Derailing the streetcar named desire. Cognitive distractions reduce individual differences in cravings and unhealthy snacking in response to palatable food

Reduced food cravings correlated with a 24-month period of weight loss and weight maintenance

Food cravings increase calorie-dense food intake, contributing to weight gain. Although reductions in food cravings are frequently reported during weight loss, it remains unclear whether these changes are sustained during weight maintenance. The study objective was to investigate associations between food cravings and weight changes in a 12-month weight loss trial followed by 12 months of maintenance. Thirty adults participated in a dietary weight loss program that included craving coping strategies, daily weigh-ins and food craving assessments every six months. Twenty-four and twenty participants remained at 12 and 24 months, respectively. Craving frequency and traits decreased during weight loss and stabilized during maintenance. Changes in general food (FCI), sweet, and carbohydrate cravings at 6 months predicted weight change over 24 months. The craving-weight correlations persisted during weight maintenance. Participants achieving >5 % weight loss at 24 months (n = 13) consistently reduced craving traits and FCI, while those with <5 % weight loss (n = 7) showed no significant change. Differences between the groups become significant at 18 and 24 months for craving traits and at 24 months for FCI. Participants who included craved foods into a balanced meal (n = 16) achieved greater weight loss and greater reduction in sweet and high-fat food cravings compared to those who did not (n = 8) at 12 months. This study showed a strong correlation between successful weight loss/maintenance and reduced food cravings, whereas users of the craving control strategy achieved greater weight loss. These results suggest that weight loss reduces cravings, and controlling cravings, in turn, further accelerates weight loss.

Overlapping and distinct relationships between hedonic hunger, uncontrolled eating, food craving, and the obesogenic home food environment during and after a 12-month behavioral weight loss program

Hedonic hunger, reward-driven eating outside of biological need, is a newer construct in eating behavior research. During behavioral weight loss (BWL), greater improvements in hedonic hunger are associated with higher weight loss, but it remains unclear if hedonic hunger predicts weight loss independent of more well-established, similar constructs (uncontrolled eating and food craving). Research also is needed to understand how hedonic hunger interacts with contextual factors (e.g., obesogenic food environment) during weight loss. Adults (N = 283) in a 12-month randomized controlled trial of BWL were weighed at 0, 12, and 24 months, and completed questionnaires assessing hedonic hunger, food craving, uncontrolled eating, and the home food environment. All variables improved at 12 and 24 months. Decreases in hedonic hunger at 12 months were associated with higher concurrent weight loss, but not when accounting for improvements in craving and uncontrolled eating. At 24 months, reduction in craving was a stronger predictor of weight loss than hedonic hunger, but improvement in hedonic hunger was a stronger predictor of weight loss than change in uncontrolled eating. Changes to the obesogenic home food environment failed to predict weight loss, regardless of levels of hedonic hunger. This study adds novel information on the individual and contextual factors associated with short- and long-term weight control, which can help refine conceptual models and treatment strategies.

Supplementing a widely available weight loss program with gamified inhibitory control training: A randomized pilot study

Background

Increasing evidence suggests that targeting self-regulatory processes may improve obesity treatment outcomes. Incorporating gamification principles in inhibitory control training may promote sustained training adherence and resulting benefits. This pilot study evaluated the preliminary efficacy of supplementing an evidence-based weight management program (WW) with sustained gamified inhibitory control training (PolyRules!) on change in Body Mass Index (BMI) among adults with overweight/obesity.

Methods

30 adults with overweight/obesity (M age 49.9 ± 12.4, 86.7% female; 23.3% Hispanic, mean BMI 35.3 ± 6.3) were randomly assigned to receive WW with or without PolyRules! for 12 weeks. The primary outcome was change in BMI from baseline to post-intervention across study arms. Implementation and process indicators were captured to inform larger trials.

Results

Average change in BMI was -0.9 in the WW arm and -1.2 in the WW + PolyRules! arm (Cohen's d = 0.26). In the WW + PolyRules! arm, increased training was associated with greater decreases in BMI (r = -0.506, p = 0.0454). WW + PolyRules! participants completed an average of 60.4% sessions and reported positive experiences. There was no difference in frequency of food (d = -0.02) and weight tracking (d = -0.19) between arms.

