Smoking, dietary restraint, gender, and the relative reinforcing value of snack food in a large university sample

Tobacco withdrawal increases junk food intake: The role of the endogenous opioid system

BACKGROUND

The aims of this study were to 1) determine whether acute nicotine withdrawal increases the intake of junk food (high in salt, fat, and sugar) and 2) assess whether the endogenous opioid system is involved in junk food intake during nicotine withdrawal using naltrexone as a pharmacological probe.

METHODS

Smokers were randomly assigned to 24-hr withdrawal from tobacco products (n = 42) or smoking ad libitum (n = 34). A non-smoking group (n = 29) was included. Participants completed two laboratory sessions where a placebo or 50 mg of naltrexone was administered. At the end of each session, participants were given a tray of snack items that differed in high to low energy density and dimensions of salty, sweet, and fat. Self-reported mood and withdrawal measures were collected immediately before the snacks were offered. Generalized linear and logistic models were used to assess the effects of acute smoking withdrawal, drug, and sex on the intake of snack items and self-reported measures.

RESULTS

Choice and consumption of food items were impacted by smoking condition (withdrawal > ad lib smoking and non-smokers; p < .05), the opioid blockade (naltrexone < placebo; p < .05), and sex (male > female; p < .05). The effects were evidenced in high sweet and high fat foods. No differences were found in low sweet and fat foods.

CONCLUSIONS

These findings extend earlier studies indicating impact of tobacco use on appetite, and identify the regulatory influence of the endogenous opioid system on appetite during nicotine withdrawal.

Food reinforcement and habituation to food are processes related to initiation and cessation of eating

An individual bout of eating involves cues to start eating, as well as cues to terminate eating. One process that determines initiation of eating is food reinforcement. Foods with high reinforcing value are also likely to be consumed in greater quantities. Research suggests both cross-sectional and prospective relationships between food reinforcement and obesity, food reinforcement is positively related to energy intake, and energy intake mediates the relationship between food reinforcement and obesity. A process related to cessation of eating is habituation. Habituation is a general behavioral process that describes a reduction in physiological or affective response to a stimulus, or a reduction in the behavioral responding to obtain a stimulus. Repeated exposure to the same food during a meal can result in habituation to that food and a reduction in consumption. Habituation is also cross-sectionally and prospectively related to body weight, as people who habituate slower consume more in a meal and are more overweight. Research from our laboratory has shown that these two processes independently influence eating, as they can account for almost 60% of the variance in ad libitum intake. In addition, habituation phenotypes show reliable relationships with reinforcing value, such that people who habituate faster also find food less reinforcing. Developing a better understanding of cues to start and stop eating is fundamental to understanding how to modify eating behavior. An overview of research on food reinforcement, habituation and food intake for people with a range of weight status and without eating disorders is provided, and ideas about integrating these two processes that are related to initiation and termination of a bout of eating are discussed.

The Relative Reinforcing Value of Cookies Is Higher Among Head Start Preschoolers With Obesity

