1
|
Jeune SC, Graziano P, Campa A, Coccia CC. The causal associations between interoception, self-regulation, non-purposeful eating behaviors, and weight status in college women: a longitudinal cross-lagged model analysis. Psychol Health 2024:1-18. [PMID: 38712828 DOI: 10.1080/08870446.2024.2352062] [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: 11/06/2023] [Accepted: 04/30/2024] [Indexed: 05/08/2024]
Abstract
AIMS Excessive weight gain has led to increased obesity and mortality risk among college students. Issues with maintaining a healthy weight may be attributed to poor internal awareness and unhealthy eating behaviors. The study's purpose was to determine the longitudinal effects among interoception, self-regulation, nonpurposeful eating behaviors, and weight status (BMI) among college women. METHODS Data from 103 females were collected via Qualtrics over 3 timepoints (T1, T2, T3) during an academic semester. Repeated measures ANOVA and cross-lagged model analyses were used. Significant changes were found in interoceptive responsiveness, external, and uncontrolled eating throughout 3 timepoints. RESULTS Longitudinally, significant causal effects were found among the study measures. Among all models, higher interoceptive responsiveness (T1) predicted increased self-regulation (T2). Higher non-purposeful eating behaviors (T1) predicted reduced self-regulation (T2). Higher BMI (T1) predicted reduced non-purposeful eating behaviors (T2), however higher BMI (T2) predicted increased non-purposeful eating (T3) and reduced interoceptive responsiveness (T3). Significant causal effects were found within each non-purposeful eating behavior models. CONCLUSION Overall, the research study provided foundational evidence of the importance of self-regulatory skills to help prevent unhealthy eating behaviors and increased weight status in college women. Future interventions educating college women to become more internally aware and better self-regulate are needed.
Collapse
Affiliation(s)
- Shanté C Jeune
- Department of Health Sciences, University of Central Florida, Orlando, FL, USA
| | - Paulo Graziano
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Adriana Campa
- Department of Dietetics and Nutrition, Florida International University, Miami, FL, USA
| | - Catherine C Coccia
- Department of Dietetics and Nutrition, Florida International University, Miami, FL, USA
| |
Collapse
|
2
|
Chew HSJ, Chew NW, Loong SSE, Lim SL, Tam WSW, Chin YH, Chao AM, Dimitriadis GK, Gao Y, So JBY, Shabbir A, Ngiam KY. Effectiveness of an Artificial Intelligence-Assisted App for Improving Eating Behaviors: Mixed Methods Evaluation. J Med Internet Res 2024; 26:e46036. [PMID: 38713909 PMCID: PMC11109864 DOI: 10.2196/46036] [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: 01/26/2023] [Revised: 12/12/2023] [Accepted: 03/12/2024] [Indexed: 05/09/2024] Open
Abstract
BACKGROUND A plethora of weight management apps are available, but many individuals, especially those living with overweight and obesity, still struggle to achieve adequate weight loss. An emerging area in weight management is the support for one's self-regulation over momentary eating impulses. OBJECTIVE This study aims to examine the feasibility and effectiveness of a novel artificial intelligence-assisted weight management app in improving eating behaviors in a Southeast Asian cohort. METHODS A single-group pretest-posttest study was conducted. Participants completed the 1-week run-in period of a 12-week app-based weight management program called the Eating Trigger-Response Inhibition Program (eTRIP). This self-monitoring system was built upon 3 main components, namely, (1) chatbot-based check-ins on eating lapse triggers, (2) food-based computer vision image recognition (system built based on local food items), and (3) automated time-based nudges and meal stopwatch. At every mealtime, participants were prompted to take a picture of their food items, which were identified by a computer vision image recognition technology, thereby triggering a set of chatbot-initiated questions on eating triggers such as who the users were eating with. Paired 2-sided t tests were used to compare the differences in the psychobehavioral constructs before and after the 7-day program, including overeating habits, snacking habits, consideration of future consequences, self-regulation of eating behaviors, anxiety, depression, and physical activity. Qualitative feedback were analyzed by content analysis according to 4 steps, namely, decontextualization, recontextualization, categorization, and compilation. RESULTS The mean age, self-reported BMI, and waist circumference of the participants were 31.25 (SD 9.98) years, 28.86 (SD 7.02) kg/m2, and 92.60 (SD 18.24) cm, respectively. There were significant improvements in all the 7 psychobehavioral constructs, except for anxiety. After adjusting for multiple comparisons, statistically significant improvements were found for overeating habits (mean -0.32, SD 1.16; P<.001), snacking habits (mean -0.22, SD 1.12; P<.002), self-regulation of eating behavior (mean 0.08, SD 0.49; P=.007), depression (mean -0.12, SD 0.74; P=.007), and physical activity (mean 1288.60, SD 3055.20 metabolic equivalent task-min/day; P<.001). Forty-one participants reported skipping at least 1 meal (ie, breakfast, lunch, or dinner), summing to 578 (67.1%) of the 862 meals skipped. Of the 230 participants, 80 (34.8%) provided textual feedback that indicated satisfactory user experience with eTRIP. Four themes emerged, namely, (1) becoming more mindful of self-monitoring, (2) personalized reminders with prompts and chatbot, (3) food logging with image recognition, and (4) engaging with a simple, easy, and appealing user interface. The attrition rate was 8.4% (21/251). CONCLUSIONS eTRIP is a feasible and effective weight management program to be tested in a larger population for its effectiveness and sustainability as a personalized weight management program for people with overweight and obesity. TRIAL REGISTRATION ClinicalTrials.gov NCT04833803; https://classic.clinicaltrials.gov/ct2/show/NCT04833803.
Collapse
Affiliation(s)
- Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Nicholas Ws Chew
- Department of Cardiology, National University Hospital, Singapore, Singapore
| | - Shaun Seh Ern Loong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Su Lin Lim
- Department of Dietetics, National University Hospital, Singapore, Singapore
| | - Wai San Wilson Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yip Han Chin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ariana M Chao
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Georgios K Dimitriadis
- Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Yujia Gao
- Division of Hepatobiliary & Pancreatic Surgery, Department of Surgery, National University Hospital, Singapore, Singapore
| | - Jimmy Bok Yan So
- Division of General Surgery (Upper Gastrointestinal Surgery), Department of Surgery, National University Hospital, Singapore, Singapore
| | - Asim Shabbir
- Division of General Surgery (Upper Gastrointestinal Surgery), Department of Surgery, National University Hospital, Singapore, Singapore
| | - Kee Yuan Ngiam
- Division of Thyroid & Endocrine Surgery, Department of Surgery, National University Hospital, Singapore, Singapore
| |
Collapse
|
3
|
Gallagher D, Spyreli E, Anderson AS, Bridges S, Cardwell CR, Coulman E, Dombrowski SU, Free C, Heaney S, Hoddinott P, Kee F, McDowell C, McIntosh E, Woodside JV, McKinley MC. Effectiveness and cost-effectiveness of a 12-month automated text message intervention for weight management in postpartum women with overweight or obesity: protocol for the Supporting MumS (SMS) multisite, parallel-group, randomised controlled trial. BMJ Open 2024; 14:e084075. [PMID: 38719295 PMCID: PMC11086389 DOI: 10.1136/bmjopen-2024-084075] [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: 01/08/2024] [Accepted: 03/25/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION The reproductive years can increase women's weight-related risk. Evidence for effective postpartum weight management interventions is lacking and engaging women during this life stage is challenging. Following a promising pilot evaluation of the Supporting MumS intervention, we assess if theory-based and bidirectional text messages to support diet and physical activity behaviour change for weight loss and weight loss maintenance, are effective and cost-effective for weight change in postpartum women with overweight or obesity, compared with an active control arm receiving text messages on child health and development. METHODS AND ANALYSIS Two-arm, parallel-group, assessor-blind randomised controlled trial with cost-effectiveness and process evaluations. Women (n=888) with body mass index (BMI) ≥25 kg/m2 and within 24 months of giving birth were recruited via community and National Health Service pathways through five UK sites targeting areas of ethnic and socioeconomic diversity. Women were 1:1 randomised to the intervention or active control groups, each receiving automated text messages for 12 months. Data are collected at 0, 6, 12 and 24 months. The primary outcome is weight change at 12 months from baseline, compared between groups. Secondary outcomes include weight change (24 months) and waist circumference (cm), proportional weight gain (>5 kg), BMI (kg/m2), dietary intake, physical activity, infant feeding and mental health (6, 12 and 24 months, respectively). Economic evaluation examines health service usage and personal expenditure, health-related quality of life and capability well-being to assess cost-effectiveness over the trial and modelled lifetime. Cost-utility analysis examines cost per quality-adjusted life-years gained over 24 months. Mixed-method process evaluation explores participants' experiences and contextual factors impacting outcomes and implementation. Stakeholder interviews examine scale-up and implementation. ETHICS AND DISSEMINATION Ethical approval was obtained before data collection (West of Scotland Research Ethics Service Research Ethics Committee (REC) 4 22/WS/0003). Results will be published via a range of outputs and audiences. TRIAL REGISTRATION NUMBER ISRCTN16299220.
Collapse
Affiliation(s)
- Dunla Gallagher
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Eleni Spyreli
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Annie S Anderson
- Centre for Research into Cancer Prevention and Screening, Ninewells Medical School, Dundee, UK
| | - Sally Bridges
- Bradford Institute for Health Research, Bradford, UK
| | | | - Elinor Coulman
- Centre for Trials Research (CTR), Cardiff University School of Medicine, Cardiff, UK
| | - Stephan U Dombrowski
- Faculty of Kinesiology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Caroline Free
- Public Health Interventions Unit, London School of Hygiene & Tropical Medicine, London, UK
| | - Suzie Heaney
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Pat Hoddinott
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Stirling, UK
| | - Frank Kee
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Emma McIntosh
- Health Economics and Health Technology Assessment (HEHTA), University of Glasgow Institute of Health and Wellbeing, Glasgow, UK
| | - Jayne V Woodside
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | |
Collapse
|
4
|
Dakin C, Finlayson G, Stubbs RJ. Can eating behaviour traits be explained by underlying, latent factors? An exploratory and confirmatory factor analysis. Appetite 2024; 195:107202. [PMID: 38199306 DOI: 10.1016/j.appet.2024.107202] [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: 09/21/2023] [Revised: 11/23/2023] [Accepted: 01/04/2024] [Indexed: 01/12/2024]
Abstract
Eating Behaviour Traits (EBTs) are psychological constructs developed to explain patterns of eating behaviour, including factors that motivate people to (over or under) eat. There is a need to align and clarify their unique contributions and harmonise the understanding they offer for human eating behaviour. Therefore, the current study examined whether 18 commonly cited EBTs could be explained by underlying, latent factors (domains of eating behaviour). An exploratory factor analysis (EFA) was used to identify latent factors, and these factors were validated using a confirmatory factor analysis (CFA). 1279 participants including the general public and members of a weight management programme were included in the analysis (957 females, 317 males, 3 others, 2 prefer not to say), with a mean age of 54 years (median = 57 years, SD = 12.03) and a mean BMI of 31.93 kg/m2 (median = 30.86, SD = 6.00). The participants completed 8 questionnaires which included 18 commonly cited EBTs and the dataset was split at random with a 70/30 ratio to conduct the EFA (n = 893) and CFA (n = 383). The results supported a four-factor model which indicated that EBTs can be organised into four domains: reactive, restricted, emotional, and homeostatic eating. The four-factor model also significantly predicted self-reported BMI and weight change. Future research should test whether this factor structure is replicated in more diverse populations, and including other EBTs, to advance these domains of eating as a unifying framework for studying individual differences in human eating behaviour.
Collapse
Affiliation(s)
- Clarissa Dakin
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK.
| | - Graham Finlayson
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - R James Stubbs
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| |
Collapse
|
5
|
Jeune SC, Graziano P, Campa A, Coccia CC. Interoception and self-regulation of eating behaviors and weight status in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-12. [PMID: 38442359 DOI: 10.1080/07448481.2024.2319200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 02/08/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE To determine the associations between interoception, self-regulation, eating behaviors, and weight status among college students. PARTICIPANTS 229 female undergraduates, predominantly classified as Juniors (51.1%) and identified as Hispanic/Latinx (75%) with a mean age of 23.4 (SD = 6.3), were examined. METHODS Cross-sectional data using baseline measures from a larger, longitudinal study, were examined. Confirmatory factor analyses and structural equation modeling were conducted to test hypotheses. RESULTS Interoception was directly associated to self-regulation. Interoception and self-regulation were inversely associated with non-purposeful eating. Non-purposeful eating was directly associated with weight status. CONCLUSION This study provided empirical evidence on the associations between interoception, self-regulation, eating behaviors, and weight status. Our results support the need for programs that target college students' cognitive skills to reduce unhealthy eating behaviors and optimize weight status. Future interventions are needed to enhance interoception and self-regulation skills so that college students can be more purposeful in their eating habits.
Collapse
Affiliation(s)
- Shanté C Jeune
- Department of Health Sciences, University of Central Florida, Orlando, Florida, USA
| | - Paulo Graziano
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - Adriana Campa
- Department of Dietetics and Nutrition, Florida International University, Miami, Florida, USA
| | - Catherine C Coccia
- Department of Dietetics and Nutrition, Florida International University, Miami, Florida, USA
| |
Collapse
|
6
|
Kim SJ, Alford-Teaster J, Schiffelbein JE, Onega T. Development of the Rural Perception Scale (RPS-18). J Rural Health 2024; 40:348-367. [PMID: 37697478 PMCID: PMC10925553 DOI: 10.1111/jrh.12795] [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: 12/19/2022] [Revised: 08/15/2023] [Accepted: 09/01/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND People living in rural areas often experience limited access to health resources, slow knowledge diffusion, and geographical isolation, and tend to be at higher risk for poor physical and mental health outcomes compared with nonrural populations. It is unclear, yet, how the concept of "rural" shapes observed differences from nonrural populations. We aim to develop a psychometrically sound scale to assess key dimensions that constitute individual-level perceived rurality. METHODS We first conducted a broad literature review to identify a priori concepts related to rurality and adapted survey items measuring relevant constructs, such as loneliness, attitudes toward people living in rural areas, and perceived social membership. We used these conceptual constructs and measures to develop a survey questionnaire focused on rural perceptions. We recruit residents in 3 rural states: Kentucky, New Hampshire, and Vermont. Using the explorative factor analysis and second-order measurement model in the structural equation model framework, we developed a rural perception scale consisting of 18 items. RESULTS We recruited 1,384 participants (n = 686 from KY; n = 698 from NH/VT) using Amazon Mechanical Turk (n = 897, 64.8%) and social media paid ads (n = 487, 35.2%). The average age of participants was 41 years old (SD = 15); 54.7% of respondents had less than college graduate education, and 94.2% reported their race as non-Hispanic White. Majority of the participants were from Rural Urban Commuting Area (RUCA)-designated urban areas (n = 798, 57.7%), followed by RUCA-designated large rural areas (257, 18.6%), RUCA-designated rural areas (n = 174, 12.6%) and RUCA-designated isolated areas (n = 133, 9.6%). Our final model revealed 4 latent constructs: "belonging" (Cronbach's α = 0.896), "attitudes toward rural life" (Cronbach's α = 0.807), "loneliness" (Cronbach's α = 0.898), and "community social ties to people in their community" (Cronbach's α = 0.846). CONCLUSIONS We identified 4 subfactors of the umbrella concept of rurality that explain how people in rural regions may perceive being in rural environments and having rural lifestyles.