Conclusions

Studies in larger samples should evaluate training-related effects on weight. Supplementing WW with gamified inhibitory training appears feasible, with no detrimental effect on engagement.

Cognitive Defusion as Strategy to Reduce the Intensity of Craving Episodes and Improve Eating Behavior

The elaborated intrusion theory of desire proposes that craving is a cognitive motivational process involving intrusive thoughts. Changing the way we react to them, cognitive defusion (CD), should limit thought elaboration and craving. We induced chocolate craving in female chocolate cravers before CD (Study 1). A decrease in craving measured by a single-item scale, Visual Analogical Scale (VAS; p < .001, ηp2 = .449) and as a state, State Food Craving Questionnaire (FCQ-S; p = .029, ηp2 = .106) were found in the experimental group, while similar results were also found in group control. The reduction in craving (VAS) in group CD correlated negatively with chocolate consumption on a bogus taste test (r = –.439, p = .036), while the correlation was positive in the case of group control (r = .429, p = .047). Food craving as a trait, measured by the Trait Food Craving Questionnaire (FCQ-T), showed negative correlations with measures of CD and mindfulness skills (lowest r = –.313, p = .018). In Study 2 participants made use of a smartphone application implementing the CD procedure in real contexts whenever they experienced food craving. A corresponding decline in self-reported craving was found, as well as in consumption of the craved food (indulgence) compared with the control condition. Our findings indicate that CD may be a promising intervention for tackling the elaboration of intrusive thoughts and eating behavior in young female food cravers, both in a controlled laboratory environment after a cue-food exposure craving induction procedure, as well as responding to naturally occurring food cravings in real-life settings.

Poorer mental health and sleep quality are associated with greater self-reported reward-related eating during pregnancy and postpartum: an observational cohort study

BACKGROUND

Depression, stress, and poor-quality sleep are common during pregnancy and postpartum, but the relationship of these factors with reward-related eating is not well understood. This observational cohort study examines associations of depression, stress, and sleep quality with self-reported reward-related eating in pregnancy and postpartum.

METHODS

Participants were enrolled at < 12 weeks gestation and followed through 1 year postpartum. Self-reported measures obtained at baseline and 23-31 weeks postpartum included the Edinburgh Postnatal Depression Scale, Perceived Stress Scale, Pittsburgh Sleep Quality Index; reward-related eating measures included the Power of Food Scale (assessing hedonic hunger), modified Yale Food Addiction Scale (assessing addictive-like eating), and frequency and intensity of cravings. Linear and logistic regression models estimated associations of depressive symptoms, stress, and sleep quality with reward-related eating during pregnancy and postpartum, as well as change in each predictor with change in outcome.

RESULTS

During pregnancy, greater depressive symptoms (β ± SE = 0.03 ± 0.01, p < .01), higher stress (0.03 ± 0.01, p < .01), and worse sleep quality (0.03 ± 0.01, p = 0.03) were associated with greater hedonic hunger. Similarly, greater depressive symptoms (OR = 1.08, 95% CI: 1.02, 1.14, p = .01), higher stress (OR = 1.09, 95% CI: 1.04, 1.14, p = <.01), and worse sleep quality (OR = 1.09, 95% CI: 1.00, 1.18, p = .04) were associated with greater odds of addictive-like eating. These associations were also significant in postpartum except that sleep quality was not associated with hedonic hunger. Greater depressive symptoms (β ± SE = 0.06 ± 0.02, p < .01; 0.08 ± 0.02, p = <.01), higher stress (0.04 ± 0.01, p < .01; 0.06 ± 0.02, p < .01), and worse sleep quality (0.11 ± 0.03, p < .01; 0.13 ± 0.03, p < .01) during pregnancy were associated with stronger and more frequent cravings, respectively. Increased depressive symptoms from pregnancy to postpartum was associated with increased hedonic hunger (β ± SE = 1.17 ± 0.57, p = 0.01) and addictive-like eating (0.88 ± 0.33, p = 0.01), and increased stress was associated with increased hedonic hunger (1.71 ± 0.76, p = 0.02). Change in stress was not associated with change in addictive-like eating and change in sleep quality was not associated with change in either hedonic hunger or addictive-like eating.

CONCLUSIONS

Greater depressive symptoms, perceived stress, and poorer sleep quality are associated with greater self-reported reward-related eating during pregnancy and postpartum, suggesting that efforts to improve diet during and after pregnancy may benefit from addressing mental health and sleep.

TRIAL REGISTRATION

Clinicaltrials.gov Registration ID - NCT02217462 . Date of registration - August 13, 2014.

Working memory load reduces the electrocortical processing of positive pictures

To date, the emotion regulation literature has focused primarily on the down-regulation of negative emotion, with far fewer studies interrogating the mechanisms at work in positive emotion regulation. This body of work has suggested that nonaffective mechanisms, such as cognitive load have a role to play in reducing emotional response. For example, the late positive potential (LPP), which tracks attention to salient stimuli, is reduced when task-irrelevant negative and neutral stimuli are presented under high compared with low working memory load. Using positive stimuli, working memory load has been shown to reduce the LPP elicited by positive words and faces but has not previously been shown to modulate the LPP elicited by positive scenes. Emotional scenes are the predominant type of stimuli used in the broader emotion regulation literature, are more arousing than faces, and have been shown to more strongly modulate the LPP. Here, 41 participants performed a working memory task interspersed with the presentation of positive and neutral scenes, while electroencephalography was recorded. Results showed that the LPP was increased for positive compared with neutral pictures and reduced on high-load compared to low-load trials. Working memory performance was worse on high-load compared with low-load trials, although it was not significantly correlated with the LPP, and picture type did not affect working memory performance. Results bridge to the willful emotion regulation literature to increase understanding of the mechanisms underlying positive emotion regulation, which has been relatively unexamined.

Functional Brain Networks: Unique Patterns with Hedonic Appetite and Confidence to Resist Eating in Older Adults with Obesity

OBJECTIVE

The purpose of this study was to determine whether baseline measures of hedonic hunger-the Power of Food Scale-and self-control for food consumption-the Weight Efficacy Lifestyle Questionnaire-were associated with network topology within two sets of brain regions (regions of interest [ROIs] 1 and 2) in a group of older adults with obesity. These previously identified brain regions were shown in a different cohort of older adults to be critical for discriminating weight loss success and failure.

METHODS

Baseline functional magnetic resonance imaging data (resting state and food cue task) were collected in a novel cohort of 67 older adults with obesity (65-85 years, BMI = 35-42 kg/m² ) participating in an 18-month randomized clinical trial on weight regain.

RESULTS

The Power of Food Scale was most related to ROI 1, which includes the visual cortex and sensorimotor processing areas during only the food cue state. During both the food cue and resting conditions, the Weight Efficacy Lifestyle Questionnaire was associated with ROI 2, which includes areas of the attention network and limbic circuitry.

CONCLUSIONS

Our findings show critical, distinct links between brain network topology with self-reported measures that capture hedonic hunger and the confidence that older adults have in resisting the consumption of food because of both intrapersonal and social/environmental cues.

Choice architecture meets motivation science: How stimulus availability interacts with internal factors in shaping the desire for food

Recent research on choice architecture has highlighted the role of external aspects such as stimulus proximity or availability on consumption. How such external factors interact with internal, intraindividual factors, however, is very poorly understood. Here we show how the wanting for palatable food emerges from the interplay of one key external factor, availability, and two key internal factors central to motivation science, need state and learning history. Across three experiments in the food domain, we find converging evidence for a main effect of stimulus availability which is qualified in theoretically predicted ways by a three-way interaction such that food desire peaks when the availability of tempting food stimuli is accompanied by high need states and a positive learning experience. A pooled analysis across the three studies supported this general conclusion. We conclude that nudging effects are strongest when external factors of choice architecture synergize with internal factors in critical ways.