The relative reinforcing value (RRV) of food measures how hard someone will work for a high-energy-dense (HED) food when an alternative reward is concurrently available. Higher RRV for HED food has been linked to obesity, yet this association has not been examined in low-income preschool-age children. Further, the development of individual differences in the RRV of food in early childhood is poorly understood. This cross-sectional study tested the hypothesis that the RRV of HED (cookies) to low-energy-dense (LED; fruit) food would be greater in children with obesity compared to children without obesity in a sample of 130 low-income 3- to 5-year-olds enrolled in Head Start classrooms in Central Pennsylvania. In addition, we examined individual differences in the RRV of food by child characteristics (i.e., age, sex, and reward sensitivity) and food security status. The RRV of food was measured on concurrent progressive-ratio schedules of reinforcement. RRV outcomes included the last schedule reached (breakpoint) for cookies (cookie Pmax) and fruit (fruit Pmax), the breakpoint for cookies in proportion to the total breakpoint for cookies and fruit combined (RRV cookie), and response rates (responses per minute). Parents completed the 18-item food security module to assess household food security status and the Behavioral Activation System scale to assess reward sensitivity. Pearson's correlations and mixed models assessed associations between continuous and discrete child characteristics with RRV outcomes, respectively. Two-way mixed effects interaction models examined age and sex as moderators of the association between RRV and Body Mass Index z-scores (BMIZ). Statistical significance was defined as p < 0.05. Children with obesity (17%) had a greater cookie Pmax [F (1, 121) = 4.95, p = 0.03], higher RRV cookie [F (1, 121) = 4.28, p = 0.04], and responded at a faster rate for cookies [F (1, 121) = 17.27, p < 0.001] compared to children without obesity. Children with higher cookie response rates had higher BMIZ (r = 0.26, p < 0.01); and RRV cookie was positively associated with BMIZ for older children (5-year-olds: t = 2.40, p = 0.02) and boys (t = 2.55, p = 0.01), but not younger children or girls. The RRV of food did not differ by household food security status. Low-income children with obesity showed greater motivation to work for cookies than fruit compared to their peers without obesity. The RRV of HED food may be an important contributor to increased weight status in boys and future research is needed to better understand developmental trajectories of the RRV of food across childhood.

Measurement of food reinforcement in preschool children. Associations with food intake, BMI, and reward sensitivity

Progressive ratio (PR) schedules of reinforcement have been used to measure the relative reinforcing value (RRV) of food in humans as young as 8 years old; however, developmentally appropriate measures are needed to measure RRV of food earlier in life. Study objectives were to demonstrate the validity of the RRV of food task adapted for use among for preschool children (3-5 y), and examine individual differences in performance. Thirty-three children completed the RRV of food task in which they worked to access graham crackers. They also completed a snack task where they had free access these foods, liking and hunger assessments, and their heights and weights were measured. Parents reported on their child's reward sensitivity. Overall, children were willing work for palatable snack foods. Boys and older children made more responses in the task, while children with higher BMI z-scores and reward sensitivity responded at a faster rate. Children who worked harder in terms of total responses and response rates consumed more calories in the snack session. This study demonstrates that with slight modifications, the RRV of food task is a valid and developmentally appropriate measure for assessing individual differences in food reinforcement among very young children.

Validation of an online questionnaire measure of the relative reinforcing value of food

Laboratory methods and questionnaires to assess the relative reinforcing value of food (RRV-F) have been developed, but this is the first study to validate an online questionnaire measure of the RRV-F. Participants (281 college students) completed an online survey assessing demographic variables, food preferences, and the RRV-F. A subsample (n=21) also completed a laboratory food choice session. The online RRV-F instrument showed strong predictive validity for laboratory food choice behavior, convergent validity with overweight status, and discriminant validity with unrelated constructs (age, gender, height). Results suggest that online methodology is appropriate for assessing the RRV-F in a manner that is cost-effective, time-efficient, affords greater anonymity, and enables recruitment from larger samples over a broader geographic region.

Effect of thought suppression on desire to smoke and tobacco withdrawal symptoms

RATIONALE

Suppressing smoking thoughts has been shown to result in elevated smoking. However, the effect of suppressing smoking thoughts on desire to smoke and withdrawal symptoms has not been investigated.

OBJECTIVES

We examined the effects of suppressing smoking thoughts on the subsequent desire to smoke and on tobacco withdrawal symptoms, relative to groups that were either thinking about anything they wished or actively thinking about smoking.

METHODS

A randomised experimental study compared the effects of three manipulations (suppressed smoking thoughts, expressed smoking thoughts and thoughts of anything they wished) on desire and withdrawal immediately after the manipulation and 5 and 10 min after.

