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Shavit Y, Tepper S, Teodorescu K. Exploring culinary diversity to enhance Mediterranean diet adherence: A randomized controlled trial. Appetite 2024; 201:107597. [PMID: 38972638 DOI: 10.1016/j.appet.2024.107597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 07/03/2024] [Accepted: 07/03/2024] [Indexed: 07/09/2024]
Abstract
We Investigated how promoting diverse, healthy food options affects long-term dietary choices. We hypothesized that encouraging exploration of nutritious plant-based foods would lead to lasting improvements in diet. Participants (N = 211) were randomly assigned into two groups for a 6-week intervention: The fixed menu group was given the same large menu every week, while the changing menu group received a new small menu each week. At the end of the intervention both groups were exposed to the same menu suggestions. Food diversity evaluation was based on weekly reports collected during the intervention. Self-reported adherence to Mediterranean diet components was assessed using the I-MEDAS screener. The proportion of plant-based foods in participants' diets was estimated using a 0-100% scale based on self-report. Both items were evaluated using online questionnaires given to participants at baseline, at the end of the intervention, as well as three and six months after the intervention concluded. Results mean(SD) demonstrated that participants in fixed menu group explored a significantly wider array of items 26.33(11.64) than those in the changing menus group [19.79(10.29), t(202) = 4.25, p < 0.001, Cohen's d = 0.60]. A repeated measures analysis of covariance rmANCOVA revealed that short-term increase in I-MEDAS and PBD score were noted in both groups; however, only participants with the fixed menu sustained this increase at months follow-up [diff = 1.50, t(132) = 4.50, p < 0.001 Our findings suggest that manipulating the rate of exposure to food suggestions may affect overall dietary variety. It seems that early presentation with options may increase overall dietary variety and may even support longer-term habits. This study contributes to developing effective interventions and highlights the challenge of promoting exploratory behavior in nutrition.
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Affiliation(s)
- Yael Shavit
- Technion - Israel Institute of Technology, Israel.
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2
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Colton E, Connors M, Mahlberg J, Verdejo-Garcia A. Episodic future thinking improves intertemporal choice and food choice in individuals with higher weight: A systematic review and meta-analysis. Obes Rev 2024; 25:e13801. [PMID: 39095999 DOI: 10.1111/obr.13801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/02/2024] [Accepted: 07/02/2024] [Indexed: 08/04/2024]
Abstract
Episodic future thinking (EFT) strengthens self-regulation abilities by increasing the perceived value of long-term reinforcements and reducing impulsive choice in delay discounting tasks. As such, EFT interventions have the potential to improve dietary and eating-related decision-making in individuals with obesity or binge eating symptoms, conditions associated with elevated delay discounting. Here, we meta-analyzed evidence from 12 studies that assessed whether EFT interventions improve delay discounting and real-world food choice compared to control interventions. Included studies involved 951 adults with overweight or obesity (body mass index [BMI] ≥25). There were no studies involving participants with binge eating disorder. EFT intervention pooled effects were significant, improving delay discounting with a medium effect, g = 0.55, p < 0.0001, and subsequent food choice outcomes with a small effect, g = 0.31, p < 0.01. Notably, our review is the first to analyze mechanisms of effect in this population, demonstrating that improvements were greater when temporal horizons of EFT episodes were aligned with delay discounting tasks and more distant horizons predicted far-transfer to subsequent dietary and eating-related choices. Our findings thus show that EFT is an effective intervention for individuals with higher weight at risk of adverse health consequences.
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Affiliation(s)
- Emily Colton
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Mia Connors
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Justin Mahlberg
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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3
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Wilson KF, Fox AE. Exercise recovers weight gain, but not increased impulsive choice, caused by a high-fat diet. Appetite 2024; 203:107668. [PMID: 39245366 DOI: 10.1016/j.appet.2024.107668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 09/03/2024] [Accepted: 09/05/2024] [Indexed: 09/10/2024]
Abstract
A high-fat diet has negative effects on physical, neurological, and behavioral outcomes. One consistent finding is that a diet high in fat increases impulsive choice behavior-behavior that is linked to a wide range of other negative health behaviors. While the mechanism for this increase in impulsive choice is not well understood, exercise, with its well-known and many benefits, may serve as an effective and accessible way to combat increased impulsive choice associated with a high-fat diet. The goal of this work was to test this possibility. Rats were divided into four groups in a two-by-two factorial design: exercise and control diet, sedentary and control diet, exercise and high-fat diet, sedentary and high-fat diet. Rats in the exercise groups engaged in 30-min of forced, moderate intensity wheel-running exercise five days per week. Rats in the high-fat diet groups ate a diet high in fat. Impulsive choice was measured using a delay discounting task. Exercise prevented weight gain associated with the high-fat diet. Exercise also preserved relative motivation for food reinforcement. However, exercise did not prevent increases in impulsive choice observed for rats that consumed a high-fat diet relative to the rats that consumed the control diet. This work rules out several possible mechanisms by which a high-fat diet may increase impulsive choice behavior. It makes clear that exercise alone may not stave off increases in impulsive choice caused by a high-fat diet. Future work is necessary to uncover the underlying mechanism for this effect and discover interventions, perhaps ones that combine both physically and cognitively demanding activities, to improve health and behavior as it relates to decision making processes.
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Affiliation(s)
- Keenan F Wilson
- Department of Psychology, St. Lawrence University, United States
| | - Adam E Fox
- Department of Psychology, St. Lawrence University, United States.
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4
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Ferracci S, Manippa V, D'Anselmo A, Bolovon L, Guagnano MT, Brancucci A, Porcelli P, Conti C. The role of impulsivity and binge eating in outpatients with overweight or obesity: an EEG temporal discounting study. J Eat Disord 2024; 12:130. [PMID: 39227881 PMCID: PMC11373217 DOI: 10.1186/s40337-024-01080-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 08/07/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Binge eating (BE) is associated with a range of cognitive control deficits related to impulsivity, including lower response inhibition, preference for immediate gratification, and maladaptive decision-making. The aim was to investigate whether impulsivity and BE may interact with the decision process and underlying brain activity in outpatients with overweight or obesity who are starting a treatment to achieve weight loss. METHODS A sample of 26 treatment-seeking outpatients with overweight or obesity was evaluated for impulsivity, BE, and temporal discounting rates. Impulsivity was measured with the Barratt Impulsiveness Scale (BIS-11), according to which two groups were composed: high BIS and low BIS; BE was assessed with the eating disorders module of the Structured Clinical Interview for DSM5-Research Version, according to which two groups were composed: with (BE group) or without BE (NBE group). Changes in subjective value of rewards were measured with the Temporal Discounting Task (TDt) where participants had to choice between sooner but smaller vs. later but larger monetary rewards. These choices were made in two differently delayed conditions ("Now" and "Not-now"). Brain rhythms were recorded through high-density electroencephalogram (hd-EEG) during the TDt. RESULTS Patients with BE reported more impulsive tendencies and perceived sooner rewards as more gratifying when both options were delayed (Not-now condition, p = 0.02). The reward choice in the TDt was accompanied by a general EEG alpha band desynchronization in parietal areas observed without differences between experimental conditions and patients groups. No effects were observed within the Now condition or in the other EEG bands. CONCLUSIONS The tendency to favor immediate rewards may constitute an obstacle to adhering to treatment plans and achieving weight loss goals for outpatients with overweight or obesity. Clinicians are therefore encouraged to include psychological factors, such as impulsivity and dysfunctional eating behaviors, when designing weight loss programs. By addressing these psychological aspects, clinicians can better support patients in overcoming barriers to adherence and achieving sustainable weight loss. TRIAL REGISTRATION This study was approved by the Ethics Committee of the Department of Psychological, Health, and Territorial Sciences of the University G. d'Annunzio of Chieti-Pescara (Prot. n. 254 of 03/14/2017).
