Episodic future thinking improves intertemporal choice and food choice in individuals with higher weight: A systematic review and meta-analysis

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.

Hunger, Satiety, and Their Vulnerabilities

The psychological states of hunger and satiety play an important role in regulating human food intake. Several lines of evidence suggest that these states rely upon declarative learning and memory processes, which are based primarily in the medial temporal lobes (MTL). The MTL, and particularly the hippocampus, is unusual in that it is especially vulnerable to insult. Consequently, we examine here the impact on hunger and satiety of conditions that: (1) are central to ingestive behaviour and where there is evidence of MTL pathology (i.e., habitual consumption of a Western-style diet, obesity, and anorexia nervosa); and (2) where there is overwhelming evidence of MTL pathology, but where ingestive behaviour is not thought central (i.e., temporal lobe epilepsy and post-traumatic stress disorder). While for some of these conditions the evidence base is currently limited, the general conclusion is that MTL impairment is linked, sometimes strongly, to dysfunctional hunger and satiety. This focus on the MTL, and declarative learning and memory processes, has implications for the development of alternative treatment approaches for the regulation of appetite.

The relationship between the food intake frequency, weight status and intelligence in school children

This study aimed to explore the relationship between food intake frequency, weight status, and intelligence among school children. A cross-sectional study involved 562 children (aged 6.3-12.7 years) randomly selected from five elementary schools in Taichung City, Taiwan. Demographic information was collected, and the children's body weight and height were measured to calculate their body mass index. A food frequency questionnaire assessed the participating children's dietary habits. Intelligence quotient scores were evaluated using Raven's colored progress matrices for first and second graders, and Raven's standard progressive matrices for third to sixth graders. This study found that there was no significant relationship in intelligence quotient scores between gender, birth order groups, and weight status. The higher consumption of pork liver, hamburgers, fruit juices, and the Taiwanese snack "Science Noodles" was associated with lower intelligence quotient scores among school children.

Sensing the Snacking Experience: Bodily Sensations Linked to the Consumption of Healthy and Unhealthy Snack Foods-A Comparison between Body Mass Index Levels

The World Health Organisation (WHO) has highlighted the need for immediate action regarding the escalating global prevalence of overweight and obesity. Based on the need for long-term strategies supporting dietary behaviour changes, the concept of 'interoception' (i.e., sensing the body's internal state) has been proposed as promising for understanding and controlling food intake behaviours. As eating behaviours are motivated by the need for securing energy demands as well as the desire for pleasure, investigating the bodily sensations perceived in relation to food consumption can support our understanding of human food and eating behaviours. Here, a consumer study was conducted on 286 Danish consumers to explore the interoceptive experience of snack food consumption. This study included an investigation of the consumers' interoceptive capabilities and ability to feel pleasure, intuitive eating behaviours, snack food consumption frequency, the drivers of snack food consumption, food-related pleasure, and post-ingestive sensations linked to snack food consumption. The study was conducted on consumers with different Body Mass Index (BMI) levels to study potential differences between these groups. The study showed normal interoceptive capabilities and abilities to feel pleasure, with no differences between BMI groups. Regarding intuitive eating, the study found intuitive eating to be more prevalent among the group holding normal BMI. No significant differences between BMI groups were found in terms of snack intake frequency. However, differences between BMI groups were found in terms of: the drivers of snack consumption, the aspects bringing food-related pleasure from snack consumption, and the post-ingestive sensations felt after eating snack foods.

The psychological basis of reductions in food desire during satiety

Satiety-the reduced desire to eat, drink or have sex in their respective aftermath-is particularly important for feeding, where it assists energy balance. During satiety, the anticipated pleasure of eating is far less than the actual pleasure of eating. Here we examine two accounts of this effect: (i) satiety signals inhibit retrieval of pleasant food memories that form desirable images, allowing unpleasant memories into mind; (ii) feelings of fullness reflect what eating would be like now, negating the need for imagery. To test these accounts, participants undertook two tasks pre- and post-lunch: (i) judging desire for palatable foods either with or without imagery impairing manipulations; (ii) explicitly recollecting food memories. Impairing imagery reduced desire equally, when hungry and sated. Food-memory recollections became more negative/less positive when sated, with this correlating with changes in desire. These findings support the first account and suggest imagery is used when hungry and when sated to simulate eating, and that the content of these memory-based simulations changes with state. The nature of this process and its implications for satiety more generally are discussed.

Nutrition Patterns of Polish Esports Players

The aim of this study was to quantify the dietary patterns (DPs) of Polish esports players aged 18-26 years. Data were obtained via questionnaires that assessed dietary habits and frequency of food consumption. Dietary patterns were derived using Principal Component Analysis (PCA) and Factor Analysis (FA). In total, nine distinct DPs were identified. Eight DPs were considered unhealthy; 'fast food', 'High-processed food, meat and confectionery', 'Sweet', 'Fat-diary products', 'Vegetable-fruit', 'Spices and additives', 'Fats' and 'Cereal'; and only one was deemed healthy. E-athletes presented mostly poor dietary habits, which included: irregular eating of meals, frequent snacking, at least three meals a day and composition of snacks, frying of meat dishes and sweetening of hot drinks. Healthy dietary habits included proper hydration during the day and consumption of mainly non-sparkling water. The unbalanced and largely unhealthy dietary habits of esports players raise health concerns for these e-athletes, particularly when combined with a sedentary lifestyle. Future research could assess the nutritional knowledge of this group as it relates to national guidelines, investigate interventions designed to introduce healthier eating options into their lifestyle and examine the relationship between DPs and health or cognitive performance.

