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Ndambo MK, Nyondo-Mipando AL, Thakwalakwa C. Eating behaviors, attitudes, and beliefs that contribute to overweight and obesity among women in Lilongwe City, Malawi: a qualitative study. BMC Womens Health 2022; 22:216. [PMID: 35681137 PMCID: PMC9185864 DOI: 10.1186/s12905-022-01811-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background Obesity is increasingly a public health concern in low- and middle-income countries, including Malawi where 36% of women have body mass index in overweight/obese categories in urban areas. Eating behaviors, attitudes, and beliefs are associated with body size, but have not been studied in-depth in sub-Saharan African countries. This study therefore, explored eating behaviors, attitudes, and beliefs of women in Lilongwe, Malawi.
Methods This was a descriptive ancillary qualitative study utilising in-depth interviews with 27 women (13 in normal weight range and 14 in overweight/obesity ranges) puporsively selected in Lilongwe City, Malawi from October to November 2017. The concept of data saturation guided data collection, and it was reached with the 27 interviewed participants when there was no new information coming from the participants. All interviews were conducted in the local language, transcribed verbatim, and translated into English. The transcripts were analysed manually using thematic content analysis. Results Majority of participants perceived overweight as an indication of good health such that with food affordability, women deliberately gain weight to demonstrate their good health. Most normal weight respondents said they ate less food than they wanted to because of financial constraints. Most women in overweight/obese ranges in our sample reported that they eat large portions and eat frequently due to the desire to portray a good image of their marital life since there is a societal expectation that when a woman is married, her weight should increase to show that the marriage is successful. The perceived contributors to weight gain include eating behaviors, feelings about weight gain, and gender roles and social expectations to gain weight. Conclusion Beliefs and attitudes related to eating behaviors may have contributed to women being in overweight range and should be considered in designing obesity prevention interventions targeting women in Malawi. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01811-0.
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Affiliation(s)
- Myness Kasanda Ndambo
- School of Global and Public Health, Kamuzu University of Health Sciences, Chichiri, Private Bag 360, Blantyre 3, Malawi.
| | - Alinane Linda Nyondo-Mipando
- School of Global and Public Health, Kamuzu University of Health Sciences, Chichiri, Private Bag 360, Blantyre 3, Malawi
| | - Chrissie Thakwalakwa
- Centre for Social Research, Chancellor College, University of Malawi, Zomba, Malawi
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Follong BM, Prieto-Rodriguez E, Miller A, Collins CE, Bucher T. Integrating nutrition into the mathematics curriculum in Australian primary schools: protocol for a randomised controlled trial. Nutr J 2020; 19:128. [PMID: 33243231 PMCID: PMC7694306 DOI: 10.1186/s12937-020-00640-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/29/2020] [Indexed: 11/18/2022] Open
Abstract
Background Nutrition education programs in schools have been effective in improving children’s knowledge and behaviours related to food and nutrition. However, teachers find it challenging to implement such programs due to overcrowded curricula. Integrating nutrition with core subjects such as mathematics could potentially address time constraints and improve the learning of both. The primary aim of this randomized controlled trial (RCT) is to evaluate the impact of a cross-curricular nutrition and mathematics program on primary school students’ portion size estimation skills. Secondary aims include impact on their nutrition knowledge, attitudes towards mathematics and evaluating the quality of the lessons. Methods Twelve Year 3–4 classes from Catholic schools in New South Wales, Australia will be randomised to intervention (n = 6) or control (n = 6) groups. Teachers in the intervention group will receive a professional development workshop and resources to teach 4–5 lessons on portion size and measurements across 1–4 weeks. Outcome measures include portion size estimation skills, nutrition knowledge and attitudes towards mathematics, with data collected during three school visits (pre-intervention, immediately post-intervention, 4 weeks post-intervention). Additionally, teaching quality will be assessed in both intervention and control groups and process evaluation undertaken using teacher interviews and student focus groups. Discussion This RCT uses an innovative approach to improve both nutrition and mathematics related learning outcomes among primary school children. It has the potential to impact teaching practices regarding integration of nutrition into curricula and enhance the implementation of nutrition education interventions. Trial registration Australian and New Zealand Clinical Trials Register ACTRN12619001071112 31/07/2019.