The accelerator, the brake, and the terrain: associations of reward-related eating, self-regulation, and the home food environment with diet quality during pregnancy and postpartum in the pregnancy eating attributes study (PEAS) cohort

Background

Neurobehavioral factors, including reward-related eating and self-regulation, in conjunction with the food environment, may influence dietary behaviors. However, these constructs have not been examined in pregnancy and postpartum, a time of changing appetite and eating behaviors, and when dietary intake has implications for maternal and child health. This study examined associations of reward-related eating, self-regulation, and the home food environment with pregnancy and postpartum diet quality.

Methods

Participants in the Pregnancy Eating Attributes Study observational cohort were enrolled at ≤12 weeks gestation and followed through one-year postpartum. Pregnancy and postpartum Healthy Eating Index-2015 (HEI-total), and adequacy and moderation scores, respectively, were calculated by pooling 24-h diet recalls administered each trimester and during 2, 6, and 12 months postpartum. Participants completed four measures of reward-related eating – Modified Yale Food Addiction Scale (mYFAS), Power of Food Scale (PFS), Multiple Choice Procedure (MCP), and Reinforcing Value of Food Questionnaire (RVFQ); two measures of self-regulation – Barratt Impulsiveness Scale (BIS) and Delay of Gratification Inventory (DGI); and a Home Food Inventory (HFI), yielding obesogenic (OBES) and fruit/vegetables (FV) scores. Linear regression analyses estimated associations of reward-related eating, self-regulation, and home food environment with diet quality during pregnancy and postpartum, adjusting for sociodemographic characteristics.

Results

Pregnancy HEI-total was inversely associated with PFS (β = − 0.14 ± 0.05, p = 0.009), mYFAS(β = − 0.14 ± 0.06, p = 0.02), 2 of the 5 RVFQ indices, MCP (β = − 0.14 ± 0.05, p = 0.01), and DGI food subscale (β = 0.23 ± 0.05, p < 0.001), but associations of postpartum HEI-total with reward-related eating measures and self-regulation were small and not statistically significant. Pregnancy and postpartum HEI-total were associated inversely with HFI-OBES (β = − 0.17 ± 0.06, p = 0.004 and β = − 0.19 ± 0.07, p = 0.006, respectively), and positively with HFI-FV (β = 0.21 ± 0.05, p < 0.001 and β = 0.17 ± 0.06, p = 0.009, respectively).

Conclusions

Associations of poorer diet quality with greater reward-related eating during pregnancy but not postpartum suggests the need to better understand differences in the determinants of eating behaviors and approaches to circumvent or moderate reward-related eating to facilitate more optimal diet quality across this critical period.

Trial registration

Clinicaltrials.gov. URL – Registration ID – NCT02217462. Date of registration – August 13, 2014.

The Power of Food: Self-control moderates the association of hedonic hunger with overeating, snacking frequency and palatable food intake

The purpose of the study was to explore whether self-control moderates the associations between hedonic hunger and overeating frequency, snacking frequency and palatable food intake. Data from the first wave of the Swiss Food Panel 2.0 study was analyzed (N = 4774), from the German- and French-speaking part of Switzerland (52% men). Measures included hedonic hunger assessed with the Power of Food Scale (PFS), the short form Self-Control Scale, overeating frequency, snacking frequency, intake of high-fat salty snack foods, and intake of high-sugar foods assessed with a semiquantitative food frequency questionnaire. Higher scores on the PFS and lower self-control capacities were correlated with higher intakes of both high-fat salty snack foods and high-sugar foods (referred to here as palatable foods), higher overeating frequency and higher snacking frequency. Four separate moderation analyses revealed that the positive associations of hedonic hunger with overeating frequency, snacking frequency and palatable food intake were significantly attenuated by self-control. Results of the present study indicate that people who are highly sensitive to the ready availability of palatable foods but also have high levels of self-control exhibit less frequent overeating and snacking, including less frequent intake of unhealthy palatable foods, than those low in self-control. Consequently, self-control may prevent overeating and thus may serve as a protective factor that decreases the risk of becoming overweight in individuals who are highly sensitive to the food environment.