RESULTS

Suppressing smoking thoughts did not result in elevated subsequent desire to smoke, relative to the other manipulations. Suppressing smoking thoughts resulted in a significant elevation in hunger ratings, relative to the other manipulations, at all measurement times. There were no significant effects for the other withdrawal symptoms. Self-reported greater use of thought suppression in everyday life was significantly associated with greater desire to smoke at baseline and was associated with lower mindfulness scores.

CONCLUSIONS

Laboratory-instructed suppression of smoking thoughts is associated with increased reports of hunger but did not lead to increases in other withdrawal symptoms or elevated desire to smoke. Reports of everyday use of thought suppression are associated with elevated desire to smoke at baseline. Further investigations need to assess the effect of suppressing smoking cravings, instead of general smoking thoughts, on desire to smoke and tobacco withdrawal.

Relative Reinforcing Value of Energy-dense Snack Foods: In Overweight and Obese Adults

Purpose: Obese people find energy-dense food more reinforcing than do their non-obese peers, and reinforcement influences food intake. We examined how the degree of adiposity, measured by body mass index (BMI), is associated with the relative reinforcing value of energy-dense snack foods versus fruits and vegetables in overweight and obese people.

Methods: Ninety-two overweight or obese students in introductory psychology courses completed questionnaires on age, sex, BMI, hunger, smoking status, dietary restraint, and hedonic (liking) ratings for energy-dense snack foods and fruits and vegetables. The questionnaire also was used to evaluate the relative reinforcing value of these snack foods in comparison with fruits and vegetables.

Results: The BMI predicted the relative reinforcing value of energy-dense snack food. This positive relationship remained significant after we controlled for age, sex, dietary restraint, hunger, smoking status, and snack food hedonics.

Conclusions: The greater the degree of overweight and obesity, the greater the motivation to obtain energy-dense snack foods. Because the rewarding value of food is a strong determinant of energy intake, a useful approach to preventing and treating obesity may be introducing pharmacological or behavioural nutrition intervention to reduce the rewarding value of energydense snack foods, or increasing the rewarding value of fruits and vegetables.

Exposure to acute stress is associated with attenuated sweet taste

This study examined the effects of stress on taste perception. Participants (N = 38; 21 women) completed two laboratory sessions: one stress (public speaking, math, and cold pressor) and one control rest session. The taste perception test was conducted at the end of each session and included rating the intensity and pleasantness of sweet, salty, sour, and savory solutions at suprathreshold concentrations. Cardiovascular, hormonal, and mood measures were collected throughout the sessions. Participants showed the expected changes in cardiovascular, hormonal, and mood measures in response to stress. Reported intensity of the sweet solution was significantly lower on the stress day than on the rest day. Cortisol level poststress predicted reduced intensity of salt and sour, suggesting that stress-related changes in adrenocortical activity were related to reduced taste intensity. Results indicate that acute stress may alter taste perception, and ongoing research investigates the extent to which these changes mediate effects of stress on appetite.

The reinforcement-enhancing effects of nicotine: implications for the relationship between smoking, eating and weight

Concerns about body weight represent an important barrier to public health efforts aimed at reducing smoking. Epidemiological studies have found that current smokers weigh less than non-smokers, smoking cessation results in weight gain, and weight restriction is commonly cited as a reason for smoking. The mechanisms underlying the relationship between smoking and weight are complex and may involve a number of factors including changes in caloric intake, physical activity, metabolic rate, and lipogenesis. Amongst these possible mechanisms, nicotine-induced enhancement of food reinforcement may be particularly important. In this paper, we first review data from our laboratory that highlight two distinct ways in which nicotine impacts reinforced behavior: 1) by acting as a primary reinforcer; and 2) by directly (non-associatively) enhancing the reinforcing effects of other stimuli. We then elaborate on the reinforcement-enhancing effects of nicotine as they pertain to behaviors and stimuli related to food. Data from both laboratory animals and humans support the assertion that nicotine enhances the reinforcing efficacy of food and suggest that the influence of these effects on eating may be most important after nicotine cessation when nicotine's effects on satiety subside. Finally, we discuss the theoretical and clinical implications of this perspective for understanding and addressing the apparent tradeoff between smoking and weight gain. Better understanding of the mechanisms underlying the reinforcement-enhancing effects of nicotine broadly, and the effects on food reinforcement per se, may aid in the development of new treatments with better long term outcomes.