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Affiliation(s)
- Berit M Follong
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Newcastle, NSW, Australia.,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Newcastle, NSW, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Newcastle, NSW, Australia
| | - Elena Prieto-Rodriguez
- School of Education, Faculty of Education and Arts, The University of Newcastle, Newcastle, NSW, Australia
| | - Andrew Miller
- School of Education, Faculty of Education and Arts, The University of Newcastle, Newcastle, NSW, Australia
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Newcastle, NSW, Australia.,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Newcastle, NSW, Australia
| | - Tamara Bucher
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Newcastle, NSW, Australia. .,Priority Research Centre for Health Behaviour, The University of Newcastle, Newcastle, NSW, Australia. .,School of Environmental and Life Sciences, Faculty of Science, The University of Newcastle, 10 Chittaway Road, Ourimbah, NSW, 2258, Australia.
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Hoppu U, Puputti S, Mattila S, Puurtinen M, Sandell M. Food Consumption and Emotions at a Salad Lunch Buffet in a Multisensory Environment. Foods 2020; 9:foods9101349. [PMID: 32977710 PMCID: PMC7598676 DOI: 10.3390/foods9101349] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/11/2020] [Accepted: 09/19/2020] [Indexed: 12/13/2022] Open
Abstract
The food experience is multisensory and multisensory external stimuli may affect food choice and emotions. The objective of this study was to evaluate the effect of a multisensory eating environment on food choice, intake and the emotional states of the subjects in a salad lunch buffet setting. A total of 30 female subjects consumed a salad lunch twice in the multisensory laboratory. The two test conditions (control and multisensory condition with environmental stimuli) were randomized and the visits were scheduled one week apart. Subjects selected and ate a meal from a salad buffet including 14 food items and the intake of each item was weighed. They answered an online questionnaire about the meal and their emotional states (20 different emotion terms) after the lunch. There was no significant difference in the food consumption between the control and multisensory conditions. The subjects were very satisfied with their lunch for both study visits but the pleasantness of the eating environment was rated higher under the multisensory condition. In emotional terms, the subjects selected the term "happy" significantly more frequently under the multisensory condition compared with the control. In conclusion, the multisensory eating environment in this study was not related to food intake but may be associated with positive emotions. The effect of the eating environment on food choice and experience deserves further study with a larger study population in a real lunch restaurant setting.
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Affiliation(s)
- Ulla Hoppu
- Functional Foods Forum, University of Turku, 20014 Turku, Finland; (U.H.); (S.P.); (S.M.)
| | - Sari Puputti
- Functional Foods Forum, University of Turku, 20014 Turku, Finland; (U.H.); (S.P.); (S.M.)
| | - Saila Mattila
- Functional Foods Forum, University of Turku, 20014 Turku, Finland; (U.H.); (S.P.); (S.M.)
| | - Marjaana Puurtinen
- Department of Teacher Education, University of Turku, 20014 Turku, Finland;
| | - Mari Sandell
- Functional Foods Forum, University of Turku, 20014 Turku, Finland; (U.H.); (S.P.); (S.M.)
- Department of Food and Nutrition, University of Helsinki, 00014 Helsinki, Finland
- Correspondence: ; Tel.: +358-40-352-4149
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The Multiple Food Test: Development and validation of a new tool to measure food choice and applied nutrition knowledge. Appetite 2020; 150:104647. [DOI: 10.1016/j.appet.2020.104647] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 02/15/2020] [Accepted: 02/26/2020] [Indexed: 11/22/2022]
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Marques ICF, Ting M, Cedillo-Martínez D, Pérez-Cueto FJ. Effect of Impulsivity Traits on Food Choice within a Nudging Intervention. Nutrients 2020; 12:E1402. [PMID: 32423143 PMCID: PMC7285079 DOI: 10.3390/nu12051402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/08/2020] [Accepted: 05/08/2020] [Indexed: 01/21/2023] Open
Abstract
Food choices are often driven by impulsive tendencies rather than rational consideration. Some individuals may find it more difficult resisting impulses related to unhealthy food choices, and low self-control and high impulsivity have been suggested to be linked to these behaviors. Recent shifts have been made towards developing strategies that target automatic processes of decision-making and focus on adjusting the environment, referred to as nudging interventions. Therefore, the purpose of this study was to investigate the effect of impulsivity traits on food choices within a nudging intervention (increased perceived variety). A total of 83 adults participated in an experimental study consisting of a self-service intelligent buffet. Impulsivity traits were measured using the UPPS-P impulsivity scale. General linear models were fitted to evaluate the effect of the five impulsivity traits on the difference of salad consumption (g) between the control and intervention situations. Results showed that impulsivity does not affect food choices in this nudging situation, suggesting that nudging works independently of the participant's impulsivity score. Results also showed a significantly higher consumption of salad in the nudging versus the control setting (17.6 g, p < 0.05), suggesting that nudging interventions can be effective in significantly increasing total vegetable consumption across the whole impulsivity scale.