(No) escape from reality? Cigarette craving in virtual smoking environments

Cue-Exposure Therapy (CET) is considered an effective strategy to combat cigarette cravings and smoking relapses, but evidence is mixed. In this lab-based experimental study, we manipulated levels of realism for smoking scenarios in Virtual Environments (VE) and randomly exposed smokers and recent-quitters to one of two versions (low versus high realism) of these scenarios. Prior and after scenario exposure, valid measures of cigarette craving were obtained. Prior to exposure, we assessed nicotine dependence and smoking status (current smokers versus recent-quitter). Within-subject repeated measures analysis of covariance showed that there was an interaction of experimental condition with smoking status on cigarette craving. Amongst recent-quitters, high realistic scenarios produced stronger increases in craving than low realistic scenarios, but this effect was reversed in current smokers. It is concluded that VE technologies are a potentially relevant tool for smoking CET that warrant further exploration.

Investigating properties of imagery-induced flash-forwards and the effect of eye movements on the experience of desire and craving in gamers

Vivid and emotionally laden imagery is a symptom across a wide range of psychiatric disorders. Flash-forwards describe the mental simulation of anticipated future events which might also be relevant in the context of gaming disorder. The aim of this laboratory study was to investigate flash-forwards and the experience of desires and craving in gamers, and to examine the effect of eye movements on their vividness and related desires. A sample of 77 gamers formed a mental picture of themselves gaming in the future and rated the vividness and emotionality of this imagination, and their current desire and craving for gaming. Thereafter, one half of the gamers conducted a dual task (i.e., horizontal eye movements while retrieving the picture), whereas the other half let their eyes rest on the middle of the computer screen while retrieving the picture (non-dual task). Vividness of the flash-forward and intensity of desire and craving were again measured after the dual or non-dual task. In the overall sample, more imagery-related desire correlated positively with associated positive affect and vividness of flash-forwards. However, in a subsample of problematic gamers, flash-forwards are experienced less vivid and less pleasurable with increasing symptom severity. Eye movements while retrieving the flash-forwards led to significantly decreased ratings of imagery-related desire intensity, which was not the case for the non-dual condition. Results suggest different properties of flash-forwards between recreational and problematic gamers. Moreover, an attention-demanding task taxing the working memory seems beneficial for reducing desires related to imagery-induced flash-forwards.

Laboratory-based interventions targeting food craving: A systematic review and meta-analysis

This systematic review and meta-analysis aimed to quantify the effects of laboratory-based interventions targeting specific mechanisms of food craving, to identify moderators of effects, and to qualitatively summarize findings. The study was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Sixty-nine studies were included in the quantitative synthesis, and separate meta-analyses were conducted for the outcomes self-reported craving and objective food intake. Results show small to medium positive effects across specific craving interventions on both outcomes. Effect sizes were partly moderated by intervention type. The most effective intervention regarding food intake was in sensu cue exposure. For subjective craving, the most robust evidence was found for beneficial effects of cognitive regulation strategies (ie, reappraisal, suppression, and distraction). Results further indicate that training inhibitory control through behavioral inhibition might be more effective than approach-avoidance training when considering its effect on subjective craving and food intake. People with external eating habits, overeating, or loss-of-control eating might benefit from these types of specific craving interventions. Future research should focus on long-term effects, transferability, and effectiveness in clinical samples.

Playing Around with Quitting Smoking: A Randomized Pilot Trial of Mobile Games as a Craving Response Strategy