Appetitive interoception, the hippocampus and western-style diet

Obesity, Type 2 diabetes and other metabolic disorders continue to pose serious challenges to human health and well-being. An important source of these challenges is the overconsumption of saturated fats and sugar, main staples of what has been called the Western-style diet (WD). The current paper describes a theoretical model and supporting evidence that links intake of a WD to interference with a specific brain substrate that underlies processing of interoceptive signals of hunger and satiety. We review findings from rats and humans that the capacity of these signals to modulate the strength of appetitive and eating behavior depends on the functional integrity of the hippocampus and the learning memory operations it performs. Important among these operations is the use of contextual information to retrieve memories that are associated with other events. Within our framework, satiety provides an interoceptive context that informs animals that food cues and appetitive behavior will not be followed by rewarding postingestive outcomes. This serves to prevent those cues and responses from retrieving those reward memories. The findings reviewed provide evidence that consuming a WD and the high amounts of saturated fat and sugar it contains (a) is associated with the emergence of pathophysiologies to which the hippocampus appears selectively vulnerable (b) impairs hippocampal-dependent learning and memory (HDLM) and (c) weakens behavioral control by interoceptive hunger and satiety contextual stimuli. It is hypothesized that these consequences of WD intake may establish the conditions for a vicious cycle of further WD intake, obesity, and potentially cognitive decline.

Retrieval-induced forgetting in children and adolescents with and without obesity

BACKGROUND/OBJECTIVES

Previous research indicates that youth with obesity exhibit deficits in executive functioning (EF), which often take the form of impaired response inhibition. One aspect of EF not previously studied in obesity is the adaptive process known as retrieval-induced forgetting (RIF), the suppression/inhibition of intrusive or non-target items by the retrieval of specific items from memory. The present study investigated if child or adolescent obesity disrupts the ability to inhibit retrieval of intrusive memories.

SUBJECTS/METHODS

We compared the manifestation of RIF in children (ages 8-12) and adolescents (ages 13-18) as a function of their weight status and sex. We also evaluated the effects of these variables on simple recall of items from episodic memory under conditions where competition from intrusive items was reduced.

RESULTS

Children with obesity did not demonstrate significant RIF, whereas RIF was exhibited by preteens without obesity and by teenage participants with- and without obesity (Weight Status × Age Group interaction p = 0.028). This pattern of results did not differ as a function of sex for either age group. No differences in episodic memory were found. Additional analyses using Age as continuous covariate (and not as a nominal group) comparing participants who exhibited RIF with those who did not, found that the no RIF group consumed fast-food meals more frequently (p = 0.024) and had higher percentages of total body adiposity and android fat compared to the RIF group (p's < 0.05).

CONCLUSIONS

The findings expand what is known about the effects of childhood obesity on cognitive functioning, identify impaired RIF with specific behavioral and dietary factors and increased adiposity, and suggest the possibility that impairments in the ability to inhibit intrusive memories of food and eating may contribute to poor early-life weight control.

Performance Nutrition for Physician Trainees Working Overnight Shifts: A Randomized Controlled Trial

PURPOSE

To compare acute effects of 2 dietary interventions with usual dietary habits on physician trainees' alertness during overnight shifts.

METHOD

This registered, controlled, block randomized crossover trial (NCT03698123) was conducted between October 2018 and May 2019 at Stanford Medicine. Physician trainees working at least 3 overnight shifts during a 1-week period were recruited. During the first night, participants followed their usual dietary habits. During the intervention nights (low carbohydrate-to-protein ratio and high carbohydrate-to-protein ratio interventions), participants received healthy dinners, snacks, water, and, upon request, caffeinated beverages, at the beginning of their shifts and were instructed to eat meals before 10 pm. The sequence of interventions on the second and third nights were block randomized across study weeks. Outcome measures (a priori) were overnight changes in validated measures of specific neurobehavioral dimensions: psychomotor vigilance, sensory-motor speed, working memory, and risk decision making, as well as self-reported sleepiness and work exhaustion.

RESULTS

Sixty-one physician trainees participated in this study. Compared with usual dietary habits, overnight changes in psychomotor vigilance scores (scale 0-1,000) improved by 51.02 points (95% CI: 12.08, 89.96) and sleepiness (scale 1-7) improved by 0.69 points (95% CI: 0.33, 1.05) under the low carbohydrate-to-protein ratio intervention. Compared with usual dietary habits, overnight changes in sleepiness (scale 1-7) improved by 0.61 points (95% CI: 0.25, 0.96) under the high carbohydrate-to-protein ratio intervention. Neither intervention had beneficial effects relative to usual dietary habits with respect to sensory-motor speed, working memory, risk decision making, or work exhaustion. There were no differences in outcomes between low carbohydrate-to-protein ratio and high carbohydrate-to-protein ratio interventions.

CONCLUSIONS

Dietary interventions may mitigate negative effects of physician trainee sleep deprivation during overnight shifts. Future studies are warranted to further examine the effectiveness of nutritional strategies on physician alertness during overnight shifts.

High sucrose diet does not impact spatial cognition in rats using advanced touchscreen technology

INTRODUCTION

Western diets, including those consisting of saturated fats, simple sugars and processed foods, is rising at an unprecedented rate. These lead to obesity and metabolic diseases, and possibly cognitive deficits. Exploring this, recent studies demonstrate marked impairment in spatial learning in rodents exposed to high-sugar diets. We utilised advanced touchscreen technology to assess several spatial and non-spatial components of cognition in rats chronically exposed to a high sucrose diet.

METHODS

Male Wistar rats received 70 ml of 10% sucrose solution each day, or control tap water, persisting for the experiment duration (total n = 32). After 5 weeks of diet, rats performed Pairwise Discrimination, Location Discrimination, or Progressive Ratio tasks on automated touchscreens, and performance compared between groups.

RESULTS

Sucrose rats consumed all the sugar solution provided to them, and had significantly increased caloric intake, compared to controls (p < 0.0001). However, in all tests, we found no significant difference in cognitive performance between Sucrose and Control treated rats. This included the number of trials for acquisition, and reversal, in Pairwise Discrimination, and number of trials required to complete Location Discrimination (p > 0.05 for all outcomes). No differences were observed in perseverative behaviour, motivation levels, or processing speed.

CONCLUSION

Our study found no evidence to suggest that chronic consumption of sucrose impairs cognition, including both spatial and non-spatial learning tasks. These findings suggest that not all aspects of spatial cognition are negatively impacted by high sugar diet in rodents, and that particular use of touchscreen technology may probe different aspects of cognition than traditional tasks.