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Affiliation(s)
| | | | | | - Federico J.A. Pérez-Cueto
- Future Consumer Lab, Department of Food Science, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark; (I.C.F.M.); (M.T.); (D.C.-M.)
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Haynes A, Hardman CA, Makin AD, Halford JC, Jebb SA, Robinson E. Visual perceptions of portion size normality and intended food consumption: A norm range model. Food Qual Prefer 2019; 72:77-85. [PMID: 30828136 PMCID: PMC6333281 DOI: 10.1016/j.foodqual.2018.10.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/01/2018] [Accepted: 10/04/2018] [Indexed: 12/29/2022]
Abstract
•Smaller portion sizes are associated with lower energy intake.•We test a norm range model of the portion size effect on intended intake.•A wide range of portion sizes were perceived as normal.•Portions perceived as normal did not prompt intended compensatory eating.•Portions perceived as smaller than normal prompted intended compensation.
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Affiliation(s)
- Ashleigh Haynes
- Institute of Psychology, Health & Society, University of Liverpool, L69 7ZA, UK
| | | | - Alexis D.J. Makin
- Institute of Psychology, Health & Society, University of Liverpool, L69 7ZA, UK
| | - Jason C.G. Halford
- Institute of Psychology, Health & Society, University of Liverpool, L69 7ZA, UK
| | - Susan A. Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Eric Robinson
- Institute of Psychology, Health & Society, University of Liverpool, L69 7ZA, UK
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Bucher T, Rollo ME, Smith SP, Dean M, Brown H, Sun M, Collins C. Position paper on the need for portion-size education and a standardised unit of measurement. Health Promot J Austr 2019; 28:260-263. [PMID: 27745570 DOI: 10.1071/he15137] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 08/31/2016] [Indexed: 11/23/2022] Open
Abstract
Large portion sizes contribute to weight gain in western societies. Portion-size interventions, aids and education can be effective in helping prevent weight gain, but consumers are unsure what appropriate portions are and express confusion about existing guidelines. A lack of clarity about suggested serving size recommendations is a major barrier to food portion-size control. Therefore, standardised measurement units and unambiguous terminologies are required. This position paper summarises the evidence regarding the impact and importance of portion-size education and estimation, and outlines strategies for improving consumer understanding and application of this through the development of an international food measurement system and a range of appropriate portion control tools. In this position paper, the authors call for the standardisation of food volume measurement terminologies, units, implementation recommendations, as well as consumer education. The target audience for this paper includes nutrition and behavioural researchers, policy makers, and stakeholders who potentially influence and implement changes in national food measurement systems, which in turn impact on consumer choice.
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Affiliation(s)
- Tamara Bucher
- Nutrition and Dietetics, School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Megan E Rollo
- Nutrition and Dietetics, School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Shamus P Smith
- School of Electrical Engineering and Computer Science, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Moira Dean
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast BT9 5AG, UK
| | - Hannah Brown
- Nutrition and Dietetics, School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Mingui Sun
- Departments of Neurosurgery, Electrical and Computer Engineering, and Bioengineering, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Clare Collins
- Nutrition and Dietetics, School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
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Image-based food portion size estimation using a smartphone without a fiducial marker. Public Health Nutr 2018; 22:1180-1192. [PMID: 29623867 DOI: 10.1017/s136898001800054x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Current approaches to food volume estimation require the person to carry a fiducial marker (e.g. a checkerboard card), to be placed next to the food before taking a picture. This procedure is inconvenient and post-processing of the food picture is time-consuming and sometimes inaccurate. These problems keep people from using the smartphone for self-administered dietary assessment. The current bioengineering study presents a novel smartphone-based imaging approach to table-side estimation of food volume which overcomes current limitations. DESIGN We present a new method for food volume estimation without a fiducial marker. Our mathematical model indicates that, using a special picture-taking strategy, the smartphone-based imaging system can be calibrated adequately if the physical length of the smartphone and the output of the motion sensor within the device are known. We also present and test a new virtual reality method for food volume estimation using the International Food Unit™ and a training process for error control. RESULTS Our pilot study, with sixty-nine participants and fifteen foods, indicates that the fiducial-marker-free approach is valid and that the training improves estimation accuracy significantly (P0·05). CONCLUSIONS Elimination of a fiducial marker and application of virtual reality, the International Food Unit™ and an automated training allowed quick food volume estimation and control of the estimation error. The estimated volume could be used to search a nutrient database and determine energy and nutrients in the diet.