Objective: Strong cravings to smoke are an obstacle to cessation success. Unfortunately, cessation medication and counseling only modestly quell craving. This pilot study was designed to examine the feasibility of mobile games as a response strategy to craving and whether a fully powered trial is warranted. Materials and Methods: Smokers interested in quitting (N = 30) were offered 4 weeks of nicotine patch plus counseling and randomized to quit with (games-on) versus without (games-off) access to 11 commercial mobile games. Outcomes included post-target quit day (TQD) game play, craving, smoking, and quitting. Almost all P's were >0.05; outcomes should be interpreted with caution due to the small N. Results: Of games-on participants (n = 16), one played games ≥80% of days post-TQD (22/28 days); 38% played >1/3 of days; 25% did not play. Games-on participants reported games moderately helped them cope with cravings; M = 3.22 on a scale from 1 (not at all) to 5 (very much). Also, games-on participants showed a slight decrease in craving from baseline to 1-week post-TQD (2.35-2.25 on a 0-5 point-scale), whereas games-off participants showed an increase (2.01-2.53). Games-on participants showed greater decreases in craving after playing a game than after the passage of time (when an app imposed a 2-minute wait period following their game request), but there was little evidence games-on versus games-off participants differed in mean post-TQD cigarettes/day. Games-on participants reported modestly but not significantly higher continuous abstinence through day 28 (31.3% vs. 21.4%). Conclusion: Feasibility results encourage a fully powered trial of this easily disseminable intervention. Clinical Trial Registration: ClinicalTrials.gov NCT02164383.

Lack of prospective relationships of the Power of Food Scale with Body Mass Index and dieting over 2 years in U.S. emerging adults

BACKGROUND

This study investigated prospective relationships of the Power of Food Scale (PFS), a self-report measure of hedonic hunger, with weight outcomes and dieting in U.S. young adults.

METHODS

PFS (PFS-aggregate and subscales: PFS-available, PFS-present, PFS-tasted) was assessed in waves (W, years) 5 and 6 of a nationally representative cohort of 10th graders assessed annually (baseline n = 2785, 83% retention at W7). Internal consistency (Cronbach's α), 1-year stability (intraclass correlation coefficient, ICC) and confirmatory factor analysis (CFA) were examined. Analyses accounting for the complex survey design examined cross-sectional associations of W6 PFS with W6 BMI and dieting, and prospective relationships of PFS in each wave with BMI, 1-year BMI change (BMIΔ, W6-W5 and W7-W6), overweight/obesity onset (OWOB, moving to a higher risk weight category) and dieting in the following wave. Multiple imputations addressed missing data.

RESULTS

Baseline participant mean ± SE age was 20.3 ± 0.02 years. Mean BMI increased by approximately 0.6 kg/m² from W5 through W7; OWOB occurred in 7.4% of participants between W5-W6; 9.0% between W6-W7. Approximately half the sample reported dieting in each wave. W6 weight outcomes were not associated with W6 PFS, but W6 dieting frequency was positively associated with W6 PFS-available, PFS-present, and PFS-aggregate (but not PFS-tasted) in multivariable models. PFS was not prospectively associated with weight outcomes. Positive prospective associations of PFS with dieting frequency were inconsistent across waves and with respect to inclusion of covariates.

CONCLUSIONS

Greater PFS is associated with dieting cross-sectionally but was not a reliable indicator of susceptibility to future weight outcomes or dieting in young adults.

Do low-calorie sweetened beverages help to control food cravings? Two experimental studies

Low-calorie sweetened (LCS) beverages may help consumers to satisfy hedonic food cravings without violating dieting goals, however this remains unexplored. The present research investigated the effect of priming hedonic eating motivations on ad libitum energy intake in frequent and non-consumers of LCS beverages. It was hypothesised that energy intake would be greater after the hedonic eating prime relative to a control prime in non-consumers, but that frequent LCS beverage consumers would be protected from this effect. In Study 1 (N = 120), frequent and non-consumers were exposed to either chocolate or neutral cues (craving vs. control condition) and then completed a beverage-related visual probe task with concurrent eye-tracking. Ad libitum energy intake from sweet and savoury snacks and beverages (including LCS) was then assessed. Study 2 followed a similar protocol, but included only frequent consumers (N = 172) and manipulated the availability of LCS beverages in the ad libitum eating context (available vs. unavailable). Measures of guilt and perceived behavioural control were also included. In Study 1, as hypothesised, non-consumers showed greater energy intake in the craving condition relative to the control condition, but frequent consumers had similar energy intake in both conditions. Frequent consumers (but not non-consumers) also demonstrated an attentional bias for LCS beverage stimuli compared to both sugar and water stimuli. In contrast, in Study 2 frequent consumers showed greater energy intake in the craving condition relative to the control condition; however, overall energy intake was significantly greater when LCS beverages were unavailable compared to when they were available. Ratings of guilt were higher and perceived control was lower in the LCS-unavailable condition relative to the LCS-available condition. Conclusions: LCS beverages did not consistently protect consumers from craving-induced increases in energy intake. However, frequent consumers consumed fewer calories overall when LCS beverages were available (relative to unavailable), as well as perceiving more control over their food intake and feeling less guilty.