Memory and eating: A bidirectional relationship implicated in obesity

This paper reviews evidence demonstrating a bidirectional relationship between memory and eating in humans and rodents. In humans, amnesia is associated with impaired processing of hunger and satiety cues, disrupted memory of recent meals, and overconsumption. In healthy participants, meal-related memory limits subsequent ingestive behavior and obesity is associated with impaired memory and disturbances in the hippocampus. Evidence from rodents suggests that dorsal hippocampal neural activity contributes to the ability of meal-related memory to control future intake, that endocrine and neuropeptide systems act in the ventral hippocampus to provide cues regarding energy status and regulate learned aspects of eating, and that consumption of hypercaloric diets and obesity disrupt these processes. Collectively, this evidence indicates that diet-induced obesity may be caused and/or maintained, at least in part, by a vicious cycle wherein excess intake disrupts hippocampal functioning, which further increases intake. This perspective may advance our understanding of how the brain controls eating, the neural mechanisms that contribute to eating-related disorders, and identify how to treat diet-induced obesity.

Influence of pro-obesogenic dietary habits on stress-induced cognitive alterations in healthy adult volunteers

Stress is a fundamental biological response that can be associated with alterations in cognitive processes. Unhealthy dietary habits are proposed to modulate this effect, notably through their pro-inflammatory potential. This cross-sectional study aimed to evaluate the influence of an obesogenic dietary pattern with inflammatory potential on stress-induced cognitive alterations in healthy volunteers. Fifty healthy adult participants were stratified into two diet groups: obesogenic vs. non-obesogenic, based on their self-reported consumption of fat, sugar, and salt, assessed by the French National Program for Nutrition and Health questionnaire and a food frequency questionnaire. Serum high-sensitive C-reactive protein (hsCRP) was measured as a marker of systemic inflammation using ELISA. Verbal memory and sustained attention were evaluated through the Verbal Recognition Memory (VRM) test and the Rapid Visual Information Processing (RVP) test respectively, from the Cambridge Neuropsychological Test Automated Battery. Assessments were performed before and after exposure to the psychological stressor Trier Social Stress Test (TSST). Stress response was evaluated by subjective stress perception, salivary cortisol, blood pressure, and heart rate. Twenty-two participants (44%) presented an obesogenic diet. Systemic inflammation was significantly higher in the obesogenic diet group (p=0.005). The TSST induced a significant stress response, regardless of dietary habits (Time effect p < 0.001). In the whole sample, exposure to TSST was associated with cognitive changes in the form of impaired performance on the VRM test and overall improved RVP scores. However, the obesogenic diet group exhibited an increased total number of false alarms (Time x Diet: p=0.014) on the RVP test after TSST exposure as well as a greater impairment in immediate verbal recognition on the VRM test (Time x Diet: p=0.002). This effect was not associated with the inflammatory component of the obesogenic diet. These results suggest that an obesogenic diet may sensitize healthy individuals to the detrimental effects of acute stress on cognitive performance.

The impact of saturated fat, added sugar and their combination on human hippocampal integrity and function: A systematic review and meta-analysis

Paralleling animal research, there is emerging evidence that a Western-style (WS) diet - high in saturated fat and added sugar - impairs human hippocampal functioning. However, the conditions under which this occurs are not fully understood and there have been published failures to detect such effects. To date, there has been no systematic review or meta-analysis of relevant human studies. We undertook a systematic database search and review. Twenty studies were identified, two experimental, with the remainder correlational. The latter were included in a meta-analyses on the impact of WS-diet and its macronutrient components on human hippocampal function. Effects of age and sex were also examined. A WS-diet adversely impacted human hippocampal volume and functioning, with a small-pooled effect size. No effects were found for individual macronutrients. There was a high-level of study heterogeneity, which was not fully explained by study/sample characteristics. This may arise via the wide range of assessment tools used to measure both dietary intake and hippocampal functioning. Overall, a WS-diet clearly impacts human hippocampal functioning as in animals.

Unravelling the impacts of western-style diets on brain, gut microbiota and cognition

The steady rise in the prevalence of obesity has been fostered by modern environments that reduce energy expenditure and encourage consumption of 'western'-style diets high in fat and sugar. Obesity has been consistently associated with impairments in executive function and episodic memory, while emerging evidence indicates that high-fat, high-sugar diets can impair aspects of cognition within days, even when provided intermittently. Here we review the detrimental effects of diet and obesity on cognition and the role of inflammatory and circulating factors, compromised blood-brain barrier integrity and gut microbiome changes. We next evaluate evidence for changing risk profiles across life stages (adolescence and ageing) and other populations at risk (e.g. through maternal obesity). Finally, interventions to ameliorate diet-induced cognitive deficits are discussed, including dietary shifts, exercise, and the emerging field of microbiome-targeted therapies. With evidence that poor diet and obesity impair cognition via multiple mechanisms across the human lifespan, the challenge for future research is to identify effective interventions, in addition to diet and exercise, to prevent and ameliorate adverse effects.

Exploratory dietary patterns and cognitive function in the "Seguimiento Universidad de Navarra" (SUN) Prospective Cohort

BACKGROUND

Dementia is projected to affect 135 million by 2050. Diet is a pertinent target for primary prevention, but firm recommendations for dementia prevention are not available yet. Our aim was to address the association between exploratory (empirically derived) dietary patterns (DP) and changes in the Spanish Telephone Interview for Cognitive Status (STICS-m, maximum score = 41 points) over 6 years.

METHOD

Information on diet was collected with a validated 136-item food-frequency questionnaire from 803 participants in the Mediterranean cohort "Seguimiento Universidad de Navarra." We used principal component analysis to derive exploratory DP. The derived DP were associated with change in STICS-m scores over 6 years, through adjusted multiple linear regression models.