Collapse
Affiliation(s)
- Sunny Jung Kim
- Department of Health Behavior and Policy, School of Population Health, Virginia Commonwealth University, Richmond, Virginia, USA
- VCU Massey Comprehensive Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jennifer Alford-Teaster
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Jenna E. Schiffelbein
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Tracy Onega
- Department of Population Health Sciences, School of Medicine, University of Utah, Salt Lake City, Utah, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
| |
Collapse
|
7
|
Chew HSJ, Achananuparp P, Dalakoti M, Chew NWS, Chin YH, Gao Y, So BYJ, Shabbir A, Peng LE, Ngiam KY. Public acceptance of using artificial intelligence-assisted weight management apps in high-income southeast Asian adults with overweight and obesity: a cross-sectional study. Front Nutr 2024; 11:1287156. [PMID: 38385011 PMCID: PMC10879329 DOI: 10.3389/fnut.2024.1287156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/19/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction With in increase in interest to incorporate artificial intelligence (AI) into weight management programs, we aimed to examine user perceptions of AI-based mobile apps for weight management in adults with overweight and obesity. Methods 280 participants were recruited between May and November 2022. Participants completed a questionnaire on sociodemographic profiles, Unified Theory of Acceptance and Use of Technology 2 (UTAUT2), and Self-Regulation of Eating Behavior Questionnaire. Structural equation modeling was performed using R. Model fit was tested using maximum-likelihood generalized unweighted least squares. Associations between influencing factors were analyzed using correlation and linear regression. Results 271 participant responses were analyzed, representing participants with a mean age of 31.56 ± 10.75 years, median (interquartile range) BMI, and waist circumference of 27.2 kg/m2 (24.2-28.4 kg/m2) and 86.4 (80.0-94.0) cm, respectively. In total, 188 (69.4%) participants intended to use AI-assisted weight loss apps. UTAUT2 explained 63.3% of the variance in our intention of the sample to use AI-assisted weight management apps with satisfactory model fit: CMIN/df = 1.932, GFI = 0.966, AGFI = 0.954, NFI = 0.909, CFI = 0.954, RMSEA = 0.059, SRMR = 0.050. Only performance expectancy, hedonic motivation, and the habit of using AI-assisted apps were significant predictors of intention. Comparison with existing literature revealed vast variabilities in the determinants of AI- and non-AI weight loss app acceptability in adults with and without overweight and obesity. UTAUT2 produced a good fit in explaining the acceptability of AI-assisted apps among a multi-ethnic, developed, southeast Asian sample with overweight and obesity. Conclusion UTAUT2 model is recommended to guide the development of AI-assisted weight management apps among people with overweight and obesity.
Collapse
Affiliation(s)
- Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Palakorn Achananuparp
- School of Computing and Information Systems, Singapore Management University, Singapore, Singapore
| | - Mayank Dalakoti
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
| | - Nicholas W. S. Chew
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
| | - Yip Han Chin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yujia Gao
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, National University Hospital, Singapore, Singapore
| | - Bok Yan Jimmy So
- Division of General Surgery (Upper Gastrointestinal Surgery), Department of Surgery, National University Hospital, Singapore, Singapore
| | - Asim Shabbir
- Division of General Surgery (Upper Gastrointestinal Surgery), Department of Surgery, National University Hospital, Singapore, Singapore
| | - Lim Ee Peng
- School of Computing and Information Systems, Singapore Management University, Singapore, Singapore
| | - Kee Yuan Ngiam
- Division of General Surgery (Upper Gastrointestinal Surgery), Department of Surgery, National University Hospital, Singapore, Singapore
| |
Collapse
|
8
|
Camacho-Cardenosa A, Clavero-Jimeno A, Martin-Olmedo JJ, Amaro-Gahete F, Cupeiro R, Cejudo MTG, García Pérez PV, Hernández-Martínez C, Sevilla-Lorente R, De-la-O A, López-Vázquez A, Molina-Fernandez M, Carneiro-Barrera A, Garcia F, Rodríguez-Nogales A, Gálvez Peralta JJ, Cabeza R, Martín-Rodríguez JL, Muñoz-Garach A, Muñoz-Torres M, Labayen I, Ruiz JR. Time-restricted eating and supervised exercise for improving hepatic steatosis and cardiometabolic health in adults with obesity: protocol for the TEMPUS randomised controlled trial. BMJ Open 2024; 14:e078472. [PMID: 38267239 PMCID: PMC10824004 DOI: 10.1136/bmjopen-2023-078472] [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: 08/03/2023] [Accepted: 12/21/2023] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION Metabolic dysfunction-associated steatotic liver disease is a major public health problem considering its high prevalence and its strong association with extrahepatic diseases. Implementing strategies based on an intermittent fasting approach and supervised exercise may mitigate the risks. This study aims to investigate the effects of a 12-week time-restricted eating (TRE) intervention combined with a supervised exercise intervention, compared with TRE or supervised exercise alone and with a usual-care control group, on hepatic fat (primary outcome) and cardiometabolic health (secondary outcomes) in adults with obesity. METHODS AND ANALYSIS An anticipated 184 adults with obesity (50% women) will be recruited from Granada (south of Spain) for this parallel-group, randomised controlled trial (TEMPUS). Participants will be randomly designated to usual care, TRE alone, supervised exercise alone or TRE combined with supervised exercise, using a parallel design with a 1:1:1:1 allocation ratio. The TRE and TRE combined with supervised exercise groups will select an 8-hour eating window before the intervention and will maintain it over the intervention. The exercise alone and TRE combined with exercise groups will perform 24 sessions (2 sessions per week+walking intervention) of supervised exercise combining resistance and aerobic high-intensity interval training. All participants will receive nutritional counselling throughout the intervention. The primary outcome is change from baseline to 12 weeks in hepatic fat; secondary outcomes include measures of cardiometabolic health. ETHICS AND DISSEMINATION This study was approved by Granada Provincial Research Ethics Committee (CEI Granada-0365-N-23). All participants will be asked to provide written informed consent. The findings will be disseminated in scientific journals and at international scientific conferences. TRIAL REGISTRATION NUMBER NCT05897073.
Collapse
Affiliation(s)
- Alba Camacho-Cardenosa
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Antonio Clavero-Jimeno
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Juan J Martin-Olmedo
- Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Francisco Amaro-Gahete
- Instituto de Investigación Biosanitaria, Ibs, University of Granada, Granada, Spain
- Department of Physiology, Faculty of Medicine, University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Rocío Cupeiro
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Madrid, Spain
| | | | | | - Carlos Hernández-Martínez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Raquel Sevilla-Lorente
- Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Alejandro De-la-O
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Alejandro López-Vázquez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Marcos Molina-Fernandez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | | | - Federico Garcia
- Instituto de Investigación Biosanitaria, Ibs, University of Granada, Granada, Spain
- Servicio de Microbiología, Hospital Universitario San Cecilio, Granada, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERinfecc), Instituto de Salud Carlos III, Madrid, Spain
| | - Alba Rodríguez-Nogales
- Instituto de Investigación Biosanitaria, Ibs, University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Department of Pharmacology, School of Pharmacy, University of Granada, Granada, Spain
| | - Julio Juan Gálvez Peralta
- Instituto de Investigación Biosanitaria, Ibs, University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Department of Pharmacology, Center for Biomedical Research, Granada, Spain
| | - Rafael Cabeza
- Department of Electrical, Electronic and Communications Engineering, Public University of Navarre, Pamplona, Spain
| | | | - Araceli Muñoz-Garach
- Instituto de Investigación Biosanitaria, Ibs, University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Endocrinology and Nutrition Unit, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Manuel Muñoz-Torres
- Instituto de Investigación Biosanitaria, Ibs, University of Granada, Granada, Spain
- Endocrinology and Nutrition Unit, Hospital Universitario San Cecilio, Granada, Spain
- Department of Medicine, Faculty of Medicine, University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERfes), Instituto de Salud Carlos III, Madrid, Spain
| | - Idoia Labayen
- Navarre Institute of Health Research, Pamplona, Spain
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain
| | - Jonatan R Ruiz
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs, University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
9
|
Silva WRD, Ferreira EB, Marôco J, da Silva Júnior SI, Teodoro MA, Campos JADB. Relationships Between Three Eating Behaviors and Nine Motives for Food Choices Among Brazilian Adults: A Structural Equation Model. Percept Mot Skills 2023; 130:2388-2409. [PMID: 37864461 DOI: 10.1177/00315125231207270] [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] [Indexed: 10/22/2023]
Abstract
We examined the relationships between three eating behaviors and nine motives underlying food choices made by Brazilian adults. Using participant responses to the short version of the Three-Factor Eating Questionnaire and the Food Choice Questionnaire, we investigated eating behaviors (cognitive restriction, uncontrolled eating, and emotional eating) and motives for food choices (health, mood, convenience, sensory appeal, natural content, price, weight control, familiarity, and ethical concern). We used a structural equation model to test relationship pathways (β), with eating behaviors as independent variables and motives for food choices as dependent variables. Participants were 1297 individuals (69.5% female) with a mean age of 25.0 years (SD = 5.8). We confirmed the validity and reliability of the questionnaires in this sample. Restrictive eating behavior was significantly related to motives of health (β = .415), mood (β = .127), natural content (β = .364), weight control (β = .681), and ethical concern (β = .161). Emotional eating behavior was related to motives of mood (β = .277), health (β = -.137), and natural content (β = -.136). Uncontrolled eating behavior was related to motives of convenience (β = .226), sensory appeal (β = .121), price (β = .153), and familiarity (β = .090). We believe these findings can now help design future research and clinical interventions for managing people's risky eating behaviors and promoting beneficial food choices.
Collapse
Affiliation(s)
- Wanderson Roberto da Silva
- Graduate Program in Food, Nutrition, and Food Engineering, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil
- Graduate Program in Nutrition and Longevity, School of Nutrition, Federal University of Alfenas (UNIFAL-MG), Alfenas, Brazil
| | - Eric B Ferreira
- Graduate Program in Nutrition and Longevity, School of Nutrition, Federal University of Alfenas (UNIFAL-MG), Alfenas, Brazil
- Statistics Department, Federal University of Alfenas (UNIFAL-MG), Alfenas, Brazil
| | - João Marôco
- William James Center for Research (WJCR), Instituto Universitário (ISPA), Lisbon, Portugal
| | - Sinézio I da Silva Júnior
- Graduate Program in Nutrition and Longevity, School of Nutrition, Federal University of Alfenas (UNIFAL-MG), Alfenas, Brazil
| | - Micaela A Teodoro
- Graduate Program in Nutrition and Longevity, School of Nutrition, Federal University of Alfenas (UNIFAL-MG), Alfenas, Brazil
| | - Juliana A D B Campos
- Graduate Program in Food, Nutrition, and Food Engineering, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil
| |
Collapse
|
10
|
Dominguez Garcia A, Mullan B, Dorina I. Predicting discretionary food consumption using temporal self-regulation theory and food reward sensitivity. Appetite 2023; 190:107010. [PMID: 37619621 DOI: 10.1016/j.appet.2023.107010] [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: 03/09/2023] [Revised: 07/17/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023]
Abstract
Discretionary foods account for over a third of the average adult's total daily energy intake. But its excess consumption is a risk factor for obesity, Type 2 diabetes, and other diet-related diseases. This study aimed to use temporal self-regulation theory (intention, past behaviour, habit, self-regulatory capacity) and food reward sensitivity to identify predictors of discretionary food consumption. Two hundred and seventy-three participants aged between 18 and 80 (M = 42.55, SD = 17.07) comprising of mostly females (79.5%) and those residing in Australia (93.4%), completed a two-part online survey, one week apart. Participants completed measures of intention, past behaviour, habit, self-regulatory capacity, food reward sensitivity and demographic information at time one, and discretionary food consumption at time two. Data was analysed using a hierarchical multiple regression analysis. All variables in combination accounted for a significant 40.3% of the variance in discretionary food consumption (R2 = 0.40, p < .001). However, past behaviour and intention were the only unique significant predictors of discretionary food consumption. No significant moderation effects found. Findings offer insight into the motivators of discretionary food consumption, which can inform the development of effective interventions to reduce discretionary food consumption. Past behaviour should be considered, and intention targeted in interventions to reduce discretionary food consumption.
Collapse
Affiliation(s)
- Alejandro Dominguez Garcia
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; Behavioural Science and Health Research Group, EnAble Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Barbara Mullan
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; Behavioural Science and Health Research Group, EnAble Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; Western Australia Cancer Prevention Unit, EnAble Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
| | - Indita Dorina
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; Behavioural Science and Health Research Group, EnAble Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; Western Australia Cancer Prevention Unit, EnAble Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| |
Collapse
|
11
|
Barakou I, Hackett KL, Finch T, Hettinga FJ. Self-regulation of effort for a better health-related quality of life: a multidimensional activity pacing model for chronic pain and fatigue management. Ann Med 2023; 55:2270688. [PMID: 37871249 PMCID: PMC10595396 DOI: 10.1080/07853890.2023.2270688] [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: 07/20/2023] [Accepted: 10/10/2023] [Indexed: 10/25/2023] Open
Abstract
PURPOSE To propose a comprehensive multidimensional model of activity pacing that improves health-related quality of life and promotes sustained physical activity engagement among adults with chronic conditions. MATERIALS AND METHODS A narrative review was conducted to examine the existing literature on activity pacing, health-related quality of life, pain and fatigue management, and physical activity promotion in chronic conditions. RESULTS The literature revealed a lack of a cohesive approach towards a multidimensional model for using activity pacing to improve health-related quality of life. A comprehensive multidimensional model of activity pacing was proposed, emphasizing the importance of considering all aspects of pacing for sustained physical activity engagement and improved health-related quality of life. The model incorporates elements such as rest breaks, self-regulatory skills, environmental factors, and effective coping strategies for depression/anxiety. It takes into account physical, psychological, and environmental factors, all of which contribute significantly to the enhancement of health-related quality of life, physical function, and overall well-being, reflecting a holistic approach. CONCLUSIONS The model offers guidance to researchers and clinicians in effectively educating patients on activity pacing acquisition and in developing effective interventions to enhance physical activity engagement and health outcomes among adults with chronic conditions. Additionally, it serves as a tool towards facilitating discussions on sustained physical activity and a healthy lifestyle for patients, which can eventually lead to improved quality of life.
Collapse
Affiliation(s)
- Ioulia Barakou
- Department of Nursing, Midwifery & Health, Northumbria University, Newcastle upon Tyne, UK
| | - Katie L. Hackett
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
- CRESTA Fatigue Clinic, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Tracy Finch
- Department of Nursing, Midwifery & Health, Northumbria University, Newcastle upon Tyne, UK
| | | |
Collapse
|
12
|
Głąbska D, Skolmowska D, Guzek D. Emotional Overeating during the COVID-19 Pandemic: Polish Adolescents' COVID-19 Experience (PLACE-19) Study. Nutrients 2023; 15:3818. [PMID: 37686850 PMCID: PMC10490068 DOI: 10.3390/nu15173818] [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: 08/04/2023] [Revised: 08/23/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Emotional overeating is the most frequently noted type of emotional eating, being commonly associated with increased consumption of energy-dense products, as well as excessive body mass, and weight gain. Even though a number of studies assessed emotional overeating during the COVID-19 pandemic in adult populations, studies of children and adolescents are scarce. The aim of the present study was to assess emotional overeating background, including consumption in response to six emotions (anxiety, sadness, loneliness, tiredness, anger, and happiness), in the population of Polish adolescents within the PLACE-19 Study during the COVID-19 pandemic. The PLACE-19 Study is a national Polish population-based study of adolescents gathered upon recruitment based on a random quota sampling of secondary schools, conducted in a population of 1126 students (818 females and 308 males, a median of age 17.0 and 16.5 years, respectively). Emotional overeating was assessed while using the Emotional Overeating Questionnaire (EOQ), and as additional factors, the following were assessed: gender, body mass, body mass change during the COVID-19 pandemic, and declared tempting food products. Female participants declared a higher frequency of overeating in response to feelings of anxiety, sadness, loneliness, and happiness, and were characterized by a higher total score than male participants, while p ≤ 0.05 was interpreted as a statistical significance. Obese participants declared a higher frequency of overeating in response to feelings of sadness, and loneliness than normal weight participants. Participants gaining weight declared a higher frequency of overeating in response to feelings of anxiety, sadness, loneliness, tiredness, and anger, and were characterized by a higher total score than participants losing weight or maintaining a stable weight, while participants gaining weight declared a higher frequency of overeating in response to feelings of happiness than participants losing weight. Participants declaring both sweet and salty products as tempting declared a higher frequency of overeating in response to feelings of anxiety, and sadness than participants declaring no tempting products; participants declaring both sweet and salty products declared a higher frequency of overeating in response to feelings of tiredness than participants declaring only salty products and those declaring no tempting products, as well as declared a higher frequency of overeating in response to feelings of happiness than participants declaring only sweet products, and those declaring no tempting products; participants declaring sweet products declared a higher frequency of overeating in response to feelings of anger than participants declaring no tempting products, while participants declaring both sweet and salty products declared a higher frequency of overeating in response to feelings of loneliness, and were characterized by a higher total score than all other respondents. The sub-groups with the highest frequency of emotional overeating were the female respondents, obese participants, those gaining weight, and those declaring both sweet and salty products as tempting, while among the emotions most often causing emotional overeating, there were sadness and loneliness.
Collapse
Affiliation(s)
- Dominika Głąbska
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland; (D.G.); (D.S.)
| | - Dominika Skolmowska
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland; (D.G.); (D.S.)
| | - Dominika Guzek
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland
| |
Collapse
|
13
|
Chew HSJ, Loong SSE, Lim SL, Tam WSW, Chew NWS, Chin YH, Chao AM, Dimitriadis GK, Gao Y, So BYJ, Shabbir A. Socio-Demographic, Behavioral and Psychological Factors Associated with High BMI among Adults in a Southeast Asian Multi-Ethnic Society: A Structural Equation Model. Nutrients 2023; 15:nu15081826. [PMID: 37111045 PMCID: PMC10144460 DOI: 10.3390/nu15081826] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/31/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023] Open
Abstract
While various influencing factors of overweight and obesity have been identified, the underlying mechanism remains unclear. We examined the relationships among sociodemographic, behavioral, and psychological factors on anthropometry in a multi-ethnic population with overweight and obesity. Participants (N = 251) were recruited from January to October 2022. Mean age and self-reported BMI were 31.7 ± 10.1 years and 29.2 ± 7.2 kg/m2. Participants were mostly female (52.4%) and overweight (58.2%). Multivariate multiple regression was performed using maximum likelihood estimation. Body mass index was associated with waist circumference, age, sex, race, marital status, education level, residential region, overeating habit, immediate thinking, self-regulation, and physical activity, but not anxiety, depression, or the intention to change eating habits. Final model indicated good fit: χ2 (30, N = 250) = 33.5, p = 0.32, CFI = 0.993, TLI = 0.988, RMSEA = 0.022, and SRMR = 0.041. Direct effects were found between BMI and overeating (β = 0.10, p = 0.004), race (β = -0.82, p < 0.001), marital status (β = -0.42, p = 0.001), and education level (β = -0.28, p = 0.019). Crisps (68.8%), cake (66.8%) and chocolate (65.6%) were identified as the most tempting foods. Immediate thinking indirectly increased overeating habits through poor self-regulation, although sociodemographic characteristics better predicted anthropometry than psycho-behavioral constructs.
Collapse
Affiliation(s)
- Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Shaun Seh Ern Loong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Su Lin Lim
- Dietetics Department, National University Hospital, Singapore 119074, Singapore
| | - Wai San Wilson Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Nicholas W S Chew
- Department of Cardiology, National University Heart Centre, Singapore 119074, Singapore
| | - Yip Han Chin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Ariana M Chao
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104-4217, USA
| | - Georgios K Dimitriadis
- Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK
- Obesity, Type 2 Diabetes and Immunometabolism Research Group, Department of Diabetes, Faculty of Cardiovascular Medicine & Sciences, School of Life Course Sciences, King's College London, London WC2R 2LS, UK
| | - Yujia Gao
- Division of Hepatobiliary & Pancreatic Surgery, Department of Surgery, National University Hospital, Singapore 119074, Singapore
| | - Bok Yan Jimmy So
- Division of General Surgery (Upper Gastrointestinal Surgery), Department of Surgery, National University Hospital, Singapore 119074, Singapore
| | - Asim Shabbir
- Division of General Surgery (Upper Gastrointestinal Surgery), Department of Surgery, National University Hospital, Singapore 119074, Singapore
| |
Collapse
|
14
|
Andrade FC, Hoyle RH. A synthesis and meta-analysis of the relationship between trait self-control and healthier practices in physical activity, eating, and sleep domains. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023. [DOI: 10.1016/j.paid.2023.112095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
|
15
|
Zahedi A, Öznur Akalin R, Lawrence JE, Baumann A, Sommer W. The nature and persistence of the effects of posthypnotic suggestions on food preferences: The final report of an online study. Front Psychol 2023; 14:1123907. [PMID: 37034940 PMCID: PMC10074491 DOI: 10.3389/fpsyg.2023.1123907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/24/2023] [Indexed: 04/11/2023] Open
Abstract
The persistence of food preferences, which are crucial for diet-related decisions, is a significant obstacle to changing unhealthy eating behavior. To overcome this obstacle, the current study investigates whether posthypnotic suggestions (PHSs) can enhance food-related decisions by measuring food choices and subjective ratings. After assessing hypnotic susceptibility in Session 1, at the beginning of Session 2, a PHS was delivered aiming to increase the desirability of healthy food items (e.g., vegetables and fruit). After the termination of hypnosis, a set of two tasks was administrated twice, once when the PHS was activated and once deactivated in counterbalanced order. The task set consisted of rating 170 pictures of food items, followed by an online supermarket where participants were instructed to select enough food from the same item pool for a fictitious week of quarantine. After 1 week, Session 3 mimicked Session 2 without renewed hypnosis induction to assess the persistence of the PHS effects. The Bayesian hierarchical modeling results indicate that the PHS increased preferences and choices of healthy food items without altering the influence of preferences in choices. In contrast, for unhealthy food items, not only both preferences and choices were decreased due to the PHS, but also their relationship was modified. That is, although choices became negatively biased against unhealthy items, preferences played a more dominant role in unhealthy choices when the PHS was activated. Importantly, all effects persisted over 1 week, qualitatively and quantitatively. Our results indicate that although the PHS affected healthy choices through resolve, i.e., preferred more and chosen more, unhealthy items were probably chosen less impulsively through effortful suppression. Together, besides the translational importance of the current results for helping the obesity epidemic in modern societies, our results contribute theoretically to the understanding of hypnosis and food choices.
Collapse
Affiliation(s)
- Anoushiravan Zahedi
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Decision Neuroscience and Nutrition, German Institute of Human Nutrition (DIfE), Nuthetal, Germany
- Neuroscience Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Neuroscience Research Center, Berlin, Germany
- Department of Psychology, University of Muenster (Westfaelische Wilhelms-Universitaet Muenster), Münster, Germany
| | - Renin Öznur Akalin
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Annika Baumann
- Weizenbaum Institute for the Networked Society, Berlin, Germany
- University of Potsdam, Chair of Business Informatics, esp. Social Media and Society, Potsdam, Germany
| | - Werner Sommer
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| |
Collapse
|
16
|
Köster M, Buabang EK, Ivančir T, Moors A. A value accumulation account of unhealthy food choices: testing the influence of outcome salience under varying time constraints. Cogn Res Princ Implic 2023; 8:4. [PMID: 36633704 PMCID: PMC9835743 DOI: 10.1186/s41235-022-00459-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023] Open
Abstract
People often engage in unhealthy eating despite having an explicit goal to follow a healthy diet, especially under certain conditions such as a lack of time. A promising explanation from the value accumulation account is that food choices are based on the sequential consideration of the values of multiple outcomes, such as health and taste outcomes. Unhealthy choices may result if taste is considered before health. We examined whether making a health outcome more salient could alter this order, thereby leading to more healthy choices even under time pressure. Two studies examined the time-dependent effect of outcome values and salience on food choices. Participants first completed priming trials on which they rated food items on healthiness (health condition), tastiness (taste condition), or both healthiness and tastiness (control condition). They then completed blocks of binary choice trials between healthy and tasty items. The available response time was manipulated continuously in Study 1 (N = 161) and categorically in Study 2 (N = 318). As predicted, results showed that the values of health and taste outcomes influenced choices and that priming led to more choices in line with the primed outcomes even when time was scarce. We did not obtain support for the prediction that the priming effect is time-dependent in the sense that primed outcomes are considered before non-primed outcomes. Together, these findings suggest that increasing the value and salience of a health outcome may be effective ways to increase healthy choices, even under poor conditions such as time pressure.
Collapse
Affiliation(s)
- Massimo Köster
- grid.5596.f0000 0001 0668 7884Research Group of Quantitative Psychology and Individual Differences, KU Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Center for Social and Cultural Psychology, KU Leuven, Leuven, Belgium
| | - Eike K. Buabang
- grid.5596.f0000 0001 0668 7884Research Group of Quantitative Psychology and Individual Differences, KU Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Center for Social and Cultural Psychology, KU Leuven, Leuven, Belgium ,grid.8217.c0000 0004 1936 9705Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Tina Ivančir
- grid.5596.f0000 0001 0668 7884Research Group of Quantitative Psychology and Individual Differences, KU Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Center for Social and Cultural Psychology, KU Leuven, Leuven, Belgium
| | - Agnes Moors
- grid.5596.f0000 0001 0668 7884Research Group of Quantitative Psychology and Individual Differences, KU Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Center for Social and Cultural Psychology, KU Leuven, Leuven, Belgium
| |
Collapse
|
17
|
Al-Hazmi MH, Noorwali EA. Morning individuals in Saudi Arabia have higher self-regulation of eating behavior compared to evening types. Chronobiol Int 2022; 40:223-233. [PMID: 36545690 DOI: 10.1080/07420528.2022.2158846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Chronotype is a manifestation of an individual's circadian system, which can be presented as a preference for morningness or eveningness. Evening chronotype has been linked to unhealthy dietary habits. These habits are partially from poor self-regulation of eating behavior (SREB). SREB is a goal-directed process that helps resist food temptation and achieve desired dietary outcomes. It is unclear whether chronotype is associated with SREB. This study aims to investigate the association between chronotypes and SREB. A total of 599 adults (18-50 years) enrolled in this cross-sectional study. Participants received an online questionnaire that collected sociodemographic, anthropometrics, chronotype through the validated reduced Morningness-Eveningness Questionnaire (rMEQ) and SREB using the SREB Questionnaire. ANOVA, Chi-square and multivariate logistic regression were used. In adjusted models, morning types had 85% higher SREB compared to evening types (p = 0.003, OR = 1.85). Evening types found fried foods (p = 0.003), chips (p = 0.005) and French fries (p = 0.018) more tempting than morning types. These findings show a link between chronotype and SREB. Strategies focusing on SREB may help evening types improve dietary habits. Further studies are required to clarify the underlying mechanisms for these associations. This may have important implications for lifestyle and behavioral change policy.
Collapse
Affiliation(s)
- Marwa Hamed Al-Hazmi
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Essra Abdulsalam Noorwali
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| |
Collapse
|
18
|
Huang Z, Tan PT, Kua Z, Ong LJ, Hamzah FBM, Tan B. Healthcare workers' self-regulatory eating behaviours are associated with being stress-free during the Covid-19 lockdown in Singapore. Sci Rep 2022; 12:16257. [PMID: 36171219 PMCID: PMC9518944 DOI: 10.1038/s41598-022-19001-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 08/23/2022] [Indexed: 11/23/2022] Open
Abstract
Our study sought to examine the impact of the pandemic and the Circuit-breaker (CB) measures on dietary behaviours of healthcare workers (HCW). In addition, the association between self-regulatory eating behaviours and psychological stress was explored. Our study employed a cross-sectional anonymous survey that examined the demographics, dietary habits, self-regulatory eating behaviours (SR) and their association to stress levels of healthcare workers (HCWs) before and during the Circuit Breaker (CB) in Singapore. The survey was conducted over four weeks from May 17 to June 18, 2020. Snowball sampling was performed in the final week. A total of 707 participants took part in the survey. Due to the CB measures and modifications of work scope and work areas, there were significant changes in their dietary behaviors before CB versus during the CB period (n = 707), with many reducing the intake of vegetables (p = 0.018) while increasing their intake of unhealthy food choices such as canned drinks (p = 0.002), convenience food (p ≤ 0.001) and alcoholic drinks (p = 0.034). Before the CB period, 91.8% (602/656) of participants who intended to have a healthy diet were classified in medium-to-high SR groups whereas during the CB period, 87.7% (575/656) were in medium-to-high SR groups and the difference was statistically significant (p = 0.011). Nurses, administrative staff, HCWs of Chinese and Indian ethnicities, staff who did not complete university education and those who did not have domestic helpers were more likely to have reduced SR. Importantly, amongst participants who intended to have a healthy diet, 70.9% displayed no change or improved eating habits and showed medium-to-high levels of SR during CB. Participants with no changes in SR were 2.11 times more likely to be stress-free as compared to those who had deteriorated SR (OR 2.11 95% CI 1.27–3.48, p = 0.004). Due to CB measures and work modifications, dietary behaviours of HCWs deteriorated with increased intake of unhealthy food choices. HCWs who maintain their self-regulatory eating behaviour are more likely to be stress-free. Short screening questionnaires based on SR changes should be developed and explored as surveillance tools for assessment of HCWs’ general well-being such that personalized interventions to vulnerable groups of workers could be implemented effectively on the ground.
Collapse
Affiliation(s)
- Zhongwei Huang
- Institute of Molecular and Cell Biology, Agency of Science, Technology and Research, Singapore, Singapore. .,Department of Obstetrics & Gynaecology, National University Health Systems, NUHS Tower Block Level 12, 1E Kent Ridge Road, Singapore, 119228, Singapore. .,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
| | - Pei Ting Tan
- Clinical Trials & Research Unit, Changi General Hospital, Singapore, Singapore
| | - Zaylea Kua
- Department of Psychological Medicine, Changi General Hospital, Singapore, Singapore
| | - Li Jiuen Ong
- Department of Dietetic and Food Services, Changi General Hospital, Singapore, Singapore
| | | | - Benedict Tan
- Department of Sport & Exercise Medicine, Changi General Hospital, Singapore, Singapore
| |
Collapse
|
19
|
Personal motivation, self-regulation barriers and strategies for weight loss in people with overweight and obesity: a thematic framework analysis. Public Health Nutr 2022; 25:2426-2435. [PMID: 35190011 PMCID: PMC9991665 DOI: 10.1017/s136898002200043x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore motivations, self-regulation barriers and strategies in a multi-ethnic Southeast Asian population with overweight and obesity. DESIGN Qualitative design using semi-structured face-to-face and videoconferencing interviews. Data were analysed using thematic framework analysis and constant comparison method. SETTING Specialist weight management clinic. PARTICIPANTS Twenty-two participants were purposively sampled from 13 April to 30 April 2021. Median age and BMI of the participants were 37·5 (interquartile range (IQR) = 13·3) and 39·2 kg/m2 (IQR = 6·1), respectively. And 31·8 % were men, majority had a high intention to adopt healthy eating behaviours (median = 6·5; IQR = 4·8-6·3) and 59 % of the participants had a medium level of self-regulation. RESULTS Six themes and fifteen subthemes were derived. Participants were motivated to lose weight by the sense of responsibility as the family's pillar of support and to feel 'normal' again. We coupled self-regulation barriers with corresponding strategies to come up with four broad themes: habitual overconsumption - mindful self-discipline; proximity and convenience of food available - mental tenacity; momentary lack of motivation and sense of control - motivational boosters; and overeating triggers - removing triggers. We highlighted six unique overeating triggers namely: trigger activities (e.g. using social media); eating with family, friends and colleagues; provision of food by someone; emotions (e.g. feeling bored at home, sad and stressed); physiological condition (e.g. premenstrual syndrome); and the time of the day. CONCLUSIONS Future weight management interventions should consider encompassing participant-led weight loss planning, motivation boosters and self-regulation skills to cope with momentary overeating triggers.
Collapse
|
20
|
A high-fibre personalised dietary advice given via a web tool reduces constipation complaints in adults. J Nutr Sci 2022; 11:e31. [PMID: 35573462 PMCID: PMC9066321 DOI: 10.1017/jns.2022.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 03/28/2022] [Accepted: 04/01/2022] [Indexed: 11/07/2022] Open
Abstract
Constipation can greatly impact the quality of life (QoL), which can be relieved by dietary fibres; however, preserving a higher fibre intake remains a challenge. We investigated the effects of a personalised dietary advice (PDA) on fibre intake and mild constipation complaints. A total number of twenty-five adults with mild constipation complaints were included in a 4-week observation period followed by a 4-week personalised intervention. The PDA provided high-fibre alternatives via a web tool. In weeks 1, 4 and 8, dietary intake, constipation complaints and QoL were assessed. Furthermore, participants collected a faecal sample at weeks 1, 4 and 8 to determine microbiota diversity and composition, and short-chain fatty acids (SCFA). Participants completed questions daily for 8 weeks regarding abdominal complaints, stool frequency and stool consistency. Fibre intake in week 8 was significantly higher compared to week 1 (Δ = 5·7 ± 6·7 g, P < 0·001) and week 4 (Δ = 5·2 ± 6·4 g, P < 0·001). Constipation severity and QoL significantly improved at week 8 compared to the observation period (P < 0·001). A higher fibre intake significantly reduced constipation severity (β = -0·031 (-0·05; -0·01), P = 0·001) and the QoL (β = -0·022 (-0·04; -0·01), P = 0·009). Stool consistency (P = 0·040) and abdominal pain (P = 0·030) improved significantly during the intervention period (P = 0·040), but stool frequency did not. Average microbial alpha diversity and composition and SCFA concentrations did not change over time, but indicated individual-specific dynamics. Several SCFAs were associated with constipation complaints. To conclude, a PDA effectively increased fibre intake and subsequently reduced constipation complaints, indicating that guided dietary adjustments are important and feasible in the treatment of mild constipation complaints.
Collapse
Key Words
- BMI, body mass index
- Constipation
- Dietary fibre
- EMA, ecological momentary assessment
- FFQ, food frequency questionnaire
- Functional bowel disorders
- IBS-C, Irritable Bowel Syndrome constipation predominant
- MET, metabolic equivalent task
- PAC-QoL, Patient Assessment of Constipation Quality of Life
- PAC-SYM, Patient Assessment of Constipation Symptoms
- PDA, personalised dietary advice
- Personalised nutrition
- QoL, quality of life
- Quality of life
- SQUASH, short questionnaire to assess health-enhancing physical activity
- VAS, visual analogue scale
Collapse
|
21
|
Zahedi A, Öznur Akalin R, Lawrence JE, Baumann A, Sommer W. The Nature and Persistence of Posthypnotic Suggestions' Effects on Food Preferences: An Online Study. Front Nutr 2022; 9:859656. [PMID: 35600831 PMCID: PMC9116029 DOI: 10.3389/fnut.2022.859656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/11/2022] [Indexed: 11/17/2022] Open
Abstract
Food preferences are crucial for diet-related decisions, which substantially impact individual health and global climate. However, the persistence of unfavorable food preferences is a significant obstacle to changing eating behavior. Here we explored the effects of posthypnotic suggestions (PHS) on food-related decisions by measuring food choices, subjective ratings, and indifference points. In Session 1, demographic data and hypnotic susceptibility of participants were assessed. In Session 2, following hypnosis induction, PHS aiming to increase the desirability of healthy food was delivered. Afterward, a task set was administrated twice, once when PHS was activated and once deactivated. The order of PHS activation was counterbalanced across participants. The task set included a liking-rating task for 170 pictures of different food items, followed by an online supermarket where participants were instructed to select enough food for a fictitious week of quarantining from the same item pool. After 1 week, Session 3 repeated Session 2 without hypnosis induction in order to assess the persistence of PHS. The crucial dependent measures were food choices, subjective ratings, and the indifference points as a function of time and PHS condition.
Collapse
Affiliation(s)
- Anoushiravan Zahedi
- Department of Psychology, Humboldt Universität zu Berlin, Berlin, Germany
- Department of Decision Neuroscience and Nutrition, German Institute of Human Nutrition (DIfE), Nuthetal, Germany
- Neuroscience Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Neuroscience Research Center, Berlin, Germany
- *Correspondence: Anoushiravan Zahedi
| | - Renin Öznur Akalin
- Berlin School of Mind and Brain, Humboldt Universitat zu Berlin, Berlin, Germany
| | | | - Annika Baumann
- Weizenbaum Institute for the Networked Society, Berlin, Germany
- University of Potsdam, Chair for Business Informatics, esp. Social Media and Society, Potsdam, Germany
| | - Werner Sommer
- Department of Psychology, Humboldt Universität zu Berlin, Berlin, Germany
- Werner Sommer
| |
Collapse
|
22
|
Hilbert A, Witte V, Meule A, Braehler E, Kliem S. Development of the Hedonic Overeating–Questionnaire (HEDO–Q). Nutrients 2022; 14:nu14091865. [PMID: 35565829 PMCID: PMC9100100 DOI: 10.3390/nu14091865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 02/01/2023] Open
Abstract
Addictive-like eating is prevalent, but a clear conceptualization and operationalization outside of an addiction framework is lacking. By adopting a biopsychological framework of food reward, this study sought to develop and evaluate a brief self-report questionnaire for the trait assessment of hedonic overeating and dyscontrol. Items in the Hedonic Overeating–Questionnaire (HEDO–Q) were constructed following a rational approach and psychometrically evaluated in a large random sample from the German population (N = 2531). A confirmatory factor analysis supported the unidimensional nature of the six-item HEDO–Q with the three postulated components of wanting, liking, and dyscontrol. Psychometric properties were favorable with good corrected item-total correlations, acceptable item difficulty and homogeneity, and high internal consistency. Population norms were provided. The HEDO–Q revealed strict measurement invariance for sex and partial invariance for age and weight status. Discriminant validity was demonstrated in distinguishing participants with versus without eating disturbances or obesity. Associations with the established measures of eating disorder and general psychopathology supported the convergent and divergent validity of the HEDO–Q. This first evaluation indicates good psychometric properties of the HEDO–Q in the general population. Future validation work is warranted on the HEDO–Q’s stability, sensitivity to change, and predictive and construct validity.
Collapse
Affiliation(s)
- Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany;
- Correspondence:
| | - Veronica Witte
- Clinic for Cognitive Neurology, University of Leipzig Medical Center, 04103 Leipzig, Germany;
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany
| | - Adrian Meule
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, 80336 Munich, Germany;
- Schoen Clinic Roseneck, 83209 Prien am Chiemsee, Germany
| | - Elmar Braehler
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany;
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, 55131 Mainz, Germany
| | - Soeren Kliem
- Ernst-Abbe-Hochschule, University of Applied Sciences, 07745 Jena, Germany;
| |
Collapse
|
23
|
Analysis of Self-Regulation of Eating Behaviors within Polish Adolescents' COVID-19 Experience (PLACE-19) Study. Nutrients 2022; 14:nu14081679. [PMID: 35458243 PMCID: PMC9030425 DOI: 10.3390/nu14081679] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/07/2022] [Accepted: 04/14/2022] [Indexed: 01/01/2023] Open
Abstract
The self-regulation of eating behaviors (suppression of behavioral short-term impulse to consume food products in the interest of pursuing long-term weight goals), has been an important determinant for adopting a healthy lifestyle in the period of the COVID-19 pandemic in adults, but there have been no such studies conducted in the population of adolescents in this period. The aim of the presented study is to analyze self-regulation of eating behaviors in the population-based sample of Polish adolescents within the Polish Adolescents’ COVID-19 Experience (PLACE-19) Study. The Self-Regulation of Eating Behavior Questionnaire (SREBQ) was used to assess self-regulation of eating behaviors in the studied population of 1126 Polish adolescents (818 females and 308 males), aged 15−20, recruited based on a random quota sampling within a national sample. Based on the screening questions of the SREBQ, 145 individuals were excluded from the analysis. The participants of the study were categorized based on their gender, body mass index, body mass index change during the COVID-19 pandemic, and food products declared as tempting. The major factors associated with SREBQ score were body mass index change and tempting food products. The respondents losing weight during the COVID-19 pandemic were characterized by a higher SREBQ score than those maintaining stable body mass or gaining weight (3.4 vs. 3.2 vs. 3.2; p = 0.0001). The respondents declaring both sweet and salty food products as tempting were characterized by a lower SREBQ score than those declaring only sweet, only salty, or declaring no tempting products (3.2 vs. 3.4 vs. 3.4 vs. 3.4; p < 0.0001). The major factors associated with SREBQ categories were gender, body mass index change, and tempting food products. A higher share of respondents characterized by a high self-regulation of eating behaviors was observed for males than for females (27.4% vs. 18.8%; p = 0.0142); for respondents losing weight during the COVID-19 pandemic than for respondents gaining weight (25.9% vs. 15.5%; p = 0.0423); as well as for respondents declaring no tempting products than those declaring both sweet and salty food products (38.3% vs. 18.2%; p < 0.0001). It was concluded that the self-regulation of eating behaviors in adolescents is closely associated with food products perceived as tempting by them, as well as with gender. During the COVID-19 pandemic, the low self-regulation of eating behaviors was a significant determinant of the body mass gain. Taking this into account, female adolescents characterized by a low self-regulation of eating behaviors especially should be subjected to a dedicated intervention program to prevent overweight and obesity.
Collapse
|
24
|
Chami R, Cardi V, Lawrence N, MacDonald P, Rowlands K, Hodsoll J, Treasure J. Targeting binge eating in bulimia nervosa and binge eating disorder using inhibitory control training and implementation intentions: a feasibility trial. Psychol Med 2022; 52:874-883. [PMID: 32713405 DOI: 10.1017/s0033291720002494] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND This trial examined the feasibility, acceptability, and effect sizes of clinical outcomes of an intervention that combines inhibitory control training (ICT) and implementation intentions (if-then planning) to target binge eating and eating disorder psychopathology. METHODS Seventy-eight adult participants with bulimia nervosa or binge eating disorder were randomly allocated to receive food-specific, or general, ICT and if-then planning for 4 weeks. RESULTS Recruitment and retention rates at 4 weeks (97.5% and 79.5%, respectively) met the pre-set cut-offs. The pre-set adherence to the intervention was met for the ICT sessions (84.6%), but not for if-then planning (53.4%). Binge eating frequency and eating disorder psychopathology decreased in both intervention groups at post-intervention (4 weeks) and follow-up (8 weeks), with moderate to large effect sizes. There was a tendency for greater reductions in binge eating frequency and eating disorders psychopathology (i.e. larger effect sizes) in the food-specific intervention group. Across both groups, ICT and if-then planning were associated with small-to-moderate reductions in high energy-dense food valuation (post-intervention), food approach (post-intervention and follow-up), anxiety (follow-up), and depression (follow-up). Participants indicated that both interventions were acceptable. CONCLUSIONS The study findings reveal that combined ICT and if-then planning is associated with reductions in binge eating frequency and eating disorder psychopathology and that the feasibility of ICT is promising, while improvements to if-then planning condition may be needed.
Collapse
Affiliation(s)
- Rayane Chami
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Valentina Cardi
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of General Psychology, University of Padova, Padova, Italy
| | | | - Pamela MacDonald
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Katie Rowlands
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - John Hodsoll
- Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| |
Collapse
|
25
|
Peng-Li D, Alves Da Mota P, Correa CMC, Chan RCK, Byrne DV, Wang QJ. “Sound” Decisions: The Combined Role of Ambient Noise and Cognitive Regulation on the Neurophysiology of Food Cravings. Front Neurosci 2022; 16:827021. [PMID: 35250463 PMCID: PMC8888436 DOI: 10.3389/fnins.2022.827021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/17/2022] [Indexed: 12/24/2022] Open
Abstract
Our ability to evaluate long-term goals over immediate rewards is manifested in the brain’s decision circuit. Simplistically, it can be divided into a fast, impulsive, reward “system 1” and a slow, deliberate, control “system 2.” In a noisy eating environment, our cognitive resources may get depleted, potentially leading to cognitive overload, emotional arousal, and consequently more rash decisions, such as unhealthy food choices. Here, we investigated the combined impact of cognitive regulation and ambient noise on food cravings through neurophysiological activity. Thirty-seven participants were recruited for an adapted version of the Regulation of Craving (ROC) task. All participants underwent two sessions of the ROC task; once with soft ambient restaurant noise (∼50 dB) and once with loud ambient restaurant noise (∼70 dB), while data from electroencephalography (EEG), electrodermal activity (EDA), and self-reported craving were collected for all palatable food images presented in the task. The results indicated that thinking about future (“later”) consequences vs. immediate (“now”) sensations associated with the food decreased cravings, which were mediated by frontal EEG alpha power. Likewise, “later” trials also increased frontal alpha asymmetry (FAA) —an index for emotional motivation. Furthermore, loud (vs. soft) noise increased alpha, beta, and theta activity, but for theta activity, this was solely occurring during “later” trials. Similarly, EDA signal peak probability was also higher during loud noise. Collectively, our findings suggest that the presence of loud ambient noise in conjunction with prospective thinking can lead to the highest emotional arousal and cognitive load as measured by EDA and EEG, respectively, both of which are important in regulating cravings and decisions. Thus, exploring the combined effects of interoceptive regulation and exteroceptive cues on food-related decision-making could be methodologically advantageous in consumer neuroscience and entail theoretical, commercial, and managerial implications.
Collapse
Affiliation(s)
- Danni Peng-Li
- Food Quality Perception and Society Team, iSENSE Lab, Department of Food Science, Aarhus University, Aarhus, Denmark
- Sino-Danish College (SDC), University of Chinese Academy of Sciences, Beijing, China
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- *Correspondence: Danni Peng-Li,
| | - Patricia Alves Da Mota
- Food Quality Perception and Society Team, iSENSE Lab, Department of Food Science, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, Center for Music in the Brain, Aarhus University, Aarhus, Denmark
| | - Camile Maria Costa Correa
- Food Quality Perception and Society Team, iSENSE Lab, Department of Food Science, Aarhus University, Aarhus, Denmark
| | - Raymond C. K. Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Derek Victor Byrne
- Food Quality Perception and Society Team, iSENSE Lab, Department of Food Science, Aarhus University, Aarhus, Denmark
- Sino-Danish College (SDC), University of Chinese Academy of Sciences, Beijing, China
| | - Qian Janice Wang
- Food Quality Perception and Society Team, iSENSE Lab, Department of Food Science, Aarhus University, Aarhus, Denmark
- Sino-Danish College (SDC), University of Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
26
|
Boedt T, Steenackers N, Verbeke J, Vermeulen A, De Backer C, Yiga P, Matthys C. A Mixed-Method Approach to Develop and Validate an Integrated Food Literacy Tool for Personalized Food Literacy Guidance. Front Nutr 2022; 8:760493. [PMID: 35127779 PMCID: PMC8814651 DOI: 10.3389/fnut.2021.760493] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
BackgroundFood literacy refers to all practicalities associated with healthy eating. Current food literacy tools are limited in practical use in clinical practice. Therefore, an integrated food literacy tool (IFLT) to assess food literacy and to personalize food literacy guidance was developed and validated.MethodsFollowing an iterative process, a food literacy framework was developed and food literacy goals were defined. A corresponding food literacy screener (FLS) to assess food literacy was developed along with an algorithm to provide personalized food literacy guidance based on the food literacy assessment. Content validation of the FLS was assessed by a panel of experts, measuring item and scale content validity index (I/S-CVI) and by the target population in semi structured interviews with 15 adults of reproductive age. Subsequently, an online cross-sectional survey was conducted among 114 adults of reproductive age to evaluate the validity of the FLS. Construct validity was examined against both the validated healthy eating and weight self-efficacy scale and against a food frequency questionnaire assessing healthy eating self-efficacy (HESE) and diet quality, respectively. Reliability was assessed with a two-week test-retest. Pearson correlation tests were conducted.ResultsAn IFLT consisting of a FLS and corresponding algorithm to personalize food literacy guidance by prioritizing food literacy goals was developed. The IFLT includes 24 food literacy goals, addressed by 17 FLS items. Every item received a weighting factor based on theory and expert opinion to prioritize food literacy goals according to personal needs. Content validity revealed that the FLS was rated relevant by experts (S-CVI = 0.93) and well-understood by the target population. The FLS has a good construct validity as it was positively correlated with diet quality (r = 0.536, p < 0.001) and with HESE (r = 0.685, p < 0.001). It also showed a good test-retest reliability (r = 0.721, p < 0.001).ConclusionThe newly developed IFLT is a practically applicable, context specific theory-and expert-based dual purpose tool to assess food literacy and to personalize food literacy guidance by prioritizing individuals' food literacy goals to their needs.
Collapse
Affiliation(s)
- Tessy Boedt
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Nele Steenackers
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Joke Verbeke
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Astrid Vermeulen
- Laboratory of Molecular Bacteriology, Department of Microbiology, Immunology and Transplanation, Rega Institute, KU Leuven, Leuven, Belgium
| | - Charlotte De Backer
- Department of Communication Sciences, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Peter Yiga
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
- Department of Food Technology, Kyambogo University, Kampala, Uganda
| | - Christophe Matthys
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
- *Correspondence: Christophe Matthys
| |
Collapse
|
27
|
Reister EJ, Mattes RD. No apparent effects of a viscous, superabsorbent hydrogel on appetite, energy intake, or fecal excretion in overweight adults. Physiol Behav 2022; 243:113643. [PMID: 34767836 DOI: 10.1016/j.physbeh.2021.113643] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 10/19/2022]
Abstract
As the obesity epidemic continues, there is a great need for safe and effective weight loss aids. A superabsorbent hydrogel device administered as a capsule demonstrates potential for weight loss, but its mechanism of action remains unclear. The present study's goal was to determine the mechanisms of action of the hydrogel through the investigation of its effects on appetitive sensations, eating behavior, energy intake, and fecal excretion of energy. Overweight and obese adults (n = 18) participated in a double-blind, randomized, crossover-design study in which they were provided all meals for a week in a supervised setting (i.e., controlled-feeding) and were required to either consume the hydrogel or a placebo with 16-oz of water 20 min before lunch and dinner. No differences in appetite (all, p > 0.05), total fecal nitrogen excretion (p = 0.74), total fecal fat excretion (p = 0.54), or total fecal energy excretion (p = 0.76) were identified when comparing the hydrogel to a placebo. Affect towards food (i.e., mood, emotions) was more positive in the hydrogel group compared with the placebo group. A subset of the controlled-feeding group (n = 10) then participated in another double-blind, randomized, crossover-design study in which they provided their own food for a week (i.e., free-feeding) and were required to either consume the hydrogel or a placebo with 16-oz of water 20 min before lunch and dinner. No differences in appetite (all, p > 0.05), energy intake (p = 0.95), diet quality (all, p > 0.05), or eating behavior (all, p > 0.05) were determined when comparing the hydrogel to the placebo. Future studies with greater statistical power should confirm these findings and investigate other potential mechanisms of action of the hydrogel.
Collapse
Affiliation(s)
- Evan J Reister
- Department of Nutrition Science, Ingestive Behavior Research Center, Purdue University, 700W State Street, West Lafayette, IN 47907-2059, USA
| | - Richard D Mattes
- Department of Nutrition Science, Ingestive Behavior Research Center, Purdue University, 700W State Street, West Lafayette, IN 47907-2059, USA.
| |
Collapse
|
28
|
Keeler JL, Chami R, Cardi V, Hodsoll J, Bonin E, MacDonald P, Treasure J, Lawrence N. App-based food-specific inhibitory control training as an adjunct to treatment as usual in binge-type eating disorders: A feasibility trial. Appetite 2022; 168:105788. [PMID: 34728250 DOI: 10.1016/j.appet.2021.105788] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 10/14/2021] [Accepted: 10/29/2021] [Indexed: 01/11/2023]
Abstract
Current treatments for binge eating disorder (BED) and bulimia nervosa (BN) only show moderate efficacy, warranting the need for novel interventions. Impairments in food-related inhibitory control contribute to BED/BN and could be targeted by food-specific inhibitory control training (ICT). The aim of this study was to establish the feasibility and acceptability of augmenting treatment for individuals with BN/BED with an ICT app (FoodT), which targets motor inhibition to food stimuli using a go/no-go paradigm. Eighty patients with BED/BN receiving psychological and/or pharmacological treatment were randomly allocated to a treatment-as-usual group (TAU; n = 40) or TAU augmented with the 5-min FoodT app daily (n = 40) for 4 weeks. This mixed-methods study assessed feasibility outcomes, effect sizes of clinical change, and acceptability using self-report measures. Pre-registered cut-offs for recruitment, retention, and adherence were met, with 100% of the targeted sample size (n = 80) recruited within 12 months, 85% of participants retained at 4 weeks, and 80% of the FoodT + TAU group completing ≤8 sessions. The reduction in binge eating did not differ between groups. However, moderate reductions in secondary outcomes (eating disorder psychopathology: SES = -0.57, 95% CI [-1.12, -0.03]; valuation of high energy-dense foods: SES = -0.61, 95% CI [-0.87, -0.05]) were found in the FoodT group compared to TAU. Furthermore, small greater reductions in food addiction (SES = -0.46, 95% CI [-1.14, 0.22]) and lack of premeditation (SES = -0.42, 95% CI [-0.77, -0.07]) were found in the FoodT group when compared to TAU. The focus groups revealed acceptability of FoodT. Participants discussed personal barriers (e.g. distractions) and suggested changes to the app (e.g. adding a meditation exercise). Augmenting treatment for BED/BN with a food-specific ICT app is feasible, acceptable, and may reduce clinical symptomatology with high reach and wide dissemination.
Collapse
Affiliation(s)
- Johanna Louise Keeler
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Rayane Chami
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Valentina Cardi
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of General Psychology, University of Padova, Padova, Italy
| | - John Hodsoll
- Department of Biostatistics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Eva Bonin
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Pamela MacDonald
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | |
Collapse
|
29
|
Cohen TR, Kakinami L, Plourde H, Hunot-Alexander C, Beeken RJ. Concurrent Validity of the Adult Eating Behavior Questionnaire in a Canadian Sample. Front Psychol 2021; 12:779041. [PMID: 34925181 PMCID: PMC8675385 DOI: 10.3389/fpsyg.2021.779041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/02/2021] [Indexed: 11/23/2022] Open
Abstract
The current study aimed to test the factor structure of the Adult Eating Behavior Questionnaire (AEBQ), its construct validity against the Three-Factor Eating Questionnaire (TFEQ-R18) and its associations with body mass index (BMI) in Canadian adults (n = 534, 76% female). Confirmatory factor analysis (CFA) revealed that a seven-factor AEBQ model, with the Hunger subscale removed, had better fit statistics than the original eight-factor structure. Cronbach's alpha was used to assess the internal reliability of each subscale and resulted with α > 0.70 for all subscales except for Hunger (α = 0.68). Pearson's correlations were used to inform the convergent and discriminant validation of AEBQ against the TFEQ-R18 and to examine the relationship between AEBQ and BMI. All AEBQ Food Approach subscales positively correlated with that of the TFEQ-R18 Emotional Eating and Uncontrolled Eating subscales. Similarly, BMI correlated positively with Food Approach subscales (except Hunger) and negatively with Food Avoidance subscales (except Food Fussiness). These results support the use of a seven-factor AEBQ for adults self-reporting eating behaviors, construct validity of the AEBQ against TFEB-R18, and provide further evidence for the association of these traits with BMI.
Collapse
Affiliation(s)
- Tamara R. Cohen
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada
- PERFORM Centre, Concordia University, Montreal, QC, Canada
| | - Lisa Kakinami
- PERFORM Centre, Concordia University, Montreal, QC, Canada
- Department of Mathematics and Statistics, Concordia University, Montreal, QC, Canada
| | - Hugues Plourde
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC, Canada
| | - Claudia Hunot-Alexander
- Instituto de Nutrición Humana, Departamento de Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Rebecca J. Beeken
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| |
Collapse
|
30
|
Vinayachandran G, Patel N, Mathavaswami V, Subitha L. Food portion size educational programme in a workplace setting in Puducherry - Is it effective? J Family Med Prim Care 2021; 10:3368-3373. [PMID: 34760759 PMCID: PMC8565166 DOI: 10.4103/jfmpc.jfmpc_849_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/01/2021] [Accepted: 07/09/2021] [Indexed: 11/04/2022] Open
Abstract
Background: Consuming larger portion sizes, i.e., in excess of a typically recommended serving size, has been attributed to the obesity epidemic. The workplace acts as an efficient target for health promotion activities. Aims: To assess the effectiveness of a food portion size educational programme in increasing knowledge among the employees of a software company in Puducherry. Methodology: An interventional study was conducted with a pre-post design. A single group of software company employees (N = 120), age ≥30 years selected by simple random sampling was included in the study. The intervention consisted of a health education programme on the portion sizes of common food items including fruits and vegetables. A self-administered questionnaire was used to collect information on personal and sociodemographic details. Self-regulation on eating was assessed using the Self-Regulation of Eating Behaviour Questionnaire (SREBQ). Results: The mean age of the study participants was 27 ± 5 years. Most of the participants were males, i.e., 72 (60%). Of the total, 55 (47.8%) participants were obese and 18 (15.7%) were overweight. The median number of meals and snacks consumed by the participants was 3 (1–3) and 1 (1–2), respectively. The median (interquartile range [IQR]) knowledge scores of the food portion size significantly increased from 9 (0–16) to 14 (5–19) (P < 0.05). Conclusions: This study has demonstrated that an educational intervention in the workplace setting is feasible and effective in increasing the knowledge of food portion size over a short term.
Collapse
Affiliation(s)
- Gopika Vinayachandran
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Namita Patel
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Vijayageetha Mathavaswami
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - L Subitha
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| |
Collapse
|
31
|
Macedo VMC, Correia I, Prada M. Injustice impairs self‐regulation and affects food choice. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2021. [DOI: 10.1111/jasp.12822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Vera Margarida Cachapa Macedo
- Departamento de Psicologia Social e das Organizações Instituto Universitário de Lisboa (ISCTE‐IUL), CIS‐IUL Lisboa Portugal
| | - Isabel Correia
- Departamento de Psicologia Social e das Organizações Instituto Universitário de Lisboa (ISCTE‐IUL), CIS‐IUL Lisboa Portugal
| | - Marília Prada
- Departamento de Psicologia Social e das Organizações Instituto Universitário de Lisboa (ISCTE‐IUL), CIS‐IUL Lisboa Portugal
| |
Collapse
|
32
|
Cole RE, Jayne JM, O'Connor K, McGraw SM, Beyl R, DiChiara AJ, Karl JP. Development and Validation of the Military Eating Behavior Survey. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:798-810. [PMID: 34215517 DOI: 10.1016/j.jneb.2021.04.467] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 04/26/2021] [Accepted: 04/29/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To describe the Military Eating Behavior Survey (MEBS), developed, and validated for use in military populations. DESIGN Questionnaire development using a 6-phase approach that included item generation, subject matter expert review, cognitive interviewing, factor analysis, test-retest reliability testing, and parallel forms testing. SETTING US Army soldiers were surveyed at 8 military bases from 2016 to 2019 (n = 1,561). MAIN OUTCOME MEASURE Content, face, and construct validity and reliability of the MEBS. ANALYSIS Item variability, internal consistency, and exploratory factor analysis using principal coordinates analysis, orthogonal varimax rotation, and scree test (correlation coefficient and Cronbach alpha), as well as consistency and agreement (intraclass correlation coefficient) of test-retest reliability and parallel forms reliability. RESULTS Over 6 phases of testing, a comprehensive tool to examine military eating habits and mediators of eating behavior was developed. Questionnaire length was reduced from 277 items to 133 items (43 eating habits; 90 mediating behaviors). Factor analysis identified 14 eating habit scales (hunger, satiety, food craving, meal pattern, restraint, diet rigidity, emotional eating, fast/slow eating rate, environmental triggers, situational eating, supplement use, and food choice) and 8 mediating factor scales (body composition strategy, perceived stress, food access, sleep habits, military fitness, physical activity, military body image, and nutrition knowledge). CONCLUSIONS AND IMPLICATIONS The MEBS provides a new approach for assessing eating behavior in military personnel and may be used to inform and evaluate health promotion interventions related to weight management, performance optimization, and military readiness and resiliency.