How many calories are on our plate? Expected fullness, not liking, determines meal-size selection

The availability of highly palatable food is thought to stimulate the selection of larger meals (leading to weight gain and obesity). In this article, we explore aspects of this proposition. Specifically, we scrutinize two basic assumptions: (i) palatable energy-dense foods are more rewarding (desired), and (ii) these palatable foods are selected in relatively larger portions. In combination with palatability, we also consider the relative role for "expected satiation"-the extent to which a food is expected to deliver satiation. A total of 17 commonly consumed foods were assessed by 28 normal-weight participants at lunchtime. Critically, our measure of food reward and expected satiation involves comparisons between foods based on equicaloric portions. When assessed in this way, we find that food reward and ideal portion sizes (in kcal) are both closely associated with expected satiation, but not with "expected liking." Low expected satiation (not expected liking) predicts the selection of large portion sizes (in kcal) and foods with this characteristic tend to be more energy dense and are regarded as less (not more) rewarding (when compared calorie for calorie). Together, these findings challenge the role of palatability in meal-size selection and they highlight the importance of expected satiation, a "nonaffective" component of food reward.

The relative reinforcing value of food predicts weight gain in a longitudinal study of 7--10-y-old children

BACKGROUND

The relative reinforcing value (RRV) of food, defined as how hard an individual is prepared to work to gain access to food rather than a nonfood alternative, has been shown to be higher in obese adults and children than in their normal-weight counterparts. However, these cross-sectional studies are unable to determine whether a high RRV of food is predictive of adiposity change or whether it is a consequence of being obese.

OBJECTIVE

The objective was to examine the association between the RRV of food and 1-y weight gain in children aged 7-10 y.

DESIGN

An observational longitudinal study design was used. The RRV of food was determined by using a questionnaire method at baseline when the children (n = 316) were aged 7-9 y. Adiposity [body mass index (BMI), BMI SD score, fat mass index, waist circumference, and waist circumference SD score] was assessed at baseline and after 1 y.

RESULTS

Regression analyses indicated that the RRV of food was not associated with any measure of adiposity at baseline or at the 1-y follow-up (all P > 0.58). Changes in BMI (B = 0.06, P < 0.001), BMI SD score (B = 0.03, P = 0.001), and fat mass index (B = 0.09, P = 0.001) after 1 y were significantly predicted by the RRV of food at baseline.

CONCLUSIONS

The RRV of food predicted the change in adiposity over a relatively short-term period of 1 y and thus may be associated with the development of obesity. The lack of association in cross-sectional analyses indicates that this behavior is a risk factor for weight gain, although weight differences may not emerge until later childhood.

Effects of dietary restraint and body mass index on the relative reinforcing value of snack food

The present study examined the independent and interactive association between dietary restraint, body mass index (BMI) and the relative reinforcing value of food. Four hundred and three introductory psychology students completed questionnaires assessing age, gender, BMI, hunger, smoking status, nicotine dependence, dietary restraint, hedonic ratings for snack food and fruits and vegetables and the relative reinforcing value of snack food and fruits and vegetables. In the overall sample, results indicated a dietary restraint x BMI interaction after controlling for age, hunger, nicotine dependence, and hedonics. However, when regression models were separated by gender, the BMI x restraint interaction emerged only for females and not for males. Findings suggest that BMI moderates the relationship between dietary restraint and snack food reinforcement in females only, such that restraint and snack food reinforcement are inversely correlated in females with lower BMI, but restraint is positively correlated with snack food reinforcement in females with higher BMI. Theoretical and clinical implications of these findings are discussed.