RESULTS

Two main DP were identified. The first DP resembled a Western dietary pattern (WDP)-high in sugar, fat, processed foods, and red meat-and the second DP resembled a Mediterranean dietary pattern (MDP)-high in vegetables, fruits, nuts, fish, and olive oil. Adherence to the WDP (tertile 3 vs tertile 1) was significantly associated with negative STICS-m changes after 6 years (between-tertile difference in changes: -0.80 points; 95% confidence interval [CI] -1.51, -0.08, p value = 0.03). Meanwhile, the MDP showed a positive +0.71 point (95% CI 0.15, 1.26, p value = 0.01) between-tertile difference in changes in the STICS-m score.

CONCLUSIONS

A healthy, prudent, MDP was associated with less decline in cognitive function and, thus, could help to lower dementia incidence. Western-type diets were associated with a greater decline in cognitive performance and could increase dementia incidence.

Evidence of a Role for the Hippocampus in Food-Cue Processing and the Association with Body Weight and Dietary Added Sugar

OBJECTIVE

The current analysis used functional magnetic resonance imaging (fMRI) to explore a model of energy regulation postulating that the hippocampus integrates interoceptive signals and environmental stimuli to suppress responding to food cues. It was hypothesized that hippocampal activity would increase in response to food cues under postnutritive relative to fasted conditions, given the role of the hippocampus in integrating postnutritive signals with food cues, and that obesity, added sugar intake, or a combination of these factors would alter this response.

METHODS

Data were analyzed on 65 participants (29 males). Participants consumed drinks containing 75 g of glucose or water and underwent an fMRI-based food-cue task. Blood-oxygen-level-dependent (BOLD) fMRI was used to examine hippocampal responses to food and nonfood cues.

RESULTS

In lean participants, the hippocampal BOLD signal was higher following glucose compared with water, but participants with obesity showed the opposite pattern. BMI interacted with added sugar intake such that BMI was more negatively correlated with hippocampal food-cue reactivity after glucose ingestion in individuals who consumed high levels of added sugar. Hippocampal BOLD was negatively correlated with prospective food intake.

CONCLUSIONS

The findings are consistent with the view that energy regulation involves hippocampal processes in humans and that added sugar and excess weight may impair this function.

Visual, Verbal and Everyday Memory 2 Years After Bariatric Surgery: Poorer Memory Performance at 1-Year Follow-Up

Severe obesity has been associated with reduced performance on tests of verbal memory in bariatric surgery candidates. There is also some evidence that bariatric surgery leads to improved verbal memory, yet these findings need further elucidation. Little is known regarding postoperative memory changes in the visual domain and how patients subjectively experience their everyday memory after surgery. The aim of the current study was to repeat and extend prior findings on postoperative memory by investigating visual, verbal, and self-reported everyday memory following surgery, and to examine whether weight loss and somatic comorbidity predict memory performance. The study was a prospective, observational study in which participants (n = 48) underwent cognitive testing at baseline, 1 and 2 years after bariatric surgery. Repeated measures analyses of variance revealed significantly poorer visual and verbal memory performance at the 1-year follow-up, with performance subsequently returning to baseline levels after 2 years. Verbal learning and self-reported everyday memory did not show significant postoperative changes. Memory performance at 1 year was not significantly predicted by weight loss, changes in C-reactive protein levels or postoperative somatic comorbidity (Type 2 diabetes, sleep apnea, and hypertension). The study demonstrated poorer visual and verbal memory performance at 1-year follow-up that returned to baseline levels after 2 years. These findings are in contrast to most previous studies and require further replication, however, the results indicate that postoperative memory improvements following bariatric surgery are not universal. Findings suggest that treatment providers should also be aware of patients potentially having poorer memory at 1 year following surgery.

From Obesity to Hippocampal Neurodegeneration: Pathogenesis and Non-Pharmacological Interventions

High-caloric diet and physical inactivity predispose individuals to obesity and diabetes, which are risk factors of hippocampal neurodegeneration and cognitive deficits. Along with the adipose-hippocampus crosstalk, chronically inflamed adipose tissue secretes inflammatory cytokine could trigger neuroinflammatory responses in the hippocampus, and in turn, impairs hippocampal neuroplasticity under obese and diabetic conditions. Hence, caloric restriction and physical exercise are critical non-pharmacological interventions to halt the pathogenesis from obesity to hippocampal neurodegeneration. In response to physical exercise, peripheral organs, including the adipose tissue, skeletal muscles, and liver, can secret numerous exerkines, which bring beneficial effects to metabolic and brain health. In this review, we summarized how chronic inflammation in adipose tissue could trigger neuroinflammation and hippocampal impairment, which potentially contribute to cognitive deficits in obese and diabetic conditions. We also discussed the potential mechanisms underlying the neurotrophic and neuroprotective effects of caloric restriction and physical exercise by counteracting neuroinflammation, plasticity deficits, and cognitive impairments. This review provides timely insights into how chronic metabolic disorders, like obesity, could impair brain health and cognitive functions in later life.

The Aetiology of Olfactory Dysfunction and Its Relationship to Diet Quality

People with olfactory loss may choose foods rich in sugar, salt and fat to compensate their loss—foods that constitute a Western-style diet (WSD). However, olfactory dysfunction has not been consistently linked to any particular type of dietary change. Here we considered whether the aetiology of olfactory dysfunction may affect consumption of a WSD. Two-hundred and twenty-two people with olfactory dysfunction of varying cause, were tested for chemosensory performance and their frequency of consumption of a WSD. There was no evidence of a link between a WSD and olfactory dysfunction at the aggregate level, but an aetiology-based approach revealed various patterns, showing both positive and negative associations between olfactory performance and consumption of a WSD. We suggest a number of reasons why, in certain cases, greater olfactory dysfunction may be linked to lower intakes of a WSD, and the role that different aetiologies may have in affecting choices for foods that may appeal following olfactory impairment.

Added sugar and dietary fiber consumption are associated with creativity in preadolescent children

Objectives: Creativity requires the ability to combine existing mental representations in new ways and depends, in part, on the hippocampus. Hippocampal function is, in turn, affected by a number of health factors, including aerobic fitness, excess adiposity, and diet. Specifically, in rodent studies, diets high in saturated fatty acids and sugar - hallmarks of a western diet- have been shown to negatively impact hippocampal function and thereby impair performance on cognitive tasks that require the hippocampus. Yet relatively few studies have examined the relationship between diet and hippocampal-dependent cognition in children. Methods: The current study therefore sought to explore the relationship of several diet quality markers including dietary lipids (saturated fatty acids and omega-3 fatty acids), simple carbohydrates (added sugars), and dietary fiber with creativity in preadolescent children. Participants (N = 57; mean age = 9.1 years) completed the Verbal Form of the Torrance Test of Creative Thinking (TTCT), a standardized test of creativity known to require the hippocampus. Additionally, participants completed a 3-day food intake record with the assistance of a parent, underwent dual energy x-ray absorptiometry (DXA) to assess central adiposity, and VO2max testing to assess aerobic fitness. Results: Added sugar intake was negatively associated, and dietary fiber was positively associated with overall TTCT performance. These relationships were sustained even after controlling for key covariates. Discussion: These findings are among the first to report an association between added sugar consumption and hippocampal-dependent cognition during childhood and, given the key role of the hippocampus in learning and memory, as well as creative thinking, have potential educational and public health implications.

The impact of hippocampal damage on appetitive control

Animal data indicates the hippocampus assists appetite-regulation.  We tested this in humans, contrasting two patients (DW, JC) with hippocampal damage to controls on an appetite-regulation test conducted hungry and sated.  When hungry, controlsviewed palatable snacks and reported a desire to eat them, a memory-based judgment.  After sampling them, they reported liking their taste.  Post-lunch (DW ate little, precluding a test of our hypothesis), controls showed a large decrease in desire for the snacks, but less change in taste-liking.  JC ate like controls, but reported no change in desire across states, suggesting that the human hippocampus also contributes to appetite-regulation.

Appetitive traits as targets for weight loss: The role of food cue responsiveness and satiety responsiveness

Individuals with overweight or obesity (OW/OB) are at increased risk for significant physical and psychological comorbidities. The current treatment for OW/OB is behavioral weight loss, which provides psychoeducation on nutrition and physical activity, as well as behavior therapy skills. However, behavioral weight loss is not effective for the majority of the individuals who participate. Research suggests that overeating, or eating past nutritional needs, is one of the leading causes of weight gain. Accumulating evidence suggests that appetitive traits, such as food cue responsiveness and satiety responsiveness, are associated with overeating and weight in youth and adults. The following review presents the current literature on the relationship between food cue responsiveness, satiety responsiveness, overeating, and OW/OB. Research suggests that higher food cue responsiveness and lower satiety responsiveness are associated with overeating and OW/OB cross-sectionally and longitudinally. Emerging data suggest that food cue responsiveness and satiety responsiveness may exist along the same continuum and can be targeted to manage overeating and reduce weight. We have developed a treatment model targeting food cue responsiveness and satiety responsiveness to reduce overeating and weight and have preliminary feasibility, acceptability, and efficacy data, with testing currently being conducted in larger trials. Through programs targeting appetitive traits we hope to develop an alternative weight loss model to assist individuals with a propensity to overeat.

The obesity epidemic in the face of homeostatic body weight regulation: What went wrong and how can it be fixed?

Ever since the pioneering discoveries in the mid nineteen hundreds, the hypothalamus was recognized as a crucial component of the neural system controlling appetite and energy balance. The new wave of neuron-specific research tools has confirmed this key role of the hypothalamus and has delineated many other brain areas to be part of an expanded neural system sub serving these crucial functions. However, despite significant progress in defining this complex neural circuitry, many questions remain. One of the key questions is why the sophisticated body weight regulatory system is unable to prevent the rampant obesity epidemic we are experiencing. Why are pathologically obese body weight levels defended, and what can we do about it? Here we try to find answers to these questions by 1) reminding the reader that the neural controls of ingestive behavior have evolved in a demanding, restrictive environment and encompass much of the brain's major functions, far beyond the hypothalamus and brainstem, 2) hypothesizing that the current obesogenic environment impinges mainly on a critical pathway linking hypothalamic areas with the motivational and reward systems to produce uncompensated hyperphagia, and 3) proposing adequate strategies for prevention and treatment.

Effect of metabolic state on implicit and explicit responses to food in young healthy females

Recent neuroscience research has delineated key psychological components of reward: wanting, liking and learning. Each component is further divided into explicit and implicit processes. While explicit processes are consciously experienced, implicit processes are not always directly accessible to conscious inspection. In the present study, we investigated the effect of metabolic state on implicit and explicit responses and their relationship in food context, especially when foods and visually matched non-food items are contrasted, and when foods in a sole food context but differing in energy content (high-energy - low-energy) or taste (sweet - savoury) were contrasted. Sixty healthy non-obese females participated in the study in fasted and fed states. Three Implicit Association Tests were used to assess implicit associations. Explicit liking and wanting ratings were assessed by visual analogue scales. In the implicit food-non-food context, food was preferred over non-food items both in fasted and fed states, though the strength of implicit associations declined significantly from fasted to fed state. However, the direction or strength of implicit associations was not significantly different between the metabolic states when comparing concepts within food context only, differing in energy content or taste. Instead, explicit responses reflected the change in the metabolic state in a manner consistent with alliesthesia and sensory-specific satiety. The results of the present study suggest that implicit associations are relatively resistant to acute change in the metabolic condition compared to explicit ratings, which shift more readily according to the fasted-fed continuum. The shift in the prevailing metabolic state was, however, reflected in the strength of implicit responses towards food in relation to non-food items, yet in the sole food contexts implicit associations were comparable between the fasted and fed states.

Facial EMG Correlates of Subjective Hedonic Responses During Food Consumption

An exploration of physiological correlates of subjective hedonic responses while eating food has practical and theoretical significance. Previous psychophysiological studies have suggested that some physiological measures, including facial electromyography (EMG), may correspond to hedonic responses while viewing food images or drinking liquids. However, whether consuming solid food could produce such subjective–physiological concordance remains untested. To investigate this issue, we assessed participants’ subjective ratings of liking, wanting, valence, and arousal while they consumed gel-type food stimuli of various flavors and textures. We additionally measured their physiological signals, including facial EMG from the corrugator supercilii. The results showed that liking, wanting, and valence ratings were negatively correlated with corrugator supercilii EMG activity. Only the liking rating maintained a negative association with corrugator supercilii activity when the other ratings were partialed out. These data suggest that the subjective hedonic experience, specifically the liking state, during food consumption can be objectively assessed using facial EMG signals and may be influenced by such somatic signals.

Diet, inflammation and the gut microbiome: Mechanisms for obesity-associated cognitive impairment

Poor diet and obesity are associated with cognitive impairment throughout adulthood, and increased dementia risk in aging. Here we review the current literature interrogating the mechanisms by which diets high in fat, or fat and sugar lead to cognitive impairment, focusing on changes to gut microbiome composition, inflammatory signalling and blood-brain barrier integrity. Preclinical studies indicate weight gain is not necessary for diet-induced cognitive impairment. Rather, gut microbiome composition, and systemic and central inflammatory processes appear to contribute to diet-induced cognitive impairment. While both obese humans and rodents exhibit reduced blood-brain barrier integrity, cognitive impairments precede these changes, suggesting other mechanisms may underly diet-induced cognitive changes. Other potential candidates include hormone, glucoregulatory and cardiovascular changes. Poor diet and obesity act through multiple mechanisms to affect cognitive health and the challenge for future research is to identify key processes that can be reversed to improve cognition and quality of life.

Hippocampal-dependent appetitive control is impaired by experimental exposure to a Western-style diet

Animals fed a Western-style diet (WS-diet) demonstrate rapid impairments in hippocampal function and poorer appetitive control. We examined if this also occurs in humans. One-hundred and ten healthy lean adults were randomized to either a one-week WS-diet intervention or a habitual-diet control group. Measures of hippocampal-dependent learning and memory (HDLM) and of appetitive control were obtained pre- and post-intervention. HDLM was retested at three-week follow-up. Relative to controls, HDLM performance declined in the WS-diet group (d = 0.43), but was not different at follow-up. Appetitive control also declined in the WS-diet group (d = 0.47) and this was strongly correlated with HDLM decline (d = 1.01). These findings demonstrate that a WS-diet can rapidly impair appetitive control in humans-an effect that could promote overeating in consumers of a WS-diet. The study also suggests a functional role for the hippocampus in appetitive control and provides new evidence for the adverse neurocognitive effects of a WS-diet.

A Preliminary Investigation of the Effects of a Western Diet on Hippocampal Volume in Children

Introduction: Over the course of the 20th century, there has been a sharp increase in the consumption of saturated fat and refined sugars. This so-called "western diet" (WD) has been extensively linked to biological alterations and associated functional deficits in the hippocampus of animals. However, the effects of a WD on the human hippocampus are less well-characterized. This preliminary study aimed to extend prior animal work by investigating the effects of a WD on hippocampal volume in children. Methods: Twenty-one healthy children (ages 5-9) completed a structural T1-weighted magnetic resonance imaging scan. Bilateral hippocampal volumes (as regions-of-interest) and bilateral amygdala volumes (as medial temporal lobe control regions-of-interest) were calculated. WD variables were derived from the parent-completed Youth/Adolescent Food Frequency Questionnaire. Specifically, variables were calculated as percent of daily calories consumed from sugars, fats, or a combination of these (WD). Results: While the relationships between overall WD consumption and bilateral hippocampal volumes were not significant, increased fat consumption was significantly related to decreased left hippocampal volume. Sugar consumption was not related to hippocampal size. Control region volumes were not related to any diet variables. Discussion: This study is the first to directly link diet-specifically fat consumption-to decreased left hippocampal volume in children. This extends previous work showing smaller left hippocampal volume related to obesity in pediatric samples. Though preliminary, findings represent an important step toward understanding the impact of diet on child brain development.

The Cognitive Control of Eating and Body Weight: It's More Than What You "Think"

Over the past decade, a great deal of research has established the importance of cognitive processes in the control of energy intake and body weight. The present paper begins by identifying several of these cognitive processes. We then summarize evidence from human and nonhuman animal models, which shows how excess intake of obesity-promoting Western diet (WD) may have deleterious effects on these cognitive control processes. Findings that these effects may be manifested as early-life deficits in cognitive functioning and may also be associated with the emergence of serious late-life cognitive impairment are described. Consistent with these possibilities, we review evidence, obtained primarily from rodent models, that consuming a WD is associated with the emergence of pathophysiologies in the hippocampus, an important brain substrate for learning, memory, and cognition. The implications of this research for mechanism are discussed within the context of a “vicious-cycle model,” which describes how eating a WD could impair hippocampal function, producing cognitive deficits that promote increased WD intake and body weight gain, which could contribute to further hippocampal dysfunction, cognitive decline, and excess eating and weight gain.

Influence of High-Fat Diets Consumed During the Juvenile Period on Hippocampal Morphology and Function

The negative impact of obesity on neurocognitive functioning is an issue of increasing clinical interest. Over the last decade, a number of studies have analyzed the influence of high-fat diets (HFDs) on cognitive performance, particularly in adolescent individuals. Different approaches, including behavioral, neurochemical, electrophysiological and morphological studies, have been developed to address the effect of HFDs on neural processes interfering with learning and memory skills in rodents. Many of the studies have focused on learning and memory related to the hippocampus and the mechanisms underlying these processes. The goal of the current review article is to highlight the relationship between hippocampal learning/memory deficits and nutritional/endocrine inputs derived from HFDs consumption, with a special emphasis on research showing the effect of HFDs intake during the juvenile period. We have also reviewed recent research regarding the effect of HFDs on hippocampal neurotransmission. An overview of research suggesting the involvement of fatty acid (FA) receptor-mediated signaling pathways in memory deficits triggered by HFDs is also provided. Finally, the role of leptin and HFD-evoked hyperleptinemia is discussed.

Phenotypic heterogeneity of obesity-related brain vulnerability: one-size interventions will not fit all

Intact memory and problem solving are key to functional independence and quality of life in older age. Considering the unprecedented demographic shift toward a greater number of older adults than children in the United States in the next few decades, it is critically important for older adults to maintain work productivity and functional independence for as long as possible. Implementing early interventions focused on modifiable risk factors for cognitive decline at midlife is a strategy with the highest chance of success at present, bearing in mind the current lack of dementia cures. We present a selective, narrative review of evidence linking nutrition, body composition, vascular health, and brain function in midlife to highlight the phenotypic heterogeneity of obesity-related brain vulnerability and to endorse the development of individually tailored lifestyle modification plans for primary prevention of cognitive decline.

Dietary patterns are associated with attention-deficit/hyperactivity disorder (ADHD) symptoms among preschoolers in mainland China

BACKGROUND/OBJECTIVES

To identify the major dietary patterns among preschoolers and assess the relation of major dietary patterns to attention-deficit/hyperactivity disorder (ADHD).

SUBJECTS/METHODS

A cross-sectional survey was conducted comprising a large sample of 14,912 children aged 3-6 years old in Ma'anshan city of Anhui Province in China. A semi-quantitative food frequency questionnaire and the 10-item Chinese version of the Conners' abbreviated symptom questionnaire were administered to assess usual dietary intakes and ADHD. Social-demographic information was also collected. Major dietary patterns were identified by principal components analysis. Logistic regression was employed to explore the association of dietary patterns with ADHD.

RESULTS

Five dietary patterns were identified explaining 47.96% of the total diet variation. The "processed" dietary component was the principal pattern that explained the higher percentage of variability, 24.69%. After controlling for potential confounders, preschoolers in the top quintile of the "processed" (odds ratio (OR) = 1.56, 95% confidence interval (CI): 1.31-1.86) and "snack" (OR = 1.76, 95% CI = 1.49-2.07) dietary pattern score had greater odds for having ADHD symptoms compared with those in the lowest quintile. Lowest scores on the "vegetarian" were associated with significantly a higher likelihood of indications of ADHD symptoms (OR = 0.67, 95% CI = 0.56-0.79).

CONCLUSIONS

This study showed that preschoolers tend to choose unhealthy dietary pattern in Ma'anshan, China. "Processed" and "snack" dietary patterns were significantly and positively correlated with ADHD symptoms, while "vegetarian" dietary patterns were negatively correlated with ADHD symptoms.

Cognitive Control of Eating: the Role of Memory in Appetite and Weight Gain

PURPOSE OF REVIEW

The present review organises the recent literature on the role of memory in eating behaviours and provides an overview of the current evidence relating to the associations between memory and weight gain.

RECENT FINDINGS

Research over the last few years has highlighted working memory as an important cognitive process that underpins many aspects of appetite control. Recent work on episodic memory and appetite has replicated work showing that manipulating memory for recent eating affects later consumption and extended this work to examine associations between individual differences in memory and eating behaviours. Poorer episodic memory ability is related to a reduced sensitivity to internal states of hunger and satiety and a tendency towards uncontrolled eating. There is also recent evidence to suggest that working memory and episodic memory impairments are related to weight gain and high BMI. Working memory and episodic memory are core cognitive processes that are critical for food-related decision-making, and disruption to these processes contributes to problems with appetite control and weight gain, which suggests that weight loss programmes might be improved by the addition of cognitive training.

Considering sex differences in the cognitive controls of feeding

Women are disproportionately affected by obesity, and obesity increases women's risk of developing dementia more so than men. Remarkably little is known about how females make decisions about when and how much to eat. Research in animal models with males supports a framework in which previous experiences with external food cues and internal physiological energy states, and the ability to retrieve memories of the consequences of eating, determines subsequent food intake. Additional evidence indicates that consumption of a high-fat, high-sugar diet interferes with hippocampal-dependent mnemonic processes that operate to suppress eating, such as in situations of satiety. Recent findings also indicate that weakening this form of hippocampal-dependent inhibitory control may also extend to other forms of learning and memory, perpetuating a vicious cycle of increased Western diet intake, hippocampal dysfunction, and further impairments in the suppression of appetitive behavior that may ultimately disrupt other types of memorial interference resolution. How these basic learning and memory processes operate in females to guide food intake has received little attention. Ovarian hormones appear to protect females from obesity and metabolic impairments, as well as modulate learning and memory processes, but little is known about how these hormones modulate learned appetitive behavior. Even less is known about how a sex-specific environmental factor - widespread hormonal contraceptive use - affects associative learning and the regulation of food intake. Extending learned models of food intake to females will require considerably investigation at many levels (e.g., reproductive status, hormonal compound, parity). This work could yield critical insights into the etiology of obesity, and its concomitant cognitive impairment, for both sexes.

The Immediate and Delayed Effects of TV: Impacts of Gender and Processed-Food Intake History

Eating while watching TV has generally been found to increase both immediate and delayed energy intake. Here we examine two factors – gender and habitual processed-food intake – that may moderate these effects. Participants [n = 153; 95 women, 58 men; M_age = 19.7 (SD = 2.9); M_BMI = 22.4 (SD = 3.1)] ate an ad libitum snack either with or without TV, followed around 1 h later by lunch. There was an interaction between TV and gender for both meals. Women tended to consume more snack food in the TV condition, with men consuming more in the no-TV condition. Participants who habitually consumed more processed food also ate more snacks, independent of any other variable, including rated liking. At lunch, men who had earlier snacked with TV ate more than men who had snacked without TV, but this effect was not evident in women. On memory recall, all participants underestimated how much snack food they had eaten, and this was a function of how much they had actually consumed, with greater error only predicted by greater consumption. The results indicate that the effects of TV on eating can vary with gender and that processed-food history can predict snack food intake. While previous findings suggest memory of prior-intake may be impaired by eating while watching TV, the current results suggest this is not necessarily because of TV per se, but because people sometimes consume more food under such conditions.

Adverse effects of consuming high fat–sugar diets on cognition: implications for understanding obesity

There is increasing evidence for important roles of key cognitive processes, including attention, memory and learning, in the short-term decision making about eating. There is parallel evidence that people who are overweight or obese tend to perform worse on a variety of cognitive tasks. In this review, the evidence for these two ideas is summarised and then the idea that overconsumption of Western-style high-fat (HF)–high-sugar diets may underlie the association between obesity and poorer cognitive performance is explored. In particular, evidence in animals and human subjects that repeated consumption of HF or HF and sugar (HFS) diets leads to specific impairments in the functioning of the hippocampus, which underpin the consequent changes in cognition is summarised. These findings lead into the vicious cycle model (VCM), which suggests that these cognitive changes have knock-on negative effects for future appetite control, and evidence that altered hippocampal function is also associated with impaired appetite control is explored. The review concludes that there is consistent evidence in the animal literature and emerging evidence from human studies that supports this VCM. It is also noted, however, that to date studies lack the nutritional specificity needed to be able to translate these basic research findings into clear nutritional effects, and concludes that there is an urgent need for additional research to clarify the precise nature of the apparent effects of consuming HFS diets on cognition.

Deficits in episodic memory are related to uncontrolled eating in a sample of healthy adults

Despite a substantial amount of animal data linking deficits in memory inhibition to the development of overeating and obesity, few studies have investigated the relevance of memory inhibition to uncontrolled eating in humans. Further, although memory for recent eating has been implicated as an important contributor to satiety and energy intake, the possibility that variations in episodic memory relate to individual differences in food intake control has been largely neglected. To examine these relationships, we recruited ninety-three adult subjects to attend a single lab session where we assessed body composition, dietary intake, memory performance, and eating behaviors (Three Factor Eating Questionnaire). Episodic recall and memory inhibition were assessed using a well-established measure of memory interference (Retrieval Practice Paradigm). Hierarchical regression analyses indicated that memory inhibition was largely unrelated to participants' eating behaviors; however, episodic recall was reliably predicted by restrained vs. uncontrolled eating: recall was positively associated with strategic dieting (β = 2.45, p = 0.02), avoidance of fatty foods (β = 3.41, p = 0.004), and cognitive restraint (β = 1.55, p = 0.04). In contrast, recall was negatively associated with uncontrolled eating (β = -1.15, p = 0.03) and emotional eating (β = -2.46, p = 0.04). These findings suggest that episodic memory processing is related to uncontrolled eating in humans. The possibility that deficits in episodic memory may contribute to uncontrolled eating by disrupting memory for recent eating is discussed.

Exposure to gestational diabetes mellitus induces neuroinflammation, derangement of hippocampal neurons, and cognitive changes in rat offspring

Background

Birth cohort studies link gestational diabetes mellitus (GDM) with impaired cognitive performance in the offspring. However, the mechanisms involved are unknown. We tested the hypothesis that obesity-associated GDM induces chronic neuroinflammation and disturbs the development of neuronal circuitry resulting in impaired cognitive abilities in the offspring.

Methods

In rats, GDM was induced by feeding dams a diet high in sucrose and fatty acids. Brains of neonatal (E20) and young adult (15-week-old) offspring of GDM and lean dams were analyzed by immunohistochemistry, cytokine assay, and western blotting. Young adult offspring of GDM and lean dams went also through cognitive assessment. Cultured microglial responses to elevated glucose and/or fatty acids levels were analyzed.

Results

In rats, impaired recognition memory was observed in the offspring of GDM dams. GDM exposure combined with a postnatal high-fat and sucrose diet resulted in atypical inattentive behavior in the offspring. These cognitive changes correlated with reduced density and derangement of Cornu Ammonis 1 pyramidal neuronal layer, decreased hippocampal synaptic integrity, increased neuroinflammatory status, and reduced expression of CX3CR1, the microglial fractalkine receptor regulating microglial pro-inflammatory responses and synaptic pruning. Primary microglial cultures that were exposed to high concentrations of glucose and/or palmitate were transformed into an activated, amoeboid morphology with increased nitric oxide and superoxide production, and altered their cytokine release profile.

Conclusions

These findings demonstrate that GDM stimulates microglial activation and chronic inflammatory responses in the brain of the offspring that persist into young adulthood. Reactive gliosis correlates positively with hippocampal synaptic decline and cognitive impairments. The elevated pro-inflammatory cytokine expression at the critical period of hippocampal synaptic maturation suggests that neuroinflammation might drive the synaptic and cognitive decline in the offspring of GDM dams. The importance of microglia in this process is supported by the reduced Cx3CR1 expression as an indication of the loss of microglial control of inflammatory responses and phagocytosis and synaptic pruning in GDM offspring.

A four-day Western-style dietary intervention causes reductions in hippocampal-dependent learning and memory and interoceptive sensitivity

In animals, a Western style diet-high in saturated fat and added sugar-causes impairments in hippocampal-dependent learning and memory (HDLM) and perception of internal bodily state (interoception). In humans, while there is correlational support for a link between Western-style diet, HDLM, and interoception, there is as yet no causal data. Here, healthy individuals were randomly assigned to consume either a breakfast high in saturated fat and added sugar (Experimental condition) or a healthier breakfast (Control condition), over four consecutive days. Tests of HDLM, interoception and biological measures were administered before and after breakfast on the days one and four, and participants completed food diaries before and during the study. At the end of the study, the Experimental condition showed significant reductions in HDLM and reduced interoceptive sensitivity to hunger and fullness, relative to the Control condition. The Experimental condition also showed a markedly different blood glucose and triglyceride responses to their breakfast, relative to Controls, with larger changes in blood glucose across breakfast being associated with greater reductions in HDLM. The Experimental condition compensated for their energy-dense breakfast by reducing carbohydrate intake, while saturated fat intake remained consistently higher than Controls. This is the first experimental study in humans to demonstrate that a Western-style diet impacts HDLM following a relatively short exposure-just as in animals. The link between diet-induced HDLM changes and blood glucose suggests one pathway by which diet impacts HDLM in humans.