Collapse
Affiliation(s)
- Renee E Cole
- US Military-Baylor University Graduate Program in Nutrition, Joint Base San Antonio-Fort Sam Houston, TX.
| | - Julianna M Jayne
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Kristie O'Connor
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Susan M McGraw
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Robbie Beyl
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | - Adam J DiChiara
- Combat Capabilities Development Command Soldier Center, US Army Soldier Systems Center, Natick MA
| | - J Philip Karl
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA
| |
Collapse
|
33
|
Bouwman EP, Reinders MJ, Galama J, Verain MCD. Context matters: Self-regulation of healthy eating at different eating occasions. Appl Psychol Health Well Being 2021; 14:140-157. [PMID: 34313378 PMCID: PMC9291911 DOI: 10.1111/aphw.12295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 07/08/2021] [Indexed: 11/24/2022]
Abstract
Self-regulation plays an important role in healthy eating behaviors. The current research explores temporary fluctuations in self-regulation next to variations between individuals. In an online observational study, 892 participants (Mage = 44.3, SDage = 12.7) monitored their self-regulation three times a week before a meal moment for 3 weeks. To analyze the data, a random intercept and slopes model was used, including variables on within-individual level (i.e. meal moment, tiredness, distractedness, social, and physical environment) and variables on between-individual level (i.e. self-efficacy, intrinsic motivation, and perception of social and physical opportunity). Self-regulation was found to be higher at breakfast compared with dinner (estimate = -0.08, p < .001), higher at home than out-of-home (estimate = -0.08, p < .001) and lower when individuals are more tired (estimate = 0.04, p < .001) and distracted (estimate = 0.07, p < .001). Moreover, self-regulation was higher for individuals with higher levels of intrinsic motivation (estimate = 0.19, p < .001) and self-efficacy (estimate = 0.41, p < .001). Insights from this research advance our knowledge regarding temporal influences on self-regulation and can provide input for behavior change tools such as personalized dietary advice.
Collapse
Affiliation(s)
- Emily P Bouwman
- Wageningen Economic Research, Wageningen University & Research, Wageningen, The Netherlands
| | - Machiel J Reinders
- Wageningen Economic Research, Wageningen University & Research, The Hague, The Netherlands
| | - Joris Galama
- Wageningen Economic Research, Wageningen University & Research, Wageningen, The Netherlands
| | - Muriel C D Verain
- Wageningen Economic Research, Wageningen University & Research, Wageningen, The Netherlands
| |
Collapse
|
34
|
Dijksterhuis GB, Bouwman EP, Taufik D. Personalized Nutrition Advice: Preferred Ways of Receiving Information Related to Psychological Characteristics. Front Psychol 2021; 12:575465. [PMID: 34239468 PMCID: PMC8258260 DOI: 10.3389/fpsyg.2021.575465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 04/30/2021] [Indexed: 01/15/2023] Open
Abstract
The primary goal of this study is to be able to discern specific types of consumers in terms of their psychosocial characteristics who may need different ways of receiving dietary advice. Knowing these types will enable a better fit of advice to consumers' psychosocial characteristics, hereby stimulating healthy eating as the probability of compliance to the advice can potentially increase. The study draws upon several psychological theories to distinguish unique underlying factors that can subsequently be used to personalize nutrition information for consumers. A number of general psychological scales (self-regulation, action and coping self-efficacy, social comparison, intrinsic motivation, health info processing, need for cognition and for affect, and regulatory focus) are filled out by 988 respondents, including their preferences for receiving personalized forms of nutrition advice. The set of joint items from various psychological constructs is analyzed using a Principal Component Analysis to find underlying psychological characteristics. The PCA produces four components (explaining 51% of variation), that could be interpreted as 'intrinsic interest and capabilities for healthy eating,' 'perceived difficulty to eat healthily,' 'self-worth insecurity,' and 'seeking positive challenges,' respectively. By means of a Logistic Regression these components are able to predict preferences for different forms of receiving nutrition advice. This first component shows that a mind set for maintaining a healthy diet goes together with an interest in receiving an advice on what do to and on how that will affect one's health. The second component predicts a preference for a fixed moment to receive information/advice. This may be a strategy of those that perceive difficulties to eat healthily, to help them control their healthy food intake. The insecurity that the third component models seems to lead to a wish for receiving specific advice about their health situation at fixed moments in time. The fourth component is a small component, therefore its prediction of a wish for an advice focussing on prevention of negative consequences is probably not a strong result. The study does point out that there appear different psychosocial types of consumers, that may benefit by being addressed according to their preference for receiving nutrition advice on specific moments, of a specific level of detail or pointing at the type of consequences the advice has. A better fit of the advice to the psychosocial characteristics of the recipient, captured in the identified components in the current study, may lead to an increase in compliance, although that will have to be further investigated in subsequent work.
Collapse
Affiliation(s)
- Garmt B Dijksterhuis
- Wageningen Food & Biobased Research, Wageningen University & Research, Wageningen, Netherlands
| | - Emily P Bouwman
- Wageningen Economic Research, Wageningen University & Research, Wageningen, Netherlands
| | - Danny Taufik
- Wageningen Economic Research, Wageningen University & Research, Wageningen, Netherlands
| |
Collapse
|
35
|
Ling J, Zahry NR. Relationships among perceived stress, emotional eating, and dietary intake in college students: Eating self-regulation as a mediator. Appetite 2021; 163:105215. [PMID: 33774134 DOI: 10.1016/j.appet.2021.105215] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 10/12/2020] [Accepted: 03/15/2021] [Indexed: 01/28/2023]
Abstract
This study aimed to examine the relationships among perceived stress, eating self-regulation, emotional eating, and dietary intake among undergraduate college students. This cross-sectional study was conducted with 523 students recruited from Amazon Mechanical Turk. All participants completed an online survey that assessed perceived stress, eating self-regulation, emotional eating, dietary intake, and demographics. The study sample was 47% female, 30% Hispanic, 8% Black, and 33% Asian. The overweight and obesity rate was 33%. Nearly 83% reported having moderate to high levels of stress, and over 80% had low to medium levels of eating self-regulation skills. On average, students consumed fruits and vegetables 2.42 times per day and sweets and soft drinks about once every other day. Perceived stress was positively correlated with emotional eating (β = 0.12, p = .005), and negatively correlated with eating self-regulation (β = -0.40, p < .001). Eating self-regulation partially mediated the relationship between perceived stress and emotional eating (β = 0.11, p < .001). Emotional eating was positively related to intake of sweets and soft drinks. Eating self-regulation was negatively related to sweet intake (β = -0.19, p < .001). Eating self-regulation and emotional eating fully mediated the relationship between perceived stress and sweet intake (β = 0.09, p < .001). Although warranting further investigation, this study's results emphasize the significant protective role of eating self-regulation for controlling college students' intake of sweets and soft drinks, and the negative effects of perceived stress and emotional eating on their dietary intake. Future interventions could consider strategies focusing on stress management and eating self-regulation to improve dietary intake among this young population.
Collapse
Affiliation(s)
- Jiying Ling
- Michigan State University College of Nursing, 1355 Bogue St., C241, East Lansing, Michigan, 48824, USA.
| | - Nagwan R Zahry
- University of Tennessee at Chattanooga, Department of Communication, 615 McCallie Avenue, Dept 3003, Chattanooga, Tennessee, 37403, USA.
| |
Collapse
|
36
|
Schmalbach I, Schmalbach B, Zenger M, Petrowski K, Beutel M, Hilbert A, Brähler E. Psychometric Properties of the German Version of the Self-Regulation of Eating Behavior Questionnaire. Front Psychol 2021; 12:649867. [PMID: 33776874 PMCID: PMC7994521 DOI: 10.3389/fpsyg.2021.649867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 02/15/2021] [Indexed: 12/02/2022] Open
Abstract
Background: The Self-Regulation of Eating Behavior Questionnaire (SREBQ) is an economical way of assessing an individual's self-regulatory abilities regarding eating behavior. Such scales are needed in the German population; therefore, the purpose of the present study was the translation and validation of a German version of the SREBQ. Method: First, we conducted a pilot study (Study 1; N = 371) after the translation procedure. Second, we assessed the final scale in a representative sample of the German population (Sample 2; N = 2,483) and its underlying factor structure. Further, we tested for measurement invariance and evaluated the SREBQ's associations with related scales to explore convergent and discriminant validity. Finally, we considered differences in SREBQ based on sociodemographic variables and provided derived reference scores (norm values). Results: Factor analysis revealed deficiencies in the original model. Thus, we shortened the scale based on statistical considerations and the adapted version showed improved fit in Confirmatory Factor Analysis and reliability. We also found evidence for partial strict invariance, which means the measure is equivalent for the tested groups of age and gender. Item and scale psychometric properties of the shortened version were satisfactory. In terms of diagnostic validity, it was shown that individuals with higher body mass index (kg/m2) have worse self-regulation of eating behavior than those with lower. Conclusion: In sum, the SREBQ evidenced good validity and reliability and is suitable for application in medical, psychological, and nutritional research.
Collapse
Affiliation(s)
- Ileana Schmalbach
- Department of Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.,Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Division of Psychological and Social Medicine and Developmental Neurosciences, Research Group Applied Medical Psychology and Medical Sociology, Dresden, Germany
| | - Bjarne Schmalbach
- Department of Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Markus Zenger
- Applied Human Studies, University of Applied Sciences Magdeburg-Stendal, Stendal, Germany.,Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Katja Petrowski
- Department of Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.,Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Abteilung für Innere Medizin III, Dresden, Germany
| | - Manfred Beutel
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center of Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Elmar Brähler
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany.,Department for Psychosomatic Medicine and Psychotherapy, University Medical Center of Johannes Gutenberg University of Mainz, Mainz, Germany
| |
Collapse
|
37
|
Lombardo C, Cerolini S, Alivernini F, Ballesio A, Violani C, Fernandes M, Lucidi F. Eating self-efficacy: validation of a new brief scale. Eat Weight Disord 2021; 26:295-303. [PMID: 32008174 DOI: 10.1007/s40519-020-00854-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 01/20/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Eating self-efficacy (ESE) is the belief in one's ability to self-regulate eating. Social and emotional situations may be differently challenging depending on the individual eating habits, body mass index and affects. Several ESE scales have been developed but most of them focus on weight management, dieting or healthy eating. The aim of the study was to validate a new brief scale assessing ESE in situations in which people face social or emotional pressures for excessive food intake. METHODS Study 1: A sample of 412 volunteer females (age M = 25.44 ± 5.03) completed a first 25-item version of the scale. Exploratory factor analysis (EFA) was conducted for selecting a subgroup of items composing the ESE brief scale (ESEBS). Study 2 assessed its psychometric properties through a Confirmatory Factor Analysis (CFA), analyzing the responses of 410 volunteer adults (273 females, 137 males). RESULTS EFA of Study 1 evidenced a bifactorial structure. Four items for each factor were selected, explaining 63% of the variance. Study 2 confirmed the good fit of the bifactorial model (CFI = 0.9589; χ2 (19) = 62.852, p < 0.001; RMSEA = 0.075; SRMR = 0.040) and provided support for the measurement invariance of the scale across gender. The internal consistency was as follows: Social (α = 0.786), Emotional (α = 0.820). The concurrent validity of the subscales was demonstrated by significant latent negative correlations with measures of eating disorders and emotional eating. CONCLUSIONS The 8-items ESEBS appears as a valid and reliable instrument to assess eating self-efficacy related to social and emotional situations. Future studies should evaluate its potential use in non-clinical and clinical research and interventions. LEVEL OF EVIDENCE Level V, descriptive cross-sectional study.
Collapse
Affiliation(s)
- Caterina Lombardo
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy.
| | - Silvia Cerolini
- Department of Development and Socialization Processes Psychology, Sapienza University of Rome, Rome, Italy
| | - Fabio Alivernini
- National Institute for the Evaluation of the Education System, Rome, Italy
| | - Andrea Ballesio
- Department of Development and Socialization Processes Psychology, Sapienza University of Rome, Rome, Italy
| | - Cristiano Violani
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy
| | - Mariana Fernandes
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy
| | - Fabio Lucidi
- Department of Development and Socialization Processes Psychology, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
38
|
Fostinelli S, De Amicis R, Leone A, Giustizieri V, Binetti G, Bertoli S, Battezzati A, Cappa SF. Eating Behavior in Aging and Dementia: The Need for a Comprehensive Assessment. Front Nutr 2020; 7:604488. [PMID: 33392240 PMCID: PMC7772186 DOI: 10.3389/fnut.2020.604488] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/23/2020] [Indexed: 01/01/2023] Open
Abstract
Eating behavior can change during aging due to physiological, psychological, and social changes. Modifications can occur at different levels: (1) in food choice, (2) in eating habits, and (3) in dietary intake. A good dietary behavior, like the Mediterranean dietary pattern, can be a protective factor for some aging related pathologies, such as dementia, while a worse eating behavior can lead to pathological conditions such as malnutrition. Changes in eating behavior can also be linked to the onset of dementia: for some types of dementia, such as frontotemporal dementia, dietary changes are one of the key clinical diagnostic feature, for others, like Alzheimer's disease, weight loss is a clinical reported feature. For these reasons, it is important to be able to assess eating behavior in a proper way, considering that there are normal age-related changes. An adequate assessment of dietary behavior can help to plan preventive intervention strategies for heathy aging or can help to identify abnormal behaviors that underline aging related-diseases. In this review, we have analyzed normal age-related and dementia-related changes and the tools that can be used to assess eating behavior. Thus, we make recommendations to screening and monitoring eating behavior in aging and dementia, and to adopt these tools in clinical practice.
