Frontostriatal and behavioral adaptations to daily sugar-sweetened beverage intake: a randomized controlled trial

Discounting of Hyper-Palatable Foods Is Associated with Eating Motives and Binge Eating Behavior

Background: High delay discounting (DD), or the tendency to prefer immediate rewards over larger delayed rewards, has been associated with health risk behaviors. This study examined the DD of hyper-palatable foods (HPFs) and money, and their associations with eating motives and binge eating behavior. Methods: An adult sample (N = 296) completed a DD task with single- and cross-commodity conditions with rewards of money and/or HPF (e.g., HPF now vs. HPF later; HPF now vs. money later). Regression models tested the association between DD, and eating motives and binge eating. Results: DD in the HPF now vs. money later condition was positively associated with the reward enhancement motive (β = 0.291; p = 0.008) and binge eating behavior (β = 0.041; p = 0.017). There were no other significant associations. Conclusions: Decisional impulsivity specific to HPFs (and not decisional impulsivity in general) may be associated with reward-motivated eating and binge eating behavior.

Decoupling of desire and salivation over repeated chocolate consumption and the moderating role of food legalizing

This study aimed to investigate the responses in desire and salivation during repeated chocolate consumption, and examining how these responses are influenced by a relaxed relationship with food, or 'food legalizing'. Salivation is often used as a proxy for desire, though evidence for this correlation is mixed. We hypothesized that both desire and salivation would decrease with repeated chocolate intake. Additionally, research has suggested that eating styles may affect habituation rates. We proposed that individuals with the food legalizing trait would habituate more rapidly to chocolate, providing an alternative mechanism to reward sensitivity associated with restrained eating. Fifty healthy-weight individuals participated in the study, consuming five blocks of chocolate (each 4 g, 22 calories) over trials. After the trials, participants were allowed to eat as much chocolate as they desired. The results showed that salivation was not correlated with self-reported desire over repeated chocolate consumption. While desire decreased with repeated intake and predicted ad libitum consumption, salivation increased and did not predict ad libitum consumption. Furthermore, food legalizing moderated the rate of responding in terms of the desire to eat but did not affect salivary flow. These findings suggest that salivation is not a reliable physiological measure of desire when eating chocolate. Instead, salivation appears to reflect sensitization to the sensory characteristics of chocolate and is less predictive of subsequent ad libitum chocolate consumption than self-reported desire. Lastly, having a carefree relationship with chocolate may help regulate its consumption, highlighting the potential benefits of a relaxed attitude toward food.

The influence of ultra-processed food consumption on reward processing and energy intake: Background, design, and methods of a controlled feeding trial in adolescents and young adults

BACKGROUND

The greatest age-related weight gain occurs in the early/mid-20s. Overall dietary quality among adolescents and emerging adults (age 18-25) is poor, with ultra-processed foods (UPF) representing more than two-thirds of adolescents' total energy intake (i.e., 68%). UPF consumption may impact cognitive and neurobiological factors that influence dietary decision-making and energy intake (EI). To date, no research has addressed this in this population.

METHODS

Participants aged 18-25 will undergo two 14-day controlled feeding periods (81% UPF, 0% UPF) using a randomly assigned crossover design, with a 4-week washout between conditions. Brain response to a UPF-rich milkshake, as well as behavioral measures of executive function, will be evaluated before and after each diet. Following each diet, measurements include ad libitum buffet meal EI, food selection, eating rate, and eating in the absence of hunger (EAH). Prior to initiating recruitment, controlled diet menus, buffet, and EAH snacks were developed and evaluated for palatability. Sensory and texture attributes of buffet and EAH snack foods were also evaluated.

RESULTS

Overall diet palatability was rated "like very much" (8)/"like moderately"(7) (UPF: 7.6 ± 1.0; Non-UPF: 6.8 ± 1.5). Subjective hardness rating (range = 1-9 [1 = soft, 9 = hard] was similar between UPF and Non-UPF buffet and snack items (UPF:4.22 ± 2.19, Non-UPF: 4.70 ± 2.03), as was the objective measure of hardness (UPF: 2874.33 ± 2497.06 g, Non-UPF: 2243.32 ± 1700.51 g).

CONCLUSIONS

Findings could contribute to an emerging neurobiological understanding of the effects of UPF consumption including energy overconsumption and weight gain among individuals at a critical developmental stage.

New form of addiction: An emerging hazardous addiction problem of milk tea among youths

BACKGROUND

Milk tea has experienced tremendous growth in popularity in China, especially among youths. The primary objective of this study is to investigate whether milk tea addiction may have a detrimental impact on youths' mental health, such as anxiety, depression, and suicidal ideation. Additionally, we aim to explore its potential role in influencing various mental health outcomes.

METHODS

A large-scale, cross-sectional study was conducted from 5281 college students in Beijing, China. Participants self-reported depressive, anxiety symptoms, suicidal ideation, and milk tea addiction symptoms including milk tea consumption, dependence, guilty feelings, withdrawal, tolerance, unable to stop, craving, and intention to stop.

RESULTS

Nearly 77 % of participants consumed milk tea at least 6-11 cups in the last year. The confirmatory factor analysis (CFA) supported the one-factor structure of the milk tea addiction scale, developed according to DSM-5 substance use guidelines. Moreover, we found that a higher level of milk tea addiction was significantly associated with a higher risk of depression (b = 0.24, p < 0.001), anxiety (b = 0.21, p < 0.001), and suicidal ideation (b = 0.06, p < 0.001), respectively, after controlling confounding variables, among youths consuming milk tea. The possible mediating role of milk tea addiction between loneliness feelings and mental health outcomes was further addressed.

CONCLUSIONS AND IMPLICATIONS

Our findings highlighted that milk tea consumption might lead to addiction, and it is associated with depression, anxiety, and suicidal ideation. Current findings can assist policymakers in developing regulations such as restricting advertising, providing psycho-education, establishing food hygiene standards for such a prosperous youth-dominant consumption industry while protecting their mental health.

Enhancement effect of odor and multi-sensory superposition on sweetness

The impact of sugary foods on public health has contributed to the development of low-sugar and sugar-substituted products, and sugar reduction has become a major challenge for the food industry. There is growing empirical evidence that odor can enhance the perception of sweetness without increasing the caloric load. This current review summarizes the researches on odor-induced sweetness enhancement published in recent years and discusses the mechanisms and influencing factors of odor-sweetness interactions. In addition, by combing existing studies, this paper also summarizes the research methods and strategies to investigate odor-induced sweetness enhancement. Finally, the feasibility of synergistic enhancement of sweetness through the superposition of odor with other senses (texture, visual, etc.) is also discussed and analyzed. In conclusion, odor-induced sweetness enhancement may present an alternative or complementary approach for developing foods with less sugar.

Food reinforcement architecture: A framework for impulsive and compulsive overeating and food abuse

Few reward-based theories address key drivers of susceptibility to food cues and consumption beyond fullness. Decision-making and habit formation are governed by reinforcement-based learning processes that, when overstimulated, can drive unregulated hedonically motivated overeating. Here, a model food reinforcement architecture is proposed that uses fundamental concepts in reinforcement and decision-making to identify maladaptive eating habits that can lead to obesity. This model is unique in that it identifies metabolic drivers of reward and incorporates neuroscience, computational decision-making, and psychology to map overeating and obesity. Food reinforcement architecture identifies two paths to overeating: a propensity for hedonic targeting of food cues contributing to impulsive overeating and lack of satiation that contributes to compulsive overeating. A combination of those paths will result in a conscious and subconscious drive to overeat independent of negative consequences, leading to food abuse and/or obesity. Use of this model to identify aberrant reinforcement learning processes and decision-making systems that can serve as markers of overeating risk may provide an opportunity for early intervention in obesity.

Sugar-sweetened beverage consumption retarded weight gain but not induced depression and anxiety-like behaviors in mice

AIMS

To assess the effects of sugar-sweetened beverage (SSB) consumption and exercise on behaviors.

METHODS

Twenty-four male mice were divided into four groups: the water + sedentary (WS), the SSB + sedentary (CS), the water + exercise (WE), and the SSB + exercise (CE). After three-month of interventions, forced swim test (FST), open field test (OFT), and morris water maze (MWM) were conducted. Then, mRNA levels of MAO-A, COMT, and 5-HT1A and protein levels of synapsin, STAT3, A2AR, CRTC1, CREB, and BDNF were measured.

RESULTS

Under a similar baseline body weight condition, SSB consumption reduced the weight gain from the 3rd week (p < 0.05, or p < 0.01). Exercise decreased the escape latency in the CE group when compared to the CS group on day5 (p < 0.01) and increased the time in the target quadrant in the WE group than the WS group on day4 (p < 0.05) and 5 (p < 0.01) during MWM. No significant differences were found during the FST and OFT. COMT mRNA level was increased after SSB consumption (p < 0.05), but no differences were found in the MAO-A and 5-HT1A mRNA levels and the concerned biomarkers, all of which were previously reported to be associated with depression and anxiety-like behaviors.

CONCLUSION

SSB consumption reduced weight gain but not result in depression and anxiety-like behaviors in mice. Therefore, the behavioral effects of exercise were not significant. This is not consistent with the results of previous epidemiological surveys of humans.

Habitual daily intake of a sweet and fatty snack modulates reward processing in humans

Western diets rich in fat and sugar promote excess calorie intake and weight gain; however, the underlying mechanisms are unclear. Despite a well-documented association between obesity and altered brain dopamine function, it remains elusive whether these alterations are (1) pre-existing, increasing the individual susceptibility to weight gain, (2) secondary to obesity, or (3) directly attributable to repeated exposure to western diet. To close this gap, we performed a randomized, controlled study (NCT05574660) with normal-weight participants exposed to a high-fat/high-sugar snack or a low-fat/low-sugar snack for 8 weeks in addition to their regular diet. The high-fat/high-sugar intervention decreased the preference for low-fat food while increasing brain response to food and associative learning independent of food cues or reward. These alterations were independent of changes in body weight and metabolic parameters, indicating a direct effect of high-fat, high-sugar foods on neurobehavioral adaptations that may increase the risk for overeating and weight gain.

Dietary trends and the decline in male reproductive health

Over the twentieth century, male reproductive health has suffered a substantial decline, as evidenced by decreases in sperm counts and testosterone levels and increases in reproductive pathologies. At the same time, the prevalence of chronic diseases such as obesity, diabetes, and metabolic syndrome has risen dramatically. Metabolic and reproductive health are highly interconnected, suggesting that their respective trends are intertwined and, given the timeframe of such trends, environmental and not genetic factors are most likely to be the primary causes. Industrialization, which began in Europe in the mid-eighteenth century, has resulted in profound changes to our diet, lifestyle, and environment, many of which are causal factors in the rise in chronic diseases. Industrialization results in a nutrition transition from an agricultural unprocessed to a modern processed diet, incorporating increases in sugar, vegetable oils, ultra-processed foods, linoleic acid, trans-fats, and total energy. This dietary shift has incurred numerous adverse effects on metabolic and reproductive health, characterized by chronic inflammation, oxidative stress, and insulin resistance. Moreover, these effects appear to multiply across subsequent generations via epigenetic inheritance. Men's fertility is markedly affected by obesity and diabetes, with an increase in total energy via processed food intake arguably being the key factor driving the diabesity pandemic. In contrast, wholefoods rich in micronutrients and phytonutrients support male fertility and a healthy body weight. Therefore, men wanting to maximize their fertility should consider making positive dietary changes, such as replacing processed foods with unprocessed foods that support metabolic and reproductive health.

University stakeholders largely unaware and unsupportive of university pouring rights contracts with companies supplying sugar-sweetened beverages

Background: Pouring rights contracts are agreements in which beverage companies pay universities for exclusive marketing and rights to sell sugar-sweetened beverages (SSB) in campus. This study explored university stakeholder's awareness and opinions of university pouring rights contracts. Methods: Nine hundred fifteen university stakeholders self-reported their awareness and support of pouring rights contracts along with several possible determinants of support (age, gender, nutrition education, beliefs about SSBs, beverage intake). Results: About 64.2% of participants reported no awareness of pouring rights contracts whereas only 38% reported agreeing with university pouring rights contracts. Males, undergraduate students, and those who felt individuals are responsible for their SSB consumption were more likely to support pouring rights contracts. Conclusions: University stakeholders were largely unaware of and unsupportive of pouring rights contracts. Universities are encouraged to consider the health impacts and opinions of university stakeholders when deciding whether to enter into pouring rights contracts.

Neural correlates of food labels on brand, nature, and nutrition: An fMRI meta-analysis

Eating is an essential act of our everyday life, and it involves complicated cognitive appraisal and gustatory evaluation. This study meta-analyzed the functional magnetic resonance imaging (fMRI) studies about food labels on brand, nature and nutrition. Web of Science Core Collection (WoS), Scopus, and PubMed were queried to identify human fMRI studies written in English and published in peer-reviewed journals and used taste or food related labels. Studies were excluded if they reported no results from taste/food related stimuli versus control, no task-based fMRI results, or no results from whole-brain analysis. Nineteen studies entered the analysis. Results for the meta-analysis on food nutrition revealed that the precuneus on the right hemisphere was significantly activated, a brain region related to internal mentation of self-consciousness and nutritional evaluation. Results for the overall analysis on all 19 studies, the analysis on food brand, and the analysis on food nature revealed no significant brain regions. Food nutrition labels were generally processed by brain regions related to internal mentation of self-consciousness and nutritional evaluation. