOVAs demonstrated that high adherers performed better across time on both tests of working memory (2-Back: F46 = 4.73, p <0.04; PASAT: F46 = 4.92, p <0.04) whereas low adherers performed more poorly. There were no treatment effects for any other cognitive measure. CONCLUSIONS The 2-Back task demonstrated adequate construct validity as a measurement of working memory in individuals with OSA. Our treatment adherence findings suggest that the construct of working memory is more sensitive to the effects OSA treatment than are any of its subordinate cognitive processes.
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Affiliation(s)
| | - Amanda S. Bruce
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI
| | - Molly Zimmerman
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI
| | - Lawrence H. Sweet
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI
| | - Richard P. Millman
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Brown Medical School, Providence, RI
| | - Mark S. Aloia
- Department of Medicine, National Jewish Medical and Research Center, Denver, CO
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