Collapse
Affiliation(s)
- Silvia Fostinelli
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Ramona De Amicis
- Department of Food, Environmental and Nutritional Sciences, International Center for the Assessment of Nutritional Status, University of Milan, Milan, Italy
| | - Alessandro Leone
- Department of Food, Environmental and Nutritional Sciences, International Center for the Assessment of Nutritional Status, University of Milan, Milan, Italy
| | - Valentina Giustizieri
- Department of Food, Environmental and Nutritional Sciences, International Center for the Assessment of Nutritional Status, University of Milan, Milan, Italy
| | - Giuliano Binetti
- Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Simona Bertoli
- Department of Food, Environmental and Nutritional Sciences, International Center for the Assessment of Nutritional Status, University of Milan, Milan, Italy.,Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Obesity Unit and Laboratory of Nutrition and Obesity Research, Milan, Italy
| | - Alberto Battezzati
- Department of Food, Environmental and Nutritional Sciences, International Center for the Assessment of Nutritional Status, University of Milan, Milan, Italy
| | - Stefano F Cappa
- University School for Advanced Studies, Pavia, Italy.,IRCCS Mondino Foundation, Pavia, Italy
| |
Collapse
|
39
|
Ferhatoglu MF, Kartal A, Filiz AI, Kebudi A. The Positive Effects of a Calorie-Restricting High-Protein Diet Combined with Intragastric Botulinum Toxin Type A Application Among Morbidly Obese Patients: A Prospective, Observational Analysis of Eighty-Seven Grade 2 Obese Patients. Obes Surg 2020; 30:3472-3479. [PMID: 32306298 DOI: 10.1007/s11695-020-04597-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Many studies evaluating the effect of intragastric botulinum toxin type A injection (IG-BTxA) for the treatment of obesity have been published. However, none of these studies combined this procedure with a calorie-restricting high-protein diet. Herein, we aimed to evaluate the effects of IG-BTxA application combined with a calorie-restricting high-protein diet. MATERIALS AND METHODS This prospective cohort study is conducted with eighty-seven grade 2 obese patients treated between January 2019 and August 2019. Group 1: IG-BTxA + refused to consult the dietitian; group 2: IG-BTxA + get calorie-restricting high-protein diet; group 3: only get a calorie-restricting high-protein diet. Loss of weight, treatment adaptation (visual analog scale score), the status and changes of comorbid conditions, and changes in eating behaviors (Self-Regulation of Eating Behaviour Questionnaire score) were assessed. RESULTS Loss of weight, treatment adaptation, and positive behavioral change in eating preferences were significantly higher in group 2 (p = 0.01; p = 0.001; p < 0.01, respectively). Additionally, the decrease in medication requirement for diabetes and hypertension was higher in group 2 (p < 0.05). CONCLUSION IG-BTxA application before calorie-restricting high-protein diet facilitates adaptation to the new diet style and helps to lose weight faster in grade 2 obese patients. Also, more positive results were achieved in terms of controlling comorbid diseases.
Collapse
Affiliation(s)
- Murat Ferhat Ferhatoglu
- Department of General Surgery, Faculty of Medicine, Istanbul Okan University, Istanbul, Turkey
| | - Abdulcabbar Kartal
- Department of General Surgery, Faculty of Medicine, Istanbul Okan University, Istanbul, Turkey.
| | - Ali Ilker Filiz
- Department of General Surgery, Faculty of Medicine, Istanbul Okan University, Istanbul, Turkey
| | - Abut Kebudi
- Department of General Surgery, Faculty of Medicine, Istanbul Okan University, Istanbul, Turkey
| |
Collapse
|
40
|
Nutrition knowledge, attitudes, and self-regulation as predictors of overweight and obesity. J Am Assoc Nurse Pract 2020; 31:502-510. [PMID: 30829975 DOI: 10.1097/jxx.0000000000000169] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND PURPOSE Nutrition knowledge, attitudes, and eating self-regulation are important determinants of overweight and obesity. Eating self-regulation is the link between eating intention and behavior. However, the extent to which these factors influence overweight and obesity has not been thoroughly studied. The study examined nutrition knowledge, attitudes, and eating self-regulation as predictors of overweight and obesity among adults in a community setting. METHODS A total of 313 adults participated in an online survey, which included the General Nutrition Knowledge Questionnaire-Revised, the Nutrition Attitudes Questionnaire, and the Self-Regulation of Eating Behavior Questionnaire. Descriptive statistics, Kendall's tau tests, and multivariate logistic regression procedures were performed. CONCLUSIONS More than half of the participants were either overweight or obese (56.5%). The mean nutrition knowledge score was 74.1%, and only 28.1% correctly identified the body mass index for obesity. Positive predictors of overweight and obesity included poor eating self-regulation of giving up too easily on eating intentions (odds ratio [OR] = 3.81), male gender (OR = 2.0), and age (OR = 1.03), whereas nutrition attitudes were a negative predictor (OR = 0.74). IMPLICATIONS FOR PRACTICE The odds of overweight or obesity were nearly four times greater for those who gave up too easily on their eating intentions. Nurse practitioners can play a critical role in establishing healthy dietary habits to maintain weight control by promoting good eating self-regulation, despite the current obesogenic environment. After assessing patient readiness and motivation, it is important to help patients make eating self-regulation as manageable as possible to promote long-term weight management.
Collapse
|
41
|
Burke LE, Sereika SM, Parmanto B, Beatrice B, Cajita M, Loar I, Pulantara IW, Wang Y, Kariuki J, Yu Y, Cedillo M, Cheng J, Conroy MB. The SMARTER Trial: Design of a trial testing tailored mHealth feedback to impact self-monitoring of diet, physical activity, and weight. Contemp Clin Trials 2020; 91:105958. [PMID: 32087342 PMCID: PMC7269678 DOI: 10.1016/j.cct.2020.105958] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/31/2020] [Accepted: 02/11/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Self-monitoring food intake and physical activity (PA) is positively related to weight loss and the addition of feedback (FB) messages has been shown to reinforce behavior change. Moreover, the more immediate the delivery of reinforcing FB messages, the more likely they will promote the desired behaviors. PURPOSE Describe design and rationale of SMARTER, a National Institute of Heart, Lung, and Blood (NHLBI)-sponsored randomized, controlled trial, which compares the differential efficacy of two weight loss treatments among 530 adults, ages 18 and older. METHODS Single-site, 2-group design trial with subjects randomized 1:1 to either: 1) self-monitoring (SM), where participants self-monitor diet, PA, and weight using a commercial smartphone application (app); or 2) SM + FB, where participants self-monitor and receive real-time, tailored feedback (FB) as pop-up messages up to 3 times/day for 12 months. Daily FB messages address diet and PA behaviors and a weekly FB message addresses self-weighing. We hypothesize that subjects assigned to SM + FB will show greater weight loss at 6 and 12 months and greater sustained engagement in the program than the SM group, measured by adherence to the study's lifestyle and SM protocol. We will explore temporal relationships of the frequency, timing, and type of FB delivered and subsequent lifestyle behaviors through examination of serially collected real-time SM (diet, PA, weight) data over 12 months. CONCLUSIONS If efficacious, this fully scalable intervention could be efficiently translated and disseminated to reach large numbers of individuals through commercial apps at lower cost than existing in-person weight loss programs.
Collapse
Affiliation(s)
- Lora E Burke
- University of Pittsburgh, School of Nursing, Department of Health and Community Systems, Pittsburgh, PA, United States of America.
| | - Susan M Sereika
- University of Pittsburgh, School of Nursing, Department of Health and Community Systems, Pittsburgh, PA, United States of America
| | - Bambang Parmanto
- University of Pittsburgh, School of Health and Rehabilitation Sciences, Pittsburgh, PA, United States of America
| | - Britney Beatrice
- University of Pittsburgh, School of Nursing, Department of Health and Community Systems, Pittsburgh, PA, United States of America
| | - Mia Cajita
- University of Pittsburgh, School of Nursing, Department of Health and Community Systems, Pittsburgh, PA, United States of America
| | - India Loar
- University of Pittsburgh, School of Nursing, Department of Health and Community Systems, Pittsburgh, PA, United States of America
| | - I Wayan Pulantara
- University of Pittsburgh, School of Health and Rehabilitation Sciences, Pittsburgh, PA, United States of America
| | - Yuhan Wang
- University of Pittsburgh, School of Health and Rehabilitation Sciences, Pittsburgh, PA, United States of America
| | - Jacob Kariuki
- University of Pittsburgh, School of Nursing, Department of Health and Community Systems, Pittsburgh, PA, United States of America
| | - Yang Yu
- University of Pittsburgh, School of Nursing, Department of Health and Community Systems, Pittsburgh, PA, United States of America
| | - Maribel Cedillo
- University of Utah, School of Medicine, Salt Lake City, UT, United States of America
| | - Jessica Cheng
- University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA, United States of America
| | - Molly B Conroy
- University of Utah, School of Medicine, Salt Lake City, UT, United States of America
| |
Collapse
|
42
|
McGirr C, Rooney C, Gallagher D, Dombrowski SU, Anderson AS, Cardwell CR, Free C, Hoddinott P, Holmes VA, McIntosh E, Somers C, Woodside JV, Young IS, Kee F, McKinley MC. Text messaging to help women with overweight or obesity lose weight after childbirth: the intervention adaptation and SMS feasibility RCT. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background
There is a need to develop weight management interventions that fit seamlessly into the busy lives of women during the postpartum period.
Objective
The objective was to develop and pilot-test an evidence- and theory-based intervention, delivered by short message service, which supported weight loss and weight loss maintenance in the postpartum period.
Design
Stage 1 involved the development of a library of short message service messages to support weight loss and weight loss maintenance, with personal and public involvement, focusing on diet and physical activity with embedded behaviour change techniques, and the programming of a short message service platform to allow fully automated intervention delivery. Stage 2 comprised a 12-month, single-centre, two-arm, pilot, randomised controlled trial with an active control.
Setting
This study was set in Northern Ireland; women were recruited via community-based approaches.
Participants
A total of 100 women with overweight or obesity who had given birth in the previous 24 months were recruited.
Interventions
The intervention group received an automated short message service intervention about weight loss and weight loss maintenance for 12 months. The active control group received automated short message service messages about child health and development for 12 months.
Main outcome measures
The main outcomes measured were the feasibility of recruitment and retention, acceptability of the intervention and trial procedures, and evidence of positive indicative effects on weight. Weight, waist circumference and blood pressure were measured by the researchers; participants completed a questionnaire booklet and wore a sealed pedometer for 7 days at baseline, 3, 6, 9 and 12 months. Outcome assessments were collected during home visits and women received a voucher on completion of each of the assessments. Qualitative interviews were conducted with women at 3 and 12 months, to gather feedback on the intervention and active control and the study procedures. Quantitative and qualitative data were used to inform the process evaluation and to assess fidelity, acceptability, dose, reach, recruitment, retention, contamination and context.
Results
The recruitment target of 100 participants was achieved (intervention, n = 51; control, n = 49); the mean age was 32.5 years (standard deviation 4.3 years); 28 (28%) participants had a household income of < £29,999 per annum. Fifteen women became pregnant during the follow-up (intervention, n = 9; control, n = 6) and withdrew from the study for this reason. At the end of the 12-month study, the majority of women remained in the study [85.7% (36/42) in the intervention group and 90.7% (39/43) in the active control group]. The research procedures were well accepted by women. Both groups indicated a high level of satisfaction with the short message service intervention that they were receiving. There was evidence to suggest that the intervention may have a positive effect on weight loss and prevention of weight gain during the postpartum period.
Limitations
The interviews at 3 and 12 months were conducted by the same researchers who collected other outcome data.
Conclusions
An evidence- and theory-based intervention delivered by short message service was successfully developed in conjunction with postpartum women with overweight and obesity. The intervention was acceptable to women and was feasible to implement in the 12-month pilot randomised controlled trial. The progression criteria for a full randomised controlled trial to examine effectiveness and cost-effectiveness were met.
Future work
Some minor refinements need to be made to the intervention and trial procedures based on the findings of the pilot trial in preparation for conducting a full randomised controlled trial.
Trial registration
Current Controlled Trial ISRCTN90393571.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 4. See the NIHR Journals Library website for further project information. The intervention costs were provided by the Public Health Agency, Northern Ireland.
Collapse
Affiliation(s)
- Caroline McGirr
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Ciara Rooney
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Dunla Gallagher
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | | | - Annie S Anderson
- Centre for Research into Cancer Prevention and Screening, Cancer Division, Medical Research Institute, Ninewells Medical School, Dundee, UK
| | - Christopher R Cardwell
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Caroline Free
- Clinical Trials Unit, Department for Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Pat Hoddinott
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Valerie A Holmes
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Emma McIntosh
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Camilla Somers
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jayne V Woodside
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Ian S Young
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Frank Kee
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Michelle C McKinley
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| |
Collapse
|
43
|
The Relationship between Sense of Coherence, Stress, Body Image Satisfaction and Eating Behavior in Japanese and Austrian Students. PSYCH 2019. [DOI: 10.3390/psych1010039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background: Restrained, emotional, and external eating are related to obesity and eating disorders. A salutogenic model has confirmed sense of coherence (SOC) as a health resource that moderates stress and helps limit the occurrence of overweightness and eating disorders. This study aimed to examine the relationship between SOC, social support, stress, body image satisfaction (BIS) and eating behaviors in different cultural environments. Methods: A total of 371 Austrian (161 men, 210 women) and 398 Japanese (226 men, 172 women) university students participated. The SOC-13 scale, Multidimensional Scale of Perceived Social Support, Dutch Eating Behavior Questionnaire, BMI-Based Silhouette Matching Test and an analogue single-stress item were used as measurements. Results: SOC negatively affected all three types of eating in Austrian students (men: β = −0.227 to −0.215; women: β = −0.262 to −0.214). In Japanese students, SOC negatively affected external eating in both sexes (men: β = −0.150; women: β = −0.198) and emotional eating (β = −0.187) in men. BIS indicated that the desire to become slim predicted restrained eating, women’s emotional eating, and men’s and Austrian women’s external eating. Stress was only predictive of emotional eating in Japanese men. Conclusions: This study found that SOC, BIS and stress might be valuable factors regulating eating behavior in a cultural context. However, the relationship between SOC, BIS, stress and eating behavior differs between cultures.
Collapse
|
44
|
Rendina D, Campanozzi A, De Filippo G. Methodological approach to the assessment of the obesogenic environment in children and adolescents: A review of the literature. Nutr Metab Cardiovasc Dis 2019; 29:561-571. [PMID: 31078362 DOI: 10.1016/j.numecd.2019.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 02/27/2019] [Accepted: 02/28/2019] [Indexed: 01/01/2023]
Abstract
AIMS Childhood and adolescent obesity has been defined as a planetary epidemic by WHO "globesity". The obesogenic environment, defined as a life environment promoting a high-energy intake and a sedentary lifestyle, significantly contributes to the genesis and the diffusion of the globesity. In the last decades, several authors and working groups tried to develop methodological instruments in order to guarantee a reliable analysis of an obesogenic environment. Their efforts have led to the production of a relatively large number of questionnaires with different characteristics. The general aim of these questionnaires is to identify the factors that significantly contribute to the creation of an obesogenic environment around children and adolescents. As a result of this work, a number of studies were carried out using such questionnaires. Aim of this review is to evaluate ad hoc questionnaires useful to identify and analyze obesogenic environment. DATA SYNTHESIS The search was carried out in February-March 2017 using the PubMed-Medline and Scopus databases (time interval: the last 10 years). After the selection and verification phases, a total of 14 studies were selected and therefore included in the present review. CONCLUSIONS The questionnaires constructed and validated to analyze multiple constitutive elements of an obesogenic environment at the same time are complex and must be administered by qualified and trained staff. On the other hand, when two or more questionnaires are used to analyze different factors, the questionnaires used are generally shorter, self-administered, and generally easier to understand and interpret.
Collapse
Affiliation(s)
- D Rendina
- Department of Clinical Medicine and Surgery, Federico II University of Naples Medical School, Naples, Italy; Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Service de Médecine des Adolescents, Le Kremlin Bicêtre, France
| | - A Campanozzi
- Department of Medical and Surgical Sciences, Pediatric Unit, University of Foggia, Foggia, Italy
| | - G De Filippo
- Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Service de Médecine des Adolescents, Le Kremlin Bicêtre, France; French Clinical Research Group in Adolescent Medicine and Health, Paris, France.
| |
Collapse
|
45
|
Kliemann N, Croker H, Johnson F, Beeken RJ. Development of the Top Tips Habit-Based Weight Loss App and Preliminary Indications of Its Usage, Effectiveness, and Acceptability: Mixed-Methods Pilot Study. JMIR Mhealth Uhealth 2019; 7:e12326. [PMID: 31094352 PMCID: PMC6533874 DOI: 10.2196/12326] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 01/29/2019] [Accepted: 02/10/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The Ten Top Tips (10TT) is an intervention based on the habit formation theory that promotes a set of weight management behaviors alongside advice about repetition in a consistent context. Overall, 3 studies have demonstrated that the 10TT can support individuals to lose weight when delivered in a leaflet format. Delivery of 10TT via new technology such as a mobile app could potentially improve its effectiveness and make it more convenient, appealing, and wide reaching. OBJECTIVE This study aimed to provide preliminary indications of the usage, effectiveness, and acceptability of an Android app of the 10TT intervention (Top Tips only app) and a second version including self-regulatory strategies for dealing with tempting foods (Top Tips plus app). METHODS The 3-month pilot randomized adults with overweight or obesity to (1) Top Tips only app, (2) Top Tips plus app, or (3) waiting list condition. Automated data from app users were collected. Validated questionnaires assessed self-regulatory skills, weight loss (kg), and behaviors at baseline and 3 months. Users' feedback on their experience using the app was assessed using open questions. RESULTS A total of 81 participants took part in the pilot; 28 participants were randomized to the Top Tips only app, 27 to the Top Tips plus app, and 26 to the waiting list condition. On average, participants viewed a mean of 43.4 (SD 66.9) screens during a mean of 24.5 (SD 44.07) log-ins and used the app for 124.2 (SD 240.2) min over the 3-month period. Participants randomized to the Top Tips only app reported the greatest improvement in self-regulatory skills (mean 0.59, SD 1.0), weight loss (mean 4.5 kg, SD 5.2), and adherence to the target behaviors (mean 0.59, SD 0.49) compared with the Top Tips plus (meanself-regulation 0.15, SD 0.42; meanweight -1.9, SD 3.9; and meanbehaviors 0.29, SD 0.29) and waiting list condition (meanself-regulation -0.02, SD 0.29; meanweight -0.01, SD 0.51; and meanbehaviors 0.08, SD 0.38). Participants who reported the largest improvements, on average, viewed pages 2 to 3 times more, had 2 to 3 times more log-ins, logged their weight 2 to 3 times more, and achieved the tips more than those who reported smaller changes in these outcomes. According to users' feedback, engagement with the app could be increased by making the app more interactive and allowing more tailoring. CONCLUSIONS This study suggests that the Top Tips app could potentially be a useful intervention for promoting eating self-regulatory skills, weight loss, and weight management behaviors among adults with overweight or obesity. Future research should develop the app further based on user feedback and test it in larger sample sizes. TRIAL REGISTRATION ISRCTN Registry ISRCTN10470937; http://www.isrctn.com/ISRCTN10470937 (Archived by Webcite at http://www.webcitation.org/76j6rQibI).
Collapse
Affiliation(s)
- Nathalie Kliemann
- Nutritional Epidemiology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Helen Croker
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Fiona Johnson
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Rebecca J Beeken
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| |
Collapse
|
46
|
Kliemann N, Croker H, Johnson F, Beeken RJ. Starting university with high eating self-regulatory skills protects students against unhealthy dietary intake and substantial weight gain over 6 months. Eat Behav 2018; 31:105-112. [PMID: 30243053 PMCID: PMC6234330 DOI: 10.1016/j.eatbeh.2018.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 08/10/2018] [Accepted: 09/14/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is consistent evidence that suggests first year students are at risk of weight gain, but the reasons for this vulnerability are still unclear. This study aimed to explore whether the ability to regulate eating behaviours is a predictor of weight and dietary changes in first year undergraduate students. METHODS First year undergraduate students from universities situated in London were invited to complete a survey at the beginning of the academic year and at 6-month follow-up. Each survey included the Self-Regulation of Eating Behaviour Questionnaire, food frequency questions, socio-demographic questions and anthropometric questions. Linear and logistic regressions were performed to explore the associations between baseline eating self-regulatory skills and weight and dietary changes. RESULTS 481 first year undergraduate students took part in the study. Students who entered university with higher eating self-regulatory skills were more likely to maintain or achieve a higher fruit and vegetable (OR = 1.8, p = 0.007) and a lower sweet and salty snack (OR = 1.9, p = 0.001) intake over the course of the first 6 months in university. Higher baseline eating self-regulatory skills were also related to lower weight changes (β = -0.15, p = 0.018) and lower likelihood of gaining 5% initial body weight (OR = 0.52, p = 0.006) at 6-month. Additionally, self-regulatory skills moderated the relationship between baseline BMI and weight changes (β = -0.25, p ≤0.001) and between baseline BMI and 5% weight gain (OR = 0.82, p = 0.008). CONCLUSIONS Starting university with higher eating self-regulatory skills may help students to maintain or achieve a healthy diet and protect them against substantial weight gain, especially among students with overweight.
Collapse
Affiliation(s)
- Nathalie Kliemann
- Department of Behavioural Science & Health, University College London, London, UK
| | - Helen Croker
- Department of Behavioural Science & Health, University College London, London, UK
| | - Fiona Johnson
- Department of Behavioural Science & Health, University College London, London, UK
| | - Rebecca J. Beeken
- Department of Behavioural Science & Health, University College London, London, UK,Leeds Institute of Health Sciences, University of Leeds, Leeds, UK,Corresponding author at: Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9JT, UK.
| |
Collapse
|
47
|
San-Cristobal R, Navas-Carretero S, Celis-Morales C, Livingstone KM, Stewart-Knox B, Rankin A, Macready AL, Fallaize R, O’Donovan CB, Forster H, Woolhead C, Walsh MC, Lambrinou CP, Moschonis G, Manios Y, Jarosz M, Daniel H, Gibney ER, Brennan L, Gundersen TE, Drevon CA, Gibney M, Marsaux CFM, Saris WHM, Lovegrove JA, Frewer LJ, Mathers JC, Martinez JA. Capturing health and eating status through a nutritional perception screening questionnaire (NPSQ9) in a randomised internet-based personalised nutrition intervention: the Food4Me study. Int J Behav Nutr Phys Act 2017; 14:168. [PMID: 29228998 PMCID: PMC5725967 DOI: 10.1186/s12966-017-0624-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 10/23/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND National guidelines emphasize healthy eating to promote wellbeing and prevention of non-communicable diseases. The perceived healthiness of food is determined by many factors affecting food intake. A positive perception of healthy eating has been shown to be associated with greater diet quality. Internet-based methodologies allow contact with large populations. Our present study aims to design and evaluate a short nutritional perception questionnaire, to be used as a screening tool for assessing nutritional status, and to predict an optimal level of personalisation in nutritional advice delivered via the Internet. METHODS Data from all participants who were screened and then enrolled into the Food4Me proof-of-principle study (n = 2369) were used to determine the optimal items for inclusion in a novel screening tool, the Nutritional Perception Screening Questionnaire-9 (NPSQ9). Exploratory and confirmatory factor analyses were performed on anthropometric and biochemical data and on dietary indices acquired from participants who had completed the Food4Me dietary intervention (n = 1153). Baseline and intervention data were analysed using linear regression and linear mixed regression, respectively. RESULTS A final model with 9 NPSQ items was validated against the dietary intervention data. NPSQ9 scores were inversely associated with BMI (β = -0.181, p < 0.001) and waist circumference (Β = -0.155, p < 0.001), and positively associated with total carotenoids (β = 0.198, p < 0.001), omega-3 fatty acid index (β = 0.155, p < 0.001), Healthy Eating Index (HEI) (β = 0.299, p < 0.001) and Mediterranean Diet Score (MDS) (β = 0. 279, p < 0.001). Findings from the longitudinal intervention study showed a greater reduction in BMI and improved dietary indices among participants with lower NPSQ9 scores. CONCLUSIONS Healthy eating perceptions and dietary habits captured by the NPSQ9 score, based on nine questionnaire items, were associated with reduced body weight and improved diet quality. Likewise, participants with a lower score achieved greater health improvements than those with higher scores, in response to personalised advice, suggesting that NPSQ9 may be used for early evaluation of nutritional status and to tailor nutritional advice. TRIAL REGISTRATION NCT01530139 .
Collapse
Affiliation(s)
- Rodrigo San-Cristobal
- Centre for Nutrition Research, Department of Nutrition, Food Science and Physiology, University of Navarra, C/Irunlarrea, 1, 31008 Pamplona, Spain
| | - Santiago Navas-Carretero
- Centre for Nutrition Research, Department of Nutrition, Food Science and Physiology, University of Navarra, C/Irunlarrea, 1, 31008 Pamplona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28023 Madrid, Spain
| | - Carlos Celis-Morales
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, NE1 7RU UK
| | - Katherine M. Livingstone
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, NE1 7RU UK
| | | | - Audrey Rankin
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, BT52 1SA UK
| | - Anna L. Macready
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, RG6 6AA UK
| | - Rosalind Fallaize
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, RG6 6AA UK
| | - Clare B. O’Donovan
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, 4 Republic of Ireland
| | - Hannah Forster
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, 4 Republic of Ireland
| | - Clara Woolhead
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, 4 Republic of Ireland
| | - Marianne C. Walsh
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, 4 Republic of Ireland
| | - Christina P. Lambrinou
- Department of Nutrition and Dietetics, Harokopio University of Athens, 17671 Athens, Greece
| | - George Moschonis
- Department of Nutrition and Dietetics, Harokopio University of Athens, 17671 Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University of Athens, 17671 Athens, Greece
| | - Miroslaw Jarosz
- Institute of Food and Nutrition (IZZ), 02-903 Warsaw, Poland
| | - Hannelore Daniel
- ZIEL Research Center of Nutrition and Food Sciences, Biochemistry Unit, Technische Universität München, 85354 Munich, Germany
| | - Eileen R. Gibney
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, 4 Republic of Ireland
| | - Lorraine Brennan
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, 4 Republic of Ireland
| | | | - Christian A. Drevon
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, 0317 Oslo, Norway
| | - Mike Gibney
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, 4 Republic of Ireland
| | - Cyril F. M. Marsaux
- Department of Human Biology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, 6200 MD The Netherlands
| | - Wim H. M. Saris
- Department of Human Biology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, 6200 MD The Netherlands
| | - Julie A. Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, RG6 6AA UK
| | - Lynn J. Frewer
- Food and Society Group, Newcastle University, Newcastle Upon Tyne, NE1 7RU UK
| | - John C. Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, NE1 7RU UK
| | - J. Alfredo Martinez
- Centre for Nutrition Research, Department of Nutrition, Food Science and Physiology, University of Navarra, C/Irunlarrea, 1, 31008 Pamplona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28023 Madrid, Spain
- Instituto de Investigaciones Sanitarias de Navarra (IDisNa), 31008 Pamplona, Spain
- Instituto Madrileño de Estudios Avanzados (IMDEA) Alimentacion, Madrid, Spain
| | - on behalf of the Food4Me Study
- Centre for Nutrition Research, Department of Nutrition, Food Science and Physiology, University of Navarra, C/Irunlarrea, 1, 31008 Pamplona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28023 Madrid, Spain
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, NE1 7RU UK
- School of Psychology, University of Bradford, West Yorkshire, BD71DP UK
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, BT52 1SA UK
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, RG6 6AA UK
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, 4 Republic of Ireland
- Department of Nutrition and Dietetics, Harokopio University of Athens, 17671 Athens, Greece
- Institute of Food and Nutrition (IZZ), 02-903 Warsaw, Poland
- ZIEL Research Center of Nutrition and Food Sciences, Biochemistry Unit, Technische Universität München, 85354 Munich, Germany
- Vitas Ltd., Oslo Science Park, Gaustadalléen 21, 0349 Oslo, Norway
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, 0317 Oslo, Norway
- Department of Human Biology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, 6200 MD The Netherlands
- Food and Society Group, Newcastle University, Newcastle Upon Tyne, NE1 7RU UK
- Instituto de Investigaciones Sanitarias de Navarra (IDisNa), 31008 Pamplona, Spain
- Instituto Madrileño de Estudios Avanzados (IMDEA) Alimentacion, Madrid, Spain
| |
Collapse
|
48
|
Kliemann N, Vickerstaff V, Croker H, Johnson F, Nazareth I, Beeken RJ. The role of self-regulatory skills and automaticity on the effectiveness of a brief weight loss habit-based intervention: secondary analysis of the 10 top tips randomised trial. Int J Behav Nutr Phys Act 2017; 14:119. [PMID: 28870208 PMCID: PMC5583960 DOI: 10.1186/s12966-017-0578-8] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 08/29/2017] [Indexed: 11/10/2022] Open
Abstract
Background Habit-interventions are designed to promote the automaticity of healthy behaviours and may also enhance self-regulatory skills during the habit-formation process. A recent trial of habit-based advice for weight loss (10 Top Tips; 10TT), found that patients allocated to 10TT lost significantly more weight over 3 months than those allocated to usual care, and reported greater increases in automaticity for the target behaviours. The current study aimed to test the hypothesis that i) 10TT increased self-regulatory skills more than usual care, and ii) that self-regulatory skills and automaticity changes mediated the effect of 10TT on weight loss. Methods 537 obese patients from 14 primary care practices in the UK were randomized to receive 10TT or usual care. Patients in the 10TT group received a leaflet containing tips for weight loss and healthy habits formation, a self-monitoring log book and a wallet-sized shopping guide on how to read food labels. Patients were weighed and completed validated questionnaires for self-regulation and automaticity at baseline and 3-month follow-up. Within-group and Between-group effects were explored using Paired T-test and ANCOVA, respectively. Mediation was assessed using bootstrapping to estimate indirect effects and the sobel test. Results Over 3 months patients who were given 10TT reported greater increases in self-regulatory skills (Mean difference: .08; 95% CI .01; .15) than those who received usual care. Changes in self-regulatory skills and automaticity over 3 months mediated the effect of the intervention on weight loss (β = .52, 95% Bias Corrected CI .17; .91). Conclusions As hypothesised, 10TT enhanced self-regulatory skills and changes in self-regulatory skills and automaticity mediated the effect of the intervention on weight loss. This supports the proposition that self-regulatory training and habit formation are important features of weight loss interventions. Trial registration This study was prospectively registered with the International Standard Randomised Controlled Trials (ISRCTN16347068) on 26 September 2011. Electronic supplementary material The online version of this article (10.1186/s12966-017-0578-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Nathalie Kliemann
- Department of Behavioural Science & Health, University College London, London, England
| | - Victoria Vickerstaff
- Department of Primary Care & Population Health, University College London, London, England
| | - Helen Croker
- Department of Behavioural Science & Health, University College London, London, England
| | - Fiona Johnson
- Department of Behavioural Science & Health, University College London, London, England
| | - Irwin Nazareth
- Department of Primary Care & Population Health, University College London, London, England
| | - Rebecca J Beeken
- Department of Behavioural Science & Health, University College London, London, England. .,Leeds Institute of Health Sciences, University of Leeds, Level 10, Worsley Building, Clarendon Way, Leeds, LS2 9NL, England.
| |
Collapse
|