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Timon CM, Cooper SE, Barker ME, Astell AJ, Adlam T, Hwang F, Williams EA. A Comparison of Food Portion Size Estimation by Older Adults, Young Adults and Nutritionists. J Nutr Health Aging 2018; 22:230-236. [PMID: 29380850 DOI: 10.1007/s12603-017-0937-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To investigate the ability of older adults, younger adults and nutritionists to assess portion size using traditional methods versus a computer-based method. This was to inform the development of a novel dietary assessment method for older adults "The NANA system". DESIGN Older and younger adults assessed the portion size of self-served portions of foods from a buffet style set up using traditional and computerised portion size assessment aids. Nutritionists assessed the portion size of foods from digital photographs using computerised portion size aids. These estimates were compared to known weights of foods using univariate analyses of covariance (ANCOVA). SETTING The University of Sheffield, United Kingdom. SUBJECTS Forty older adults (aged 65 years and over), 41 younger adults (aged between 18 and 40 years) and 25 nutritionists. RESULTS There was little difference in the abilities of older and younger adults to assess portion size using both assessment aids with the exception of small pieces morphology. Even though the methods were not directly comparable among the test groups, there was less variability in portion size estimates made by the nutritionists. CONCLUSION Older adults and younger adults are similar in their ability to assess food portion size and demonstrate wide variability of estimation compared to the ability of nutritionists to estimate portion size from photographs. The results suggest that the use of photographs of meals consumed for portion size assessment by a nutritionist may improve the accuracy of dietary assessment. Improved portion size assessment aids are required for all age groups.
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Affiliation(s)
- C M Timon
- Claire Marie Timon, Room S2.58 Institute of Food and Health, Science Centre South, University College Dublin, Belfield, Dublin 4, Ireland, , Phone: 0035317162442, Fax: 003531716 6104
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Evaluation of food photographs assessing the dietary intake of children up to 10 years old. Public Health Nutr 2017; 21:888-895. [PMID: 29199628 DOI: 10.1017/s1368980017003354] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Young children lack basic skills related to recognizing the types of foods they consume and dietary surveys often rely on parents' response. The present study aimed to evaluate how well parents of children aged from 3 months to 10 years perceive images of portions of foods commonly consumed by young children. DESIGN Pre-weighed, actual food portions (n 2314) were shown to the study participants who were asked to indicate the picture that corresponded to the food in view. Mean differences between picture numbers selected and shown were estimated and compared using unpaired t tests or Tukey-Cramer pairwise comparisons. SETTING Real-time testing of parents' perception of food images presenting portion sizes consumed by children up to 10 years old. SUBJECTS A convenience sample of 138 parents/caregivers of young children (69 % females). RESULTS Individuals selected the correct or adjacent image in about 97 % of the assessments. Images presenting amorphous solids (i.e. pies and pastries with a filling), liquid or semi-liquid dishes (i.e. soups, porridges, fruit and vegetable purées) were more prone to bias. There was no indication that personal characteristics (gender, age, educational background, age, number of offspring) were associated with differences in the way parents/caregivers perceived the food pictures. CONCLUSIONS Food pictures may not be appropriate to quantify the intake of liquid, semi-liquid or amorphous solid foods in surveys addressing young children and studies evaluating their performance as food portion anchors should ensure the inclusion of several and various amorphous foods in the assessment.