Understanding everyday strategies used to manage indulgent food consumption: A mixed-methods design

To maintain a healthy body weight or support weight loss efforts, dietary self-management must allow for the limitation of tempting high energy-dense foods. We were interested in people's implementation of day-to-day strategies in order to successfully manage their indulgent food and beverage consumption. Participants from the Swansea area, UK (N = 25; M_age = 37; 68% male) were divided into four focus groups. The average BMI was within the healthy range (23 kg/m²). Each group discussed the approaches that they used to manage their consumption of indulgent foods and drinks. Group discussions were then transcribed, thematically analysed and independently reviewed by a second researcher. In a follow-up phase, participants were asked to rate how often they used the identified strategies and to rate the perceived effectiveness of any that applied to them. The thematic analysis revealed four major themes: Exercise, Cognitive Strategies, Availability and Meal Formation. Variability in the frequency with which strategies were used and perceived as effective was evident. Notably, participants tended to use multiple strategies and even lean participants who did not identify themselves as 'dieters' none-the-less employed a variety of strategies to successfully manage their exposure to and consumption of tempting foods. The findings suggest that dietary advice could be improved by taking into account the strategies for managing indulgent food consumption that are frequently used by individuals, as well as those that are perceived as effective.

Feasibility and Effectiveness of Adding an Approach Avoidance Training With Game Elements to a Residential Childhood Obesity Treatment — A Pilot Study

Childhood obesity treatment programs only result in moderate outcomes in the short term and do not reduce risk for future weight gain. Therefore, in the current study, Approach Avoidance Training (AAT) with motivational game elements will be added to an inpatient childhood obesity program with the aim of improving outcomes. Forty-one children (10–15 years) in the final months of an inpatient treatment program were randomised to either the AAT plus care-as-usual condition group or to a care-as-usual-only control group. During the 10 sessions, the children were trained to approach healthy food stimuli and to avoid unhealthy food stimuli. Treatment outcomes were child performances on tasks of AAT, implicit attitudes and attentional bias, self-report ratings on craving symptoms, and weight loss maintenance after leaving the clinic (12-week follow-up). Changes over time were not significantly different between conditions for the measures of automatic processes, craving, and weight loss maintenance. Possible accounts for the null findings, including sample size, influence of game elements, point of time in therapeutic process, limitations of the setting, and the control group are discussed. More research is needed before firm conclusions can be drawn about the clinical usefulness of CBM for weight control in childhood obesity.

A narrative review of the construct of hedonic hunger and its measurement by the Power of Food Scale

INTRODUCTION

The term 'hedonic hunger' refers to one's preoccupation with and desire to consume foods for the purposes of pleasure and in the absence of physical hunger. The Power of Food Scale (PFS) was developed as a quantitative measure of this construct in 2009. Since then, over 50 published studies have used the PFS to predict appetite-related outcomes including neural, cognitive, behavioural, anthropometric and clinical measures.

OBJECTIVE

This narrative review evaluates how closely the PFS captures the construct it was originally presumed to assess and to more clearly define hedonic hunger itself.

METHODS

The measure's relationship to four domains is reviewed and summarized: motivation to consume palatable foods; level of actual consumption of such foods; body mass; and subjective loss-of-control over one's eating behaviour. Findings are synthesized to generate a more accurate understanding of what the PFS measures and how it may relate to the broader definition of hedonic hunger.

RESULTS

Results suggest that the PFS is closely related to motivation to consume palatable foods and, in extreme cases, occurrence of loss-of-control eating episodes. PFS scores are not consistently predictive of amount of food consumed or body mass.

CONCLUSIONS

Implications of these findings are discussed in the context of behavioural health, and avenues for further inquiry are identified.

Validity of assessing child feeding with virtual reality

Assessment of parents' child feeding behavior is challenging, and there is need for additional methodological approaches. Virtual reality technology allows for the creation of behavioral measures, and its implementation overcomes several limitations of existing methods. This report evaluates the validity and usability of the Virtual Reality (VR) Buffet among a sample of 52 parents of children aged 3-7. Participants served a meal of pasta and apple juice in both a virtual setting and real-world setting (counterbalanced and separated by a distractor task). They then created another meal for their child, this time choosing from the full set of food options in the VR Buffet. Finally, participants completed a food estimation task followed by a questionnaire, which assessed their perceptions of the VR Buffet. Results revealed that the amount of virtual pasta served by parents correlated significantly with the amount of real pasta they served, rs = 0.613, p < .0001, as did served amounts of virtual and real apple juice, rs = 0.822, p < .0001. Furthermore, parents' perception of the calorie content of chosen foods was significantly correlated with observed calorie content (rs = 0.438, p = .002), and parents agreed that they would feed the meal they created to their child (M = 4.43, SD = 0.82 on a 1-5 scale). The data presented here demonstrate that parent behavior in the VR Buffet is highly related to real-world behavior, and that the tool is well-rated by parents. Given the data presented and the potential benefits of the abundant behavioral data the VR Buffet can provide, we conclude that it is a valid and needed addition to the array of tools for assessing feeding behavior.

Tuning down the hedonic brain: Cognitive load reduces neural responses to high-calorie food pictures in the nucleus accumbens

The present research examined whether cognitive load modulates the neural processing of appetitive, high-calorie food stimuli. In a functional magnetic resonance imaging (fMRI) study, participants quickly categorized high-calorie and low-calorie food pictures versus object pictures as edible or inedible while they concurrently performed a digit-span task that varied between low and high cognitive load (memorizing six digits vs. one digit). In line with predictions, the digit-span task engaged the dorsolateral prefrontal cortex (DLPFC) when cognitive load was high compared to low. Moreover, exposure to high-calorie compared to low-calorie food pictures led to increased activation in the nucleus accumbens (NAcc), but only when cognitive load was low and not when it was high. In addition, connectivity analyses showed that load altered the functional coupling between NAcc and right DLPFC during presentation of the high-calorie versus low-calorie food pictures. Together, these findings indicate that loading the cognitive system moderates hedonic brain responses to high-calorie food pictures via interactions between NAcc and DLPFC. Our findings are consistent with the putative cognitive nature of food motivation. Implications for future research are discussed.

Greater Food Reward Sensitivity Is Associated with More Frequent Intake of Discretionary Foods in a Nationally Representative Sample of Young Adults

Food reward sensitivity may influence individual susceptibility to an environment replete with highly palatable foods of minimal nutritional value. These foods contain combinations of added sugar, fat, and/or salt that may enhance their motivational salience. This study examined associations of food reward sensitivity with eating behaviors in the NEXT Generation Health Study, a nationally representative sample of U.S. young adults. Participants (n = 2202) completed self-report measures including the Power of Food Scale, assessing food reward sensitivity, and intake frequency of 14 food groups. Multiple linear regressions estimated associations of food reward sensitivity with each of the eating behaviors adjusting for covariates. Higher food reward sensitivity was associated with more frequent intake of fast food (b ± linearized SE = 0.24 ± 0.05, p < 0.001), sweet and salty snacks (0.21 ± 0.05, p < 0.001), foods made with cheese (0.14 ± 0.06, p = 0.03), soda (0.12 ± 0.04, p = 0.009), processed meats (0.12 ± 0.05, p = 0.045), and fish (0.08 ± 0.03, p = 0.03) but was not associated with intake frequency of fruit or juice, green or orange vegetables, beans, whole grains, nuts/seeds, or dairy products. Food reward sensitivity was associated with greater intake of discretionary foods but was not associated with intake of most health-promoting foods, suggesting food reward sensitivity may lead to preferential intake of unhealthful foods.