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Affiliation(s)
- Sara Ferracci
- Department of Communication Sciences, Humanities and International Studies, University "Carlo Bo", Urbino, Italy
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Valerio Manippa
- Department of Education, Psychology and Communication, University "Aldo Moro", Bari, Italy
| | - Anita D'Anselmo
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio", Chieti, Italy
- Department of Medicine and Aging Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Luca Bolovon
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Maria Teresa Guagnano
- Department of Medicine and Aging Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Alfredo Brancucci
- Department of Motor, Human and Health Sciences, University "Foro Italico", Rome, Italy
| | - Piero Porcelli
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Chiara Conti
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio", Chieti, Italy.
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5
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Brancati GE, Cosentino V, Barbuti M, Weiss F, Calderone A, Fierabracci P, Salvetti G, Santini F, Perugi G. Prevalence and Correlates of Self-Reported ADHD Symptoms in Bariatric Patients: Focus on Mood and Anxiety Comorbidity, Disordered Eating, and Temperamental Traits. Obes Surg 2024; 34:3335-3347. [PMID: 39052175 PMCID: PMC11349801 DOI: 10.1007/s11695-024-07308-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/18/2024] [Accepted: 05/23/2024] [Indexed: 07/27/2024]
Abstract
PURPOSE Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by inattention, hyperactivity, and impulsivity. A positive association between ADHD and obesity has been observed, especially in adult samples. In this study, prevalence and correlates of self-reported symptoms indicative of a positive screening for ADHD were examined in patients seeking bariatric treatment. MATERIAL AND METHODS The study sample was composed of 260 adult patients with obesity referred for bariatric surgery to the Obesity Center of the Endocrinology Unit in Pisa University Hospital between January 2006 and November 2016 (BMI ≥ 30 kg/m2; mean ± standard deviation = 46.27 ± 7.45 kg/m2). ADHD symptoms were identified using ADHD Symptom Check-List-90-R Screening Scale. Night-eating, binge-eating/purging behaviors, and temperamental and character traits were assessed in a subsample of 95 patients. RESULTS Thirty participants had a positive screening for ADHD (11.5%, 95% CI = 7.9-16.1%). Patients with a positive screening showed significantly higher rates of anxiety disorders (40% vs. 16.5%, χ2 = 7.97, p = 0.005) panic disorder (40% vs. 14.3%, χ2 = 10.48, p = 0.001), and a higher severity of psychopathological symptoms and sleep disturbances than those without. In subsample analyses, ADHD symptoms severity was associated with more bulimic behaviors (r = 0.31-0.46), greater harm avoidance (r = 0.45-0.66), less self-directedness (r = - 0.44-0.63), and cooperativeness (r = - 0.26-0.42). CONCLUSION ADHD symptoms may be common in patients with obesity seeking bariatric treatment and are positively associated with disordered eating, internalizing features, and maladaptive character traits. LEVEL OF EVIDENCE V, cross sectional descriptive study.
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Affiliation(s)
- Giulio Emilio Brancati
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy
| | - Viarda Cosentino
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy
| | - Margherita Barbuti
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy
| | - Francesco Weiss
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy
| | - Alba Calderone
- Endocrinology Unit, Department of Clinical and Experimental Medicine, Obesity and Lipodystrophy Research Center, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - Paola Fierabracci
- Endocrinology Unit, Department of Clinical and Experimental Medicine, Obesity and Lipodystrophy Research Center, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - Guido Salvetti
- Endocrinology Unit, Department of Clinical and Experimental Medicine, Obesity and Lipodystrophy Research Center, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - Ferruccio Santini
- Endocrinology Unit, Department of Clinical and Experimental Medicine, Obesity and Lipodystrophy Research Center, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - Giulio Perugi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy.
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6
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Myers KP, Temple JL. Translational science approaches for food insecurity research. Appetite 2024; 200:107513. [PMID: 38795946 PMCID: PMC11227396 DOI: 10.1016/j.appet.2024.107513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 05/20/2024] [Accepted: 05/22/2024] [Indexed: 05/28/2024]
Abstract
Food insecurity is a pervasive problem that impacts health and well-being across the lifespan. The human research linking food insecurity to poor metabolic and behavioral health outcomes is inherently correlational and suffers from a high degree of variability both between households and even within the same household over time. Further, food insecurity is impacted by societal and political factors that are largely out of the control of individuals, which narrows the range of intervention strategies. Animal models of food insecurity are being developed to address some of the barriers to mechanistic research. However, animal models are limited in their ability to consider some of the more complex societal elements of the human condition. We believe that understanding the role that food insecurity plays in ingestive behavior and chronic disease requires a truly translational approach, and that understanding the health impacts of this complex social phenomenon requires understanding both its psychological and physiological dimensions. This brief review will outline some key features of food insecurity, highlighting those that are amenable to investigation with controlled animal models and identifying areas where integrating animal and human studies can improve our understanding of the psychological burden and health impacts of food insecurity. In the interest of brevity, this review will largely focus on food insecurity in the United States, as the factors that contribute to food insecurity vary considerably across the globe.
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Affiliation(s)
- Kevin P Myers
- Department of Psychology, Animal Behavior & Neuroscience Programs, Bucknell University, Lewisburg, PA, USA.
| | - Jennifer L Temple
- Departments of Exercise and Nutrition Sciences, Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
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7
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Begho T, Rui S. Exploring the impact of impulsivity and indulgent consumption on eating patterns of Chinese consumers. Int J Food Sci Nutr 2024; 75:509-517. [PMID: 38899483 DOI: 10.1080/09637486.2024.2368840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/15/2024] [Accepted: 06/10/2024] [Indexed: 06/21/2024]
Abstract
There is a growing concern about unhealthy eating habits and their impact on public health, underscoring the importance of research to understand its determinants and encourage healthy food habits. Using behavioural economic insights in researching dietary habit offer advantages beyond the scope of observational studies. Therefore, this paper examines impulsivity, self-indulgence, prudence and their associations with an individual's eating habits and body mass index (BMI). Data were collected from a sample of 487 Chinese participants. Most participants (88%) had good eating habits based on the Healthy Eating Assessment score. The findings of a logistic regression analysis investigating the determinants of individual dietary behaviour based on participants' self-rating of their overall dietary habits indicate that consumers who showed temporal impulsivity for favourite food tend to have poorer habits of eating healthy foods. The results of a multiple linear regression examining the factors that influence eating habits from a composite score of the Healthy Eating Assessment indicate that the score is better with temporal impulsivity for healthy food and poor with temporal impulsivity for unhealthy food. Further, the score decreases with impulsivity measured as low self-control. The control variables, age and gender, are also significant. The findings of a linear regression analysis exploring the determinants of BMI and their association with impulsivity, self-indulgence and prudence indicate that individuals with higher impulsivity measured as low self-control are mostly in the higher BMI category. These findings are important for designing and implementing public health initiatives to promote healthier dietary habits.
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Affiliation(s)
- Toritseju Begho
- Rural Economy, Environment & Society, Scotland's Rural College (SRUC), Edinburgh, UK
| | - Sizhuo Rui
- School of GeoSciences, University of Edinburgh, Edinburgh, UK
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8
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Montalban E, Giralt A, Taing L, Nakamura Y, Pelosi A, Brown M, de Pins B, Valjent E, Martin M, Nairn AC, Greengard P, Flajolet M, Hervé D, Gambardella N, Roussarie JP, Girault JA. Operant Training for Highly Palatable Food Alters Translating Messenger RNA in Nucleus Accumbens D 2 Neurons and Reveals a Modulatory Role of Ncdn. Biol Psychiatry 2024; 95:926-937. [PMID: 37579933 PMCID: PMC11059129 DOI: 10.1016/j.biopsych.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/04/2023] [Accepted: 08/04/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Highly palatable food triggers behavioral responses including strong motivation. These effects involve the reward system and dopamine neurons, which modulate neurons in the nucleus accumbens (NAc). The molecular mechanisms underlying the long-lasting effects of highly palatable food on feeding behavior are poorly understood. METHODS We studied the effects of 2-week operant conditioning of mice with standard or isocaloric highly palatable food. We investigated the behavioral responses and dendritic spine modifications in the NAc. We compared the translating messenger RNA in NAc neurons identified by the type of dopamine receptors they express, depending on the kind of food and training. We tested the consequences of invalidation of an abundant downregulated gene, Ncdn. RESULTS Operant conditioning for highly palatable food increased motivation for food even in well-fed mice. In wild-type mice, free choice between regular and highly palatable food increased weight compared with access to regular food only. Highly palatable food increased spine density in the NAc. In animals trained for highly palatable food, translating messenger RNAs were modified in NAc neurons expressing dopamine D2 receptors, mostly corresponding to striatal projection neurons, but not in neurons expressing D1 receptors. Knockout of Ncdn, an abundant downregulated gene, opposed the conditioning-induced changes in satiety-sensitive feeding behavior and apparent motivation for highly palatable food, suggesting that downregulation may be a compensatory mechanism. CONCLUSIONS Our results emphasize the importance of messenger RNA alterations in D2 striatal projection neurons in the NAc in the behavioral consequences of highly palatable food conditioning and suggest a modulatory contribution of Ncdn downregulation.
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Affiliation(s)
- Enrica Montalban
- Institut National de la Santé et de la Recherche Médicale Unite Mixte de Recherche-S 1270, Paris, France; Faculty of Sciences and Engineering, Sorbonne Université, Paris, France; Institut du Fer à Moulin, Paris, France.
| | - Albert Giralt
- Institut National de la Santé et de la Recherche Médicale Unite Mixte de Recherche-S 1270, Paris, France; Faculty of Sciences and Engineering, Sorbonne Université, Paris, France; Institut du Fer à Moulin, Paris, France
| | - Lieng Taing
- Institut National de la Santé et de la Recherche Médicale Unite Mixte de Recherche-S 1270, Paris, France; Faculty of Sciences and Engineering, Sorbonne Université, Paris, France; Institut du Fer à Moulin, Paris, France
| | - Yuki Nakamura
- Institut National de la Santé et de la Recherche Médicale Unite Mixte de Recherche-S 1270, Paris, France; Faculty of Sciences and Engineering, Sorbonne Université, Paris, France; Institut du Fer à Moulin, Paris, France
| | - Assunta Pelosi
- Institut National de la Santé et de la Recherche Médicale Unite Mixte de Recherche-S 1270, Paris, France; Faculty of Sciences and Engineering, Sorbonne Université, Paris, France; Institut du Fer à Moulin, Paris, France
| | - Mallory Brown
- Laboratory of Molecular and Cellular Neuroscience, Rockefeller University, New York, New York
| | - Benoit de Pins
- Institut National de la Santé et de la Recherche Médicale Unite Mixte de Recherche-S 1270, Paris, France; Faculty of Sciences and Engineering, Sorbonne Université, Paris, France; Institut du Fer à Moulin, Paris, France
| | - Emmanuel Valjent
- Institut de Génomique Fonctionnelle, University of Montpellier, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | - Miquel Martin
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Reus, Spain; Instituto de investigaciones médicas Hospital del Mar, Barcelona, Spain
| | - Angus C Nairn
- Department of Psychiatry, Yale School of Medicine, Connecticut Mental Health Center, New Haven, Connecticut
| | - Paul Greengard
- Laboratory of Molecular and Cellular Neuroscience, Rockefeller University, New York, New York
| | - Marc Flajolet
- Laboratory of Molecular and Cellular Neuroscience, Rockefeller University, New York, New York
| | - Denis Hervé
- Institut National de la Santé et de la Recherche Médicale Unite Mixte de Recherche-S 1270, Paris, France; Faculty of Sciences and Engineering, Sorbonne Université, Paris, France; Institut du Fer à Moulin, Paris, France
| | | | - Jean-Pierre Roussarie
- Laboratory of Molecular and Cellular Neuroscience, Rockefeller University, New York, New York
| | - Jean-Antoine Girault
- Institut National de la Santé et de la Recherche Médicale Unite Mixte de Recherche-S 1270, Paris, France; Faculty of Sciences and Engineering, Sorbonne Université, Paris, France; Institut du Fer à Moulin, Paris, France.
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9
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Tuyizere O, Gustafson CR, Rose DJ. Health Prompts Affect Consideration of Health but Not Intertemporal Preferences While Promoting Healthier Food Choices. Nutrients 2024; 16:1454. [PMID: 38794692 PMCID: PMC11123726 DOI: 10.3390/nu16101454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Diet-related diseases impact populations across the globe. While intertemporal preferences-a fundamental preference for the distribution of benefits across time-have been used to explain low-quality food choices, the recent literature proposes another cause: inattention to the future implications (or opportunity costs) of the options faced. Food choices tend to become habitual to conserve cognitive resources, rather than carefully modeling future health impacts. Both low discount rates for future benefits and attention to future health impacts predict healthier decisions. While intertemporal preferences are stable, attention may provide an opportunity to intervene in the decision process to promote healthier decisions. In this study, we test the impact of a simple message that highlights health during food choice on the healthiness of the foods chosen and on health consideration and intertemporal preferences. Our results show that actively considering health outcomes and lower discount rates lead to healthier food choices. We find that messaging increases the consideration of health outcomes during food choice but does not affect intertemporal preferences, suggesting that simple prompts may be an effective way to promote decisions balancing short- and long-term benefits by drawing attention to the overlooked opportunity costs of choices.
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Affiliation(s)
- Olivier Tuyizere
- Department of Agricultural Economics, University of Nebraska-Lincoln, Lincoln, NE 68583, USA
| | | | - Devin J. Rose
- Department of Food Science and Technology, University of Nebraska-Lincoln, Lincoln, NE 68588, USA;
- Department of Agronomy & Horticulture, University of Nebraska-Lincoln, Lincoln, NE 68583, USA
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10
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Epstein LH, Temple JL, Faith MS, Hostler D, Rizwan A. A psychobioecological model to understand the income-food insecurity-obesity relationship. Appetite 2024; 196:107275. [PMID: 38367912 DOI: 10.1016/j.appet.2024.107275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 02/19/2024]
Abstract
Food insecurity, defined by unpredictable access to food that may not meet a person's nutritional needs, is associated with higher BMI (kg/m2) and obesity. People with food insecurity often have less access to food, miss meals and go hungry, which can lead to psychological and metabolic changes that favor energy conservation and weight gain. We describe a conceptual model that includes psychological (food reinforcement and delay discounting) and physiological (thermic effect of food and substrate oxidation) factors to understand how resource scarcity associated with food insecurity evolves into the food insecurity-obesity paradox. We present both animal and human translational research to describe how behavioral and metabolic adaptations to resource scarcity based on behavioral ecology theory may occur for people with food insecurity. We conclude with ideas for interventions to prevent or modify the behaviors and underlying physiology that characterize the income-food insecurity-obesity relationship.