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Hughes JW, Goldstein CM, Logan C, Mulvany JL, Hawkins MAW, Sato AF, Gunstad J. Controlled testing of novel portion control plate produces smaller self-selected portion sizes compared to regular dinner plate. BMC OBESITY 2017; 4:30. [PMID: 28775849 PMCID: PMC5534105 DOI: 10.1186/s40608-017-0167-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 07/18/2017] [Indexed: 12/20/2022]
Abstract
Background Obesity is a global health crisis, and portion control is a key method for reducing excess body weight. Given consumers’ familiarity with large portion sizes, reducing portion sizes can be difficult. Smaller plates are often recommended to reduce portion sizes and appear to reduce portion sizes. However, there are no studies evaluating dishes specifically designed to facilitate portion control. The aim of the present study was to validate the efficacy of a novel portion control plate inspired by the Ebbinghaus and Delboeuf visual illusions to promote serving smaller portions compared to a larger dinner plate. Methods In two studies with a total of 110 university students, we determined whether the use of the portion control plate would result in smaller food portions compared to a larger dinner plate. The portion control plate was smaller and incorporated portion size indicators. Study 1 used instructions from My Plate based on plate ratios (e.g., “the USDA recommends filling half your plate with vegetables”) and study 2 used absolute portion size recommendations (e.g., “1 cup of vegetables”). Results The portion control plate produced smaller self-selected servings in both studies. However, the servings of vegetables selected were smaller than recommended portion sizes for both the portion control plate and the regular dinner plate. Conclusions Portion control plates have the potential to reduce self-selected portion sizes. Future research should include studies in a broader range of ages and clinical trials of portion control dishes for weight loss. Electronic supplementary material The online version of this article (doi:10.1186/s40608-017-0167-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Joel W Hughes
- Department of Psychological Sciences, Kent State University, P.O. Box 5190, Kent, Ohio 44242 USA
| | - Carly M Goldstein
- Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island USA
| | - Carly Logan
- Department of Psychology, University of Florida, Gainesville, Florida USA
| | - Jessica L Mulvany
- Department of Psychological Sciences, Kent State University, P.O. Box 5190, Kent, Ohio 44242 USA
| | - Misty A W Hawkins
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma USA
| | - Amy F Sato
- Department of Psychological Sciences, Kent State University, P.O. Box 5190, Kent, Ohio 44242 USA
| | - John Gunstad
- Department of Psychological Sciences, Kent State University, P.O. Box 5190, Kent, Ohio 44242 USA
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Friis R, Skov LR, Olsen A, Appleton KM, Saulais L, Dinnella C, Hartwell H, Depezay L, Monteleone E, Giboreau A, Perez-Cueto FJA. Comparison of three nudge interventions (priming, default option, and perceived variety) to promote vegetable consumption in a self-service buffet setting. PLoS One 2017; 12:e0176028. [PMID: 28562678 PMCID: PMC5450998 DOI: 10.1371/journal.pone.0176028] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 04/04/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Dietary choices in out-of-home eating are key for individual as well as for public health. These dietary choices are caused by a wide array of determinants, one of which is automatic decision-making. Nudging is attracting considerable interest due to its understanding and application of heuristic biases among consumers. The aim of this study is to test and compare three nudges in promoting vegetable consumption among test persons in a food lab-based experiment. METHODS The initial sample consisted of 88 participants recruited in Copenhagen, Denmark. Each study participant was randomly assigned to one of the three experiments: priming, default and perceived variety. The priming arm of the experiment consisted of creating a leafy environment with green plants and an odour of herbs. In the default arm of the experiment, the salad was pre-portioned into a bowl containing 200g of vegetables. The third experiment divided the pre-mixed salad into each of its components, to increase the visual variety of vegetables, yet not providing an actual increase in items. Each individual was partaking twice thus serving as her/his own control, randomly assigned to start with control or experimental setting. RESULTS The default experiment successfully increased the energy intake from vegetables among the study participants (124 kcal vs. 90 kcal in control, p<0.01). Both the priming condition and perceived variety reduced the total energy intake among the study participants (169 kcal, p<0.01 and 124 kcal, p<0.01, respectively), mainly through a decrease in the meat-based meal component. CONCLUSIONS Considerable progress has been made with regard to understanding the use of nudging in promoting a healthier meal composition, including increasing vegetable intake. This study suggests that the nature of a nudge-based intervention can have different effects, whether it is increasing intake of healthy components, or limiting intake of unhealthy meal components. This work has demonstrated that consumer behaviour can be influenced without restricting or providing incentives for behaviour change. The present findings have promising application to the foodservice sector.
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Affiliation(s)
- Rasmus Friis
- Department of Food Science, University of Copenhagen, Frederiksberg C, Denmark
| | - Laurits Rohden Skov
- Institute for Planning & Development, Aalborg University, Copenhagen SV, Denmark
| | - Annemarie Olsen
- Department of Food Science, University of Copenhagen, Frederiksberg C, Denmark
| | - Katherine Marie Appleton
- Research Centre for Behaviour Change, Department of Psychology, Faculty of Science and Technology, Bournemouth University, Poole, Dorset, United Kingdom
| | - Laure Saulais
- Centre for Food and Hospitality Research, Institut Paul Bocuse, Chateau du vivier, Ecully Cedex, France
- UMR GAEL, CNRS, INPG, INRA, Université Grenoble-Alpes, Saint Martin d'Hères, France
| | - Caterina Dinnella
- Department of Management of Agricultural, Food and Forestry Systems, University of Florence, Florence, Italy
| | - Heather Hartwell
- School of Tourism, Foodservice and Applied Nutrition Research Group & Health and Wellbeing, Faculty of Management, Bournemouth University, Bournemouth, United Kingdom
| | - Laurence Depezay
- BONDUELLE Corporate Research & Communication, Food & Behaviours department, Fondation Louis Bonduelle, Villeneuve D’Ascq, France
| | - Erminio Monteleone
- Department of Management of Agricultural, Food and Forestry Systems, University of Florence, Florence, Italy
| | - Agnès Giboreau
- Centre for Food and Hospitality Research, Institut Paul Bocuse, Chateau du vivier, Ecully Cedex, France
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Abstract
PURPOSE OF REVIEW The aim of this review is to provide an overview of (1) underlying mechanisms of the effect of portion size on energy intake, (2) external factors explaining the portion size effect and (3) interventions and measurements aimed at food portion size. RECENT FINDINGS Previous studies have shown that portion sizes have increased in recent decades. Many experimental studies have been conducted to unravel the mechanisms underlying the portion-size effect on food intake (e.g. the appropriateness mechanism, the 'unit bias' mechanism, the 'previous experience/expectation' mechanism, the 'visual cue' mechanism and the 'bite size' mechanism). In addition, external factors have been found to drive food portion selection and consumption (e.g. value for money, mindless eating, levels of awareness, estimation bias. Research on several interventions (ranging from 'providing information' to 'eliminating choice') have been conducted, but remain scarce, especially intervention studies in which portion size is a key focus in weight loss. Moreover, only three new instruments with respect to portion control behavior have been developed. There is considerable evidence for the portion-size effect on energy intake. However, the work on interventions targeting portion size and measurements for portion control behavior are limited. Moreover, from the literature it is not yet clear what type of interventions work best, for whom and in what context.
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Affiliation(s)
- Ingrid Steenhuis
- Department of Health Sciences, Faculty of Earth & Life Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Maartje Poelman
- Department of Human Geography and Spatial Planning, Utrecht University, Heidelberglaan 2, PO Box 80115, 3508 TC, Utrecht, The Netherlands
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Abstract
Background Obesity is a consequence of chronic energy imbalance. We need accurate and precise measurements of energy intake and expenditure, as well as the related behaviors, to fully understand how energy homeostasis is regulated in order to develop interventions and evaluate their effectiveness to combat the global obesity epidemic. Scope of review We provide an in-depth review of the methodologies currently used to measure energy intake and expenditure in humans, including their principles, advantages, and limitations in the clinical research setting. The aim is to provide researchers with a comprehensive guide to conduct obesity research of the highest possible quality. Major conclusions An array of methodologies is available to measure various aspects of energy metabolism and none is perfect under all circumstances. The choice of methods should be specific to particular research questions with practicality and quality of data the priorities for consideration. A combination of complementary measurements may be preferable. There is an imperative need to develop new methodologies to improve the accuracy and precision of energy intake assessments. Image-based technology is a significant step to improve energy intake measurement. Physical activity informs patterns but not absolute energy expenditure. Combining complementary measurements overcomes shortfalls of individual methods.
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Abstract
Little is known about laypeople's practical understanding of a healthy diet, although this is important to successfully promote healthy eating. The present study is the first to experimentally examine how consumers define healthy and balanced food choices for an entire day compared with normal choices and compared with dietary guidelines. We used an extensive fake food buffet (FFB) with 179 foods commonly consumed in the Swiss diet. The FFB is a validated method to investigate food choice behaviour in a well-controlled laboratory setting. People from the general population in Switzerland (n 187; 51·9 % females), aged between 18 and 65 years, were randomly assigned to one of two conditions. In the control group, the participants were instructed to serve themselves foods they would eat on a normal day, whereas in the 'healthy' group they were instructed to choose foods representing a healthy diet. Participants chose significantly more healthy foods, with 4·5 g more dietary fibre, 2 % more protein and 2 % less SFA in the 'healthy' group compared with the control group. However, in both experimental conditions, participants served themselves foods containing twice as much sugar and salt than recommended by dietary guidelines. The results suggest that laypeople lack knowledge about the recommended portion sizes and the amounts of critical nutrients in processed food, which has important implications for communicating dietary guidelines. Furthermore, the energy of the food served was substantially correlated with the energy needs of the participants, demonstrating the potential of the fake food buffet method.
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Kongsbak I, Skov LR, Nielsen BK, Ahlmann FK, Schaldemose H, Atkinson L, Wichmann M, Pérez-Cueto FJ. Increasing fruit and vegetable intake among male university students in an ad libitum buffet setting: A choice architectural nudge intervention. Food Qual Prefer 2016. [DOI: 10.1016/j.foodqual.2015.12.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Manton S, Magerowski G, Patriarca L, Alonso-Alonso M. The "Smart Dining Table": Automatic Behavioral Tracking of a Meal with a Multi-Touch-Computer. Front Psychol 2016; 7:142. [PMID: 26903934 PMCID: PMC4749696 DOI: 10.3389/fpsyg.2016.00142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 01/26/2016] [Indexed: 12/03/2022] Open
Abstract
Studying how humans eat in the context of a meal is important to understanding basic mechanisms of food intake regulation and can help develop new interventions for the promotion of healthy eating and prevention of obesity and eating disorders. While there are a number of methodologies available for behavioral evaluation of a meal, there is a need for new tools that can simplify data collection through automatic and online analysis. Also, there are currently no methods that leverage technology to add a dimension of interactivity to the meal table. In this study, we examined the feasibility of a new technology for automatic detection and classification of bites during a laboratory meal. We used a SUR40 multi-touch tabletop computer, powered by an infrared camera behind the screen. Tags were attached to three plates, allowing their positions to be tracked, and the saturation (a measure of the infrared intensity) in the surrounding region was measured. A Kinect camera was used to record the meals for manual verification and provide gesture detection for when the bites were taken. Bite detections triggered classification of the source plate by the SUR40 based on saturation flux in the preceding time window. Five healthy subjects (aged 20–40 years, one female) were tested, providing a total sample of 320 bites. Sensitivity, defined as the number of correctly detected bites out of the number of actual bites, was 67.5%. Classification accuracy, defined as the number of correctly classified bites out of those detected, was 82.4%. Due to the poor sensitivity, a second experiment was designed using a single plate and a Myo armband containing a nine-axis accelerometer as an alternative method for bite detection. The same subjects were tested (sample: 195 bites). Using a simple threshold on the pitch reading of the magnetometer, the Myo data achieved 86.1% sensitivity vs. 60.5% with the Kinect. Further, the precision of positive predictive value was 72.1% for the Myo vs. 42.8% for the Kinect. We conclude that the SUR40 + Myo combination is feasible for automatic detection and classification of bites with adequate accuracy for a range of applications.
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Affiliation(s)
- Sean Manton
- Laboratory of Bariatric and Nutritional Neuroscience, Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA, USA
| | - Greta Magerowski
- Laboratory of Bariatric and Nutritional Neuroscience, Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA, USA
| | - Laura Patriarca
- Laboratory of Bariatric and Nutritional Neuroscience, Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA, USA
| | - Miguel Alonso-Alonso
- Laboratory of Bariatric and Nutritional Neuroscience, Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA, USA
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