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Affiliation(s)
- Leonard H Epstein
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
| | - Jennifer L Temple
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Myles S Faith
- Department of Counseling, School and Educational Psychology, Graduate School of Education, University at Buffalo, Buffalo, NY, USA
| | - David Hostler
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Ashfique Rizwan
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA; Department of Counseling, School and Educational Psychology, Graduate School of Education, University at Buffalo, Buffalo, NY, USA
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11
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Italia M, Salvadè M, La Greca F, Zianni E, Pelucchi S, Spinola A, Ferrari E, Archetti S, Alberici A, Benussi A, Solje E, Haapasalo A, Hoffmann D, Katisko K, Krüger J, Facchinetti R, Scuderi C, Padovani A, DiLuca M, Scheggia D, Borroni B, Gardoni F. Anti-GluA3 autoantibodies define a new sub-population of frontotemporal lobar degeneration patients with distinct neuropathological features. Brain Behav Immun 2024; 118:380-397. [PMID: 38485064 DOI: 10.1016/j.bbi.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 03/19/2024] Open
Abstract
Autoantibodies directed against the GluA3 subunit (anti-GluA3 hIgGs) of AMPA receptors have been identified in 20%-25% of patients with frontotemporal lobar degeneration (FTLD). Data from patients and in vitro/ex vivo pre-clinical studies indicate that anti-GluA3 hIgGs negatively affect glutamatergic neurotransmission. However, whether and how the chronic presence of anti-GluA3 hIgGs triggers synaptic dysfunctions and the appearance of FTLD-related neuropathological and behavioural signature has not been clarified yet. To address this question, we developed and characterized a pre-clinical mouse model of passive immunization with anti-GluA3 hIgGs purified from patients. In parallel, we clinically compared FTLD patients who were positive for anti-GluA3 hIgGs to negative ones. Clinical data showed that the presence of anti-GluA3 hIgGs defined a subgroup of patients with distinct clinical features. In the preclinical model, anti-GluA3 hIgGs administration led to accumulation of phospho-tau in the postsynaptic fraction and dendritic spine loss in the prefrontal cortex. Remarkably, the preclinical model exhibited behavioural disturbances that mostly reflected the deficits proper of patients positive for anti-GluA3 hIgGs. Of note, anti-GluA3 hIgGs-mediated alterations were rescued in the animal model by enhancing glutamatergic neurotransmission with a positive allosteric modulator of AMPA receptors. Overall, our study clarified the contribution of anti-GluA3 autoantibodies to central nervous system symptoms and pathology and identified a specific subgroup of FTLD patients. Our findings will be instrumental in the development of a therapeutic personalised medicine strategy for patients positive for anti-GluA3 hIgGs.
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Affiliation(s)
- Maria Italia
- Department of Pharmacological and Biomolecular Sciences (DiSFeB), University of Milan, Milan, Italy
| | - Michela Salvadè
- Department of Pharmacological and Biomolecular Sciences (DiSFeB), University of Milan, Milan, Italy
| | - Filippo La Greca
- Department of Pharmacological and Biomolecular Sciences (DiSFeB), University of Milan, Milan, Italy
| | - Elisa Zianni
- Department of Pharmacological and Biomolecular Sciences (DiSFeB), University of Milan, Milan, Italy
| | - Silvia Pelucchi
- Department of Pharmacological and Biomolecular Sciences (DiSFeB), University of Milan, Milan, Italy
| | - Alessio Spinola
- Department of Pharmacological and Biomolecular Sciences (DiSFeB), University of Milan, Milan, Italy
| | - Elena Ferrari
- Department of Pharmacological and Biomolecular Sciences (DiSFeB), University of Milan, Milan, Italy
| | - Silvana Archetti
- Department of Laboratories, Central Laboratory of Clinical Chemistry Analysis. ASST Spedali Civili, Brescia, Italy
| | - Antonella Alberici
- Neurology Unit, Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alberto Benussi
- Neurology Unit, Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Eino Solje
- Institute of Clinical Medicine - Neurology, University of Eastern Finland, Kuopio, Finland; Neuro Center, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Annakaisa Haapasalo
- A. I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Dorit Hoffmann
- A. I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Kasper Katisko
- Institute of Clinical Medicine - Neurology, University of Eastern Finland, Kuopio, Finland; Neuro Center, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Johanna Krüger
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland; Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland; Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Roberta Facchinetti
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | - Caterina Scuderi
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | - Alessandro Padovani
- Neurology Unit, Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Monica DiLuca
- Department of Pharmacological and Biomolecular Sciences (DiSFeB), University of Milan, Milan, Italy
| | - Diego Scheggia
- Department of Pharmacological and Biomolecular Sciences (DiSFeB), University of Milan, Milan, Italy
| | - Barbara Borroni
- Neurology Unit, Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Fabrizio Gardoni
- Department of Pharmacological and Biomolecular Sciences (DiSFeB), University of Milan, Milan, Italy.
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12
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Gebru NM, Wongsomboon V. Sexual Arousal-Delay Discounting: When Condoms Delay Arousal. JOURNAL OF SEX RESEARCH 2024; 61:727-741. [PMID: 37506314 PMCID: PMC10822021 DOI: 10.1080/00224499.2023.2239216] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
Sexual arousal plays an important role in condom use decisions. However, combined effects of reduced sexual arousal and delay to achieving arousal on condom use decisions remain understudied. This study used a novel sexual arousal-delay discounting (SADD) task to measure individuals' willingness to use a condom in situations where condom use would (1) delay time to arousal and (2) reduce the level of arousal one could achieve even after the delay (e.g., 5 minutes to reach 50% arousal). In Study 1, U.S. college students (N = 115; Mage = 18.6) reported their willingness to have sex with a condom in hypothetical scenarios where the condom delayed and reduced their partner's sexual arousal. In Study 2, U.S. college students (N = 208; Mage = 19.6; 99% ≤ 24 years old) completed the same task for two partners-partner perceived as most desirable and partner perceived as least likely to have an STI. In this study, a condom would affect either participants' own or partner's arousal. Study 3 replicated Study 2 using a non-college sample in the U.S. (N = 227; Mage = 30.5; 84% ≥ 25 years old). Across studies, willingness to use a condom decreased as the delay to reduced arousal increased. This effect of SADD was stronger when condoms reduced participants' own (vs. partner's) arousal, whereas comparisons between most desirable and least likely-to-have-STI partners provided mixed findings. Men had higher discounting rates than women across conditions. Greater SADD was associated with lower condom use self-efficacy, providing initial evidence for the task's validity. The role of delayed arousal in condom use and implications are discussed.
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Affiliation(s)
- Nioud Mulugeta Gebru
- Center for Alcohol and Addictions Studies; Department of Behavioral and Social Sciences; Brown University School of Public Health, Providence, RI USA
| | - Val Wongsomboon
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL USA
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13
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Gelino BW, Schlitzer RD, Reed DD, Strickland JC. A systematic review and meta-analysis of test-retest reliability and stability of delay and probability discounting. J Exp Anal Behav 2024; 121:358-372. [PMID: 38499476 PMCID: PMC11078611 DOI: 10.1002/jeab.910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 02/13/2024] [Indexed: 03/20/2024]
Abstract
In this meta-analysis, we describe a benchmark value of delay and probability discounting reliability and stability that might be used to (a) evaluate the meaningfulness of clinically achieved changes in discounting and (b) support the role of discounting as a valid and enduring measure of intertemporal choice. We examined test-retest reliability, stability effect sizes (dz; Cohen, 1992), and relevant moderators across 30 publications comprising 39 independent samples and 262 measures of discounting, identified via a systematic review of PsychInfo, PubMed, and Google Scholar databases. We calculated omnibus effect-size estimates and evaluated the role of proposed moderators using a robust variance estimation meta-regression method. The meta-regression output reflected modest test-retest reliability, r = .670, p < .001, 95% CI [.618, .716]. Discounting was most reliable when measured in the context of temporal constraints, in adult respondents, when using money as a medium, and when reassessed within 1 month. Testing also suggested acceptable stability via nonsignificant and small changes in effect magnitude over time, dz = 0.048, p = .31, 95% CI [-0.051, 0.146]. Clinicians and researchers seeking to measure discounting can consider the contexts when reliability is maximized for specific cases.
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Affiliation(s)
- Brett W. Gelino
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, US
| | - Rebekah D. Schlitzer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, US
| | - Derek D. Reed
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
| | - Justin C. Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, US
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14
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Yeh YH, Tegge AN, Freitas-Lemos R, Myerson J, Green L, Bickel WK. Discounting of delayed rewards: Missing data imputation for the 21- and 27-item monetary choice questionnaires. PLoS One 2023; 18:e0292258. [PMID: 37844072 PMCID: PMC10578570 DOI: 10.1371/journal.pone.0292258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/17/2023] [Indexed: 10/18/2023] Open
Abstract
The Monetary Choice Questionnaire (MCQ) is a widely used behavioral task that measures the rate of delay discounting (i.e., k), the degree to which a delayed reward loses its present value as a function of the time to its receipt. Both 21- and 27-item MCQs have been extensively validated and proven valuable in research. Different methods have been developed to streamline MCQ scoring. However, existing scoring methods have yet to tackle the issue of missing responses or provide clear guidance on imputing such data. Due to this lack of knowledge, the present study developed and compared three imputation approaches that leverage the MCQ's structure and prioritize ease of implementation. Additionally, their performance was compared with mode imputation. A Monte Carlo simulation was conducted to evaluate the performance of these approaches in handling various missing responses in each observation across two datasets from prior studies that employed the 21- and 27-item MCQs. One of the three approaches consistently outperformed mode imputation across all performance measures. This approach involves imputing missing values using congruent non-missing responses to the items corresponding to the same k value or introducing random responses when congruent answers are unavailable. This investigation unveils a straightforward method for imputing missing data in the MCQ while ensuring unbiased estimates. Along with the investigation, an R tool was developed for researchers to implement this strategy while streamlining the MCQ scoring process.
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Affiliation(s)
- Yu-Hua Yeh
- Psychology Department, Illinois College, Jacksonville, IL, United States of America
| | - Allison N. Tegge
- Fralin Biomedical Research Institute at VTC, Roanoke, VA, United States of America
- Department of Statistics, Virginia Tech, Blacksburg, VA, United States of America
| | | | - Joel Myerson
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States of America
| | - Leonard Green
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States of America
| | - Warren K. Bickel
- Fralin Biomedical Research Institute at VTC, Roanoke, VA, United States of America
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15
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Button AM, Paluch RA, Schechtman KB, Wilfley DE, Geller N, Quattrin T, Cook SR, Eneli IU, Epstein LH. Parents, but not their children, demonstrate greater delay discounting with resource scarcity. BMC Public Health 2023; 23:1983. [PMID: 37828503 PMCID: PMC10568819 DOI: 10.1186/s12889-023-16832-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 09/25/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Individuals with obesity tend to discount the future (delay discounting), focusing on immediate gratification. Delay discounting is reliably related to indicators of economic scarcity (i.e., insufficient resources), including lower income and decreased educational attainment in adults. It is unclear whether the impact of these factors experienced by parents also influence child delay discounting between the ages of 8 and 12-years in families with obesity. METHODS The relationship between indices of family income and delay discounting was studied in 452 families with parents and 6-12-year-old children with obesity. Differences in the relationships between parent economic, educational and Medicaid status, and parent and child delay discounting were tested. RESULTS Results showed lower parent income (p = 0.019) and Medicaid status (p = 0.021) were differentially related to greater parent but not child delay discounting among systematic responders. CONCLUSIONS These data suggest differences in how indicators of scarcity influence delay discounting for parents and children, indicating that adults with scarce resources may be shaped to focus on immediate needs instead of long-term goals. It is possible that parents can reduce the impact of economic scarcity on their children during preadolescent years. These findings suggest a need for policy change to alleviate the burden of scarce conditions and intervention to modify delay discounting rate and to improve health-related choices and to address weight disparities.
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Affiliation(s)
- Alyssa M Button
- Division of Population and Public Health Science, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Rocco A Paluch
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 3435 Main Street, Building #26, Buffalo, NY, 14214, USA
| | - Kenneth B Schechtman
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Denise E Wilfley
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Nancy Geller
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Teresa Quattrin
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 3435 Main Street, Building #26, Buffalo, NY, 14214, USA
| | - Stephen R Cook
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Ihouma U Eneli
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Leonard H Epstein
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 3435 Main Street, Building #26, Buffalo, NY, 14214, USA.
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16
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Epstein LH, Rizwan A, Paluch RA, Temple JL. Delay Discounting and the Income-Food Insecurity-Obesity Paradox in Mothers. J Obes 2023; 2023:8898498. [PMID: 37766882 PMCID: PMC10522429 DOI: 10.1155/2023/8898498] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/09/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Food insecurity, defined as unpredictable access to food that may not meet a person's nutritional needs, is paradoxically associated with higher BMI (kg/m2) and obesity. Research has shown delay discounting, a behavioral economic measure of the preference for immediate rather than delayed rewards, is related to higher BMI, and moderates the relationship between income and food insecurity. Based on this research, we used regression models to test whether delay discounting, consideration of future consequences, and perceived stress were atemporal mediators of the food insecurity-BMI relation in 313 mothers, controlling for demographic variables. A secondary aim was to replicate the finding that delay discounting moderates the relationship between low income and high food insecurity. Results showed that low income was associated with higher food insecurity, and higher food insecurity was associated with higher BMI. Delay discounting was the only variable that was indirectly related to both paths of the food-insecurity-BMI relation. Delay discounting accounted for 22.2% of the variance in the low-income-food insecurity-obesity relation, and the total model accounted for 38.0% of the variance. The relation between low income and food insecurity was moderated by delay discounting. These data suggest that delay discounting is a potential mediator of the relationship between food insecurity and high BMI, which suggests reducing discounting in the future could be a novel target to reduce food insecurity and help people with food insecurity to reduce their excess body weight. Trial Registration. This trial is registered with NCT02873715.
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Affiliation(s)
- Leonard H. Epstein
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Ashfique Rizwan
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Rocco A. Paluch
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Jennifer L. Temple
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
- Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
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17
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Colton E, Wilson KE, Chong TTJ, Verdejo-Garcia A. Dysfunctional decision-making in binge-eating disorder: A meta-analysis and systematic review. Neurosci Biobehav Rev 2023; 152:105250. [PMID: 37263530 DOI: 10.1016/j.neubiorev.2023.105250] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/26/2023] [Accepted: 05/28/2023] [Indexed: 06/03/2023]
Abstract
Binge-Eating Disorder (BED) involves anticipatory craving and urges, subjective loss-of-control during binge-eating episodes, and post-feeding psychological distress and guilt. Evidence indicates neurocognitive dysfunctions contribute to BED onset, maintenance, and treatment response. However, an integrated understanding of how cognitive processes underpin BED symptomology is lacking. We utilised a multi-stage decision-making model defining ten cognitive processes underpinning Preference Formation, Choice Implementation, Feedback Processing, and Flexibility/Shifting, to comprehensively review research published since 2013. We used preregistered PICOS criteria to assess 1966 articles identified from PubMed, PsycInfo, and Scopus database searches. This yielded 50 studies reporting behavioural cognitive tasks outcomes, comparing individuals with BED to controls with normal and higher weight. Meta-analyses revealed a unique profile of cognitive dysfunctions that spanned all decision-making stages. Significant deficits were evident in Uncertainty Evaluation, Attentional Inhibition, Choice Consistency, and Cognitive Flexibility/Set-shifting. We propose a novel model of dysfunctional decision-making processes in BED and describe their role in binge-eating behaviour. We further highlight the potential for cognitive interventions to target these processes and address the significant treatment gap in BED.
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Affiliation(s)
- Emily Colton
- Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia.
| | - Kira-Elise Wilson
- Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
| | - Trevor T-J Chong
- Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
| | - Antonio Verdejo-Garcia
- Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
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18
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Reach G. How is Patient Adherence Possible? A Novel Mechanistic Model of Adherence Based on Humanities. Patient Prefer Adherence 2023; 17:1705-1720. [PMID: 37484740 PMCID: PMC10362896 DOI: 10.2147/ppa.s419277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 06/19/2023] [Indexed: 07/25/2023] Open
Abstract
Patient non-adherence is a major contemporary medical issue because of its consequences in terms of frequency, morbidity and mortality, and health care costs. This article aims to propose a mechanistic model of adherence based on the tenet that non-adherence is the default option, as long-term adherence in chronic diseases requires sustained effort. The real question becomes, how is patient adherence possible? By focusing on adherent patients, the paper explains the mental mechanisms of adherence using concepts largely drawn from humanities, philosophy of mind, and behavioral economics and presents the findings of empirical studies supporting these hypotheses. The analysis first demonstrates the relationship between patient adherence and temporality and the influence of character traits. Further, it points out the importance of habit, which allows adherence to become non-intentional, thereby sparing patients' cognitive efforts. Finally, it points out the importance of the quality of the interaction between the person with a chronic disease and the health professional. These features explain why adherence is a syndrome (the healthy adherer phenotype), separating people into those who are safe and those who are at risk of non-adherence, non-control of diabetes, and complications. The concepts presented in this article summarize 20 years of personal clinical and philosophical reflection on patient adherence. They are mainly illustrated by examples from diabetes care but can be applied to all chronic diseases. This novel model of adherence has major practical and ethical implications, explaining the importance of patient education and shared medical decision-making in chronic disease management.
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Affiliation(s)
- Gérard Reach
- Education and Health Promotion Laboratory, Sorbonne Paris Nord University, Bobigny, Île-de-France, 93000, France
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19
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Kakoschke N, Cox DN, Ryan J, Gwilt I, Davis A, Jansons P, de Courten B, Brinkworth G. Disrupting future discounting: a commentary on an underutilised psychological approach for improving adherence to diet and physical activity interventions. Public Health Nutr 2023; 26:1088-1093. [PMID: 36786324 PMCID: PMC10346014 DOI: 10.1017/s136898002200252x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/09/2022] [Accepted: 11/21/2022] [Indexed: 02/15/2023]
Abstract
Non-communicable diseases (NCD) such as CVD and type 2 diabetes mellitus are major contributors to the burden of disease. NCD are largely driven by modifiable lifestyle factors including poor diet and insufficient physical activity, and consequently, prevention is a public health priority. Although diet and physical activity levels can be improved via lifestyle interventions, long-term adherence to such interventions remains low, which limits their effectiveness. Thus, it is critical to identify the underlying mechanisms that challenge uptake and adherence to such interventions. The current commentary discusses an important, but underexplored, psychological driver of poor adherence to lifestyle interventions, namely, future discounting, which describes the tendency to prefer smaller, short-term rewards over larger, long-term rewards. For example, in the nutrition domain, future discounting refers to valuing the immediate reward of excessive intake of energy-dense, nutrient-poor, discretionary foods high in salt, sugar, and saturated fat, and insufficient intake of low-energy, nutrient-dense, whole foods such as vegetables. Prominent theoretical models propose that excessive future discounting is a major contributor to the development of unhealthy lifestyle behaviours. Furthermore, a vast body of evidence suggests that future discounting plays a key role in risk of NCD. Thus, the evidence to date supports the idea that future discounting is an important multi-behaviour target for supporting lifestyle behaviour change; however, this approach has been largely neglected in preventive health efforts. Furthermore, this commentary discusses promising techniques (e.g. Episodic Future Thinking) for disrupting future discounting to promote improved adherence to lifestyle interventions aimed at reducing NCD risk.
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Affiliation(s)
- Naomi Kakoschke
- Human Health, CSIRO Health & Biosecurity, SAHMRI, North Terrace, Adelaide5000, Australia
| | - David N Cox
- Human Health, CSIRO Health & Biosecurity, SAHMRI, North Terrace, Adelaide5000, Australia
| | - Jillian Ryan
- Human Health, CSIRO Health & Biosecurity, SAHMRI, North Terrace, Adelaide5000, Australia
- BVA BDRC, Sydney, Australia
| | - Ian Gwilt
- UniSA Creative, The University of South Australia, Adelaide, Australia
| | - Aaron Davis
- UniSA Creative, The University of South Australia, Adelaide, Australia
| | - Paul Jansons
- School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | | | - Grant Brinkworth
- Human Health, CSIRO Health & Biosecurity, SAHMRI, North Terrace, Adelaide5000, Australia
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20
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Ljusic N, Fagerstrøm A, Sigurdsson V, Arntzen E. Information, ingestion, and impulsivity: The impact of technology-enabled healthy food labels on online grocery shopping in impulsive and non-impulsive consumers. Front Nutr 2023; 10:1129883. [PMID: 37063326 PMCID: PMC10099808 DOI: 10.3389/fnut.2023.1129883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/10/2023] [Indexed: 03/30/2023] Open
Abstract
IntroductionUnhealthy food consumption is a problem for society, companies, and consumers. This study aims to contribute to knowledge regarding such issues by investigating how technology-enabled healthy food labels can impact food choice in an online grocery store context. We conceptualized unhealthy and healthy food choice as a matter of impulsivity problems. Three technology-enabled healthy food labels were derived based on variables that might impact self-control, and their influence on food choice was investigated.MethodsThe empirical study consisted of three parts. In the first part, participants’ impulsivity was measured using an adjusting delay task. Part two investigated the effects of self-monitoring, pre-commitment, and social comparison-based technology-enabled healthy food labels on food choice in a hypothetical online grocery shopping setting using a choice-based conjoint experiment. Lastly, in the third part, three where demographical questions were asked.ResultsThe results (n = 405) show that self-monitoring, pre-commitment, and social comparison-based technology-enabled healthy food labels had the most to least impact on food choice in that order. Furthermore, the results indicate that self-monitoring and pre-commitment labels had more impact on the choice for impulsive compared to non-impulsive participants. Similarly, the results indicate that social comparison had more impact on choice for non-impulsive participants. These findings suggest that self-monitoring of previous healthy food choices might be more effective than pre-commitment based on discounts for healthy food products. However, these differences were minor.DiscussionThis finding has managerial implications as grocery stores might increase their revenue by introducing self-monitoring labels in an online grocery shopping setting. Future research should investigate these technology-enabled healthy food labels in natural food purchase settings.
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Affiliation(s)
- Nikola Ljusic
- Behavior and Technology Lab, School of Economics, Innovation, and Technology, Kristiania University College, Oslo, Norway
- *Correspondence: Nikola Ljusic,
| | - Asle Fagerstrøm
- Behavior and Technology Lab, School of Economics, Innovation, and Technology, Kristiania University College, Oslo, Norway
| | - Valdimar Sigurdsson
- Centre for Research in Marketing and Consumer Psychology, Department of Business Administration, School of Social Sciences, Reykjavik University, Reykjavik, Iceland
| | - Erik Arntzen
- Experimental Studies of Complex Human Behavior, Department of Behavioral Science, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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21
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Matikainen-Ankney BA, Legaria AA, Pan Y, Vachez YM, Murphy CA, Schaefer RF, McGrath QJ, Wang JG, Bluitt MN, Ankney KC, Norris AJ, Creed MC, Kravitz AV. Nucleus Accumbens D 1 Receptor-Expressing Spiny Projection Neurons Control Food Motivation and Obesity. Biol Psychiatry 2023; 93:512-523. [PMID: 36494220 DOI: 10.1016/j.biopsych.2022.10.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Obesity is a chronic relapsing disorder that is caused by an excess of caloric intake relative to energy expenditure. There is growing recognition that food motivation is altered in people with obesity. However, it remains unclear how brain circuits that control food motivation are altered in obese animals. METHODS Using a novel behavioral assay that quantifies work during food seeking, in vivo and ex vivo cell-specific recordings, and a synaptic blocking technique, we tested the hypothesis that activity of circuits promoting appetitive behavior in the core of the nucleus accumbens (NAc) is enhanced in the obese state, particularly during food seeking. RESULTS We first confirmed that mice made obese with ad libitum exposure to a high fat diet work harder than lean mice to obtain food, consistent with an increase in food motivation in obese mice. We observed greater activation of D1 receptor-expressing NAc spiny projection neurons (NAc D1SPNs) during food seeking in obese mice relative to lean mice. This enhanced activity was not observed in D2 receptor-expressing neurons (D2SPNs). Consistent with these in vivo findings, both intrinsic excitability and excitatory drive onto D1SPNs were enhanced in obese mice relative to lean mice, and these measures were selective for D1SPNs. Finally, blocking synaptic transmission from D1SPNs, but not D2SPNs, in the NAc core decreased physical work during food seeking and, critically, attenuated high fat diet-induced weight gain. CONCLUSIONS These experiments demonstrate the necessity of NAc core D1SPNs in food motivation and the development of diet-induced obesity, establishing these neurons as a potential therapeutic target for preventing obesity.
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Affiliation(s)
| | - Alex A Legaria
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri; Department of Neuroscience, Washington University in St. Louis, St. Louis, Missouri
| | - Yiyan Pan
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri
| | - Yvan M Vachez
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri
| | - Caitlin A Murphy
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri
| | - Robert F Schaefer
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri; Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri
| | - Quinlan J McGrath
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri
| | - Justin G Wang
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri; Department of Neuroscience, Washington University in St. Louis, St. Louis, Missouri
| | - Maya N Bluitt
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri
| | - Kevin C Ankney
- Department of Economics, Georgetown University, Washington, DC
| | - Aaron J Norris
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri
| | - Meaghan C Creed
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri; Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri; Department of Neuroscience, Washington University in St. Louis, St. Louis, Missouri
| | - Alexxai V Kravitz
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri; Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri; Department of Neuroscience, Washington University in St. Louis, St. Louis, Missouri.
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22
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Montalban E, Giralt A, Taing L, Nakamura Y, Pelosi A, Brown M, de Pins B, Valjent E, Martin M, Nairn AC, Greengard P, Flajolet M, Herv D, Gambardella N, Roussarie JP, Girault JA. Operant training for highly palatable food alters translating mRNA in nucleus accumbens D2 neurons and reveals a modulatory role of Neurochondrin. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.03.07.531496. [PMID: 36945487 PMCID: PMC10028890 DOI: 10.1101/2023.03.07.531496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND Highly palatable food triggers behavioral alterations reminiscent of those induced by addictive drugs. These effects involve the reward system and dopamine neurons, which modulate neurons in the nucleus accumbens (NAc). The molecular mechanisms underlying the effects of highly palatable food on feeding behavior are poorly understood. METHODS We studied the effects of 2-week operant conditioning of mice with standard or isocaloric highly palatable food. We investigated the behavioral effects and dendritic spine modifications in the NAc. We compared the translating mRNA in NAc neurons identified by the type of dopamine receptors they express, depending on the type of food and training. We tested the consequences of invalidation of an abundant downregulated gene, Ncdn (Neurochondrin). RESULTS Operant conditioning for highly palatable food increases motivation for food even in well-fed mice. In control mice, free access to regular or highly palatable food results in increased weight as compared to regular food only. Highly palatable food increases spine density in the NAc. In animals trained for highly palatable food, translating mRNAs are modified in NAc dopamine D2-receptor-expressing neurons, mostly corresponding to striatal projection neurons, but not in those expressing D1-receptors. Knock-out of Ncdn, an abundant down-regulated gene, opposes the conditioning-induced changes in satiety-sensitive feeding behavior and apparent motivation for highly palatable food, suggesting down-regulation may be a compensatory mechanism. CONCLUSIONS Our results emphasize the importance of mRNA alterations D2 striatal projection neurons in the NAc in the behavioral consequences of highly palatable food conditioning and suggest a modulatory contribution of Ncdn downregulation.
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23
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Thrailkill EA, DeSarno M, Higgins ST. Intersections between environmental reward availability, loss aversion, and delay discounting as potential risk factors for cigarette smoking and other substance use. Prev Med 2022; 165:107270. [PMID: 36152818 PMCID: PMC10876085 DOI: 10.1016/j.ypmed.2022.107270] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 09/08/2022] [Accepted: 09/17/2022] [Indexed: 02/03/2023]
Abstract
Behavioral theory suggests that density of environmental rewarding activities and biases in decision making influence risk for substance use disorder (SUD). To better understand intersections of these potential risk factors, this study examined whether environmental reward predicted smoking status or other drug use and whether such associations were independent of two decision-making biases known to predict SUD risk, namely loss aversion and delay discounting. Individuals that reported current daily cigarette smoking (n = 186; >10 cigarettes/day) and never-smoking (n = 241; <100 cigarettes lifetime) were recruited with standard crowdsourcing methods. Participants answered questions on alcohol and other drug use. Environmental reward was assessed using the Reward Probability Index (RPI), and loss aversion (LA) and delay discounting (DD) using a gamble-acceptance task and monetary choice questionnaire, respectively. Associations of RPI, LA, and DD with cigarette smoking, alcohol use, other drug use, and combinations of co-use were examined with logistic regression controlling for sociodemographic variables (educational attainment, gender, age). Low RPI (odds ratio[OR] = 0.97, p = .006), low LA (OR = 1.22, p < .001), and high DD (OR = 1.12, p = .03), were each independently associated with increased risk for cigarette smoking, as well as other substance use, and use combinations. We saw no evidence that RPI was significantly influencing associations between LA and DD with smoking status or other substance use. Finally, RPI, but not LA or DD, was significantly associated with depressed mood and sleep disturbance. These results provide new evidence on associations of RPI with smoking status and other substance use while further documenting independent associations between LA and DD and those outcomes.
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Affiliation(s)
- Eric A Thrailkill
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Department of Psychological Science, University of Vermont, Burlington, VT, USA; Department of Psychiatry, University of Vermont, Burlington, VT, USA.
| | - Michael DeSarno
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Department of Biomedical Statistics, University of Vermont, Burlington, VT, USA
| | - Stephen T Higgins
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Department of Psychological Science, University of Vermont, Burlington, VT, USA; Department of Psychiatry, University of Vermont, Burlington, VT, USA
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24
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Lynn S, Satyal MK, Smith AJ, Tasnim N, Gyamfi D, English DF, Suzuki WA, Basso JC. Dispositional mindfulness and its relationship to exercise motivation and experience. Front Sports Act Living 2022; 4:934657. [PMID: 36524058 PMCID: PMC9745059 DOI: 10.3389/fspor.2022.934657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 10/14/2022] [Indexed: 01/11/2024] Open
Abstract
Mindfulness is the psychological state of staying attuned to the present moment, without ruminating on past or future events, and allowing thoughts, feelings, or sensations to arise without judgment or attachment. Previous work has shown that heightened dispositional mindfulness is associated with the awareness of the importance of exercise, exercise self-efficacy, exercise motivation, and self-reported exercise level. However, more methodologically rigorous studies are needed to understand the relationship between mindfulness and the psychological mechanisms related to exercise motivation, including the identification of why individuals are motivated to engage in exercise, the subjective experience of exercise, and the propensity for exercise dependence and addiction. In this cross-sectional investigation, we utilized the framework of the Self-Determination Theory to examine the hypothesis that heightened dispositional mindfulness (as measured by the Mindful Attention Awareness Scale) would be associated with increased levels of exercise motivation that were derived by higher levels of autonomous self-regulation. Individuals were recruited from urban areas who self-reported either low (exercising 2 or fewer times per week for 20 min or less; n = 78) or moderate (exercising 1 or 2 times per week for 20 min or more; n = 127) levels of exercise engagement. As hypothesized, heightened dispositional mindfulness was significantly associated with heightened levels of exercise self-determination as measured by the Behavioral Regulations in Exercise Questionnaire, with this effect being driven by negative associations with amotivation, external regulation, and introjected regulation. Additionally, we found that heightened dispositional mindfulness was associated with lower levels of psychological distress upon exercise and decreased exercise dependence/addiction. Overall, increased dispositional mindfulness may support a healthy relationship with exercise. These findings have implications for the utility of mindfulness interventions to support the regulation of exercise behaviors in service of enhancing exercise motivation and engagement.
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Affiliation(s)
- Sarah Lynn
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States
| | - Medha Kumari Satyal
- Translational Biology, Medicine, and Health Graduate Program, Virginia Tech, Blacksburg, VA, United States
| | - Alana J. Smith
- School of Neuroscience, Virginia Tech, Blacksburg, VA, United States
| | - Noor Tasnim
- Translational Biology, Medicine, and Health Graduate Program, Virginia Tech, Blacksburg, VA, United States
| | - Daphne Gyamfi
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States
| | - Daniel F. English
- School of Neuroscience, Virginia Tech, Blacksburg, VA, United States
| | - Wendy A. Suzuki
- Center for Neural Science, New York University, New York, NY, United States
| | - Julia C. Basso
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States
- School of Neuroscience, Virginia Tech, Blacksburg, VA, United States
- Center for Health Behaviors Research, Fralin Biomedical Research Institute at VTC, Roanoke, VA, United States
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25
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Brown JM, Stein JS. Putting prospection into practice: Methodological considerations in the use of episodic future thinking to reduce delay discounting and maladaptive health behaviors. Front Public Health 2022; 10:1020171. [PMID: 36408004 PMCID: PMC9669959 DOI: 10.3389/fpubh.2022.1020171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
In recent years, episodic future thinking (EFT) has emerged as a promising behavioral intervention to reduce delay discounting or maladaptive health behaviors; however, considerable methodological heterogeneity in methods for eliciting engagement in EFT has been observed in prior research. In this narrative review, we briefly describe methods for generating EFT cues, the content of EFT cues, common control conditions for experiments utilizing EFT, and considerations for cue delivery and implementation. Where possible, we make suggestions for current best practices in each category while identifying gaps in knowledge and potential areas of future research. Finally, we conclude by using the NIH Stage model to better frame the current state of the literature on EFT and propose gaps to be addressed if EFT is to be both an efficacious and effective behavioral intervention.
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Affiliation(s)
- Jeremiah Michael Brown
- Fralin Biomedical Research Institute, Virginia Tech Carilion, Roanoke, VA, United States
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Tech, Blacksburg, VA, United States
| | - Jeffrey Scott Stein
- Fralin Biomedical Research Institute, Virginia Tech Carilion, Roanoke, VA, United States
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Tech, Blacksburg, VA, United States
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26
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Mattes RD, Rowe SB, Ohlhorst SD, Brown AW, Hoffman DJ, Liska DJ, Feskens EJM, Dhillon J, Tucker KL, Epstein LH, Neufeld LM, Kelley M, Fukagawa NK, Sunde RA, Zeisel SH, Basile AJ, Borth LE, Jackson E. Valuing the Diversity of Research Methods to Advance Nutrition Science. Adv Nutr 2022; 13:1324-1393. [PMID: 35802522 PMCID: PMC9340992 DOI: 10.1093/advances/nmac043] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/08/2022] [Indexed: 12/13/2022] Open
Abstract
The ASN Board of Directors appointed the Nutrition Research Task Force to develop a report on scientific methods used in nutrition science to advance discovery, interpretation, and application of knowledge in the field. The genesis of this report was growing concern about the tone of discourse among nutrition professionals and the implications of acrimony on the productive study and translation of nutrition science. Too often, honest differences of opinion are cast as conflicts instead of areas of needed collaboration. Recognition of the value (and limitations) of contributions from well-executed nutrition science derived from the various approaches used in the discipline, as well as appreciation of how their layering will yield the strongest evidence base, will provide a basis for greater productivity and impact. Greater collaborative efforts within the field of nutrition science will require an understanding that each method or approach has a place and function that should be valued and used together to create the nutrition evidence base. Precision nutrition was identified as an important emerging nutrition topic by the preponderance of task force members, and this theme was adopted for the report because it lent itself to integration of many approaches in nutrition science. Although the primary audience for this report is nutrition researchers and other nutrition professionals, a secondary aim is to develop a document useful for the various audiences that translate nutrition research, including journalists, clinicians, and policymakers. The intent is to promote accurate, transparent, verifiable evidence-based communication about nutrition science. This will facilitate reasoned interpretation and application of emerging findings and, thereby, improve understanding and trust in nutrition science and appropriate characterization, development, and adoption of recommendations.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Leonard H Epstein
- University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | | | - Michael Kelley
- Michael Kelley Nutrition Science Consulting, Wauwatosa, WI, USA
| | - Naomi K Fukagawa
- USDA Beltsville Human Nutrition Research Center, Beltsville, MD, USA
| | | | - Steven H Zeisel
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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27
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Basso JC, Satyal MK, Athamneh L, Bickel WK. Changes in temporal discounting, hedonic hunger, and food addiction during recovery from substance misuse. Appetite 2022; 169:105834. [PMID: 34871591 PMCID: PMC8790806 DOI: 10.1016/j.appet.2021.105834] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/26/2021] [Accepted: 11/30/2021] [Indexed: 02/06/2023]
Abstract
Substance use disorders (SUDs) and obesity are both chronic, relapsing, remitting disorders that arise from a heightened preference for immediate-focused rewards (i.e., steep temporal discounting). During recovery from SUDs, overweight and obese outcomes are common as individuals may replace drug rewards for food rewards. However, little has been done to investigate the neuropsychological processes underlying food reward and addiction in individuals recovering from SUDs. Using data collected from the International Quit and Recovery Registry and Amazon Mechanical Turk, we aimed to elucidate the factors that influence the attraction to palatable foods in a population in recovery from substance misuse (n = 114) as well as a population with no history of substance misuse (n = 97). We hypothesized that individuals in recovery from substance misuse would have steeper temporal discounting, an increased drive for palatable foods (i.e., hedonic hunger), and greater food addiction symptoms than non-substance users. Contrary to our hypotheses, we found that individuals in recovery from SUDs show improved outcomes in temporal discounting, hedonic hunger, and food addiction symptoms. Moreover, recovery status and temporal discounting significantly predicted these outcomes. Our findings suggest that the enhanced executive control processes needed for successful SUD recovery may transfer to other reward-related processes such as food reward and consumption. Interventions targeted at improving executive function including episodic future thinking, meditation, or exercise, may be excellent ways to support a successful recovery and improve other reward-related processes, including food consumption, to decrease the risk of overweight or obese outcomes during recovery.
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Affiliation(s)
- Julia C Basso
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, 2 Riverside Circle, Roanoke, VA, USA; Center for Transformative Research on Health Behaviors, Fralin Biomedical Research Institute at VTC, 1 Riverside Circle, Roanoke, VA, USA; Department of Human Nutrition, Foods and Exercise, Virginia Tech, 1981, Kraft Dr., Blacksburg, VA, USA
| | - Medha K Satyal
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, 1981, Kraft Dr., Blacksburg, VA, USA
| | - Liqa Athamneh
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, 2 Riverside Circle, Roanoke, VA, USA
| | - Warren K Bickel
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, 2 Riverside Circle, Roanoke, VA, USA; Center for Transformative Research on Health Behaviors, Fralin Biomedical Research Institute at VTC, 1 Riverside Circle, Roanoke, VA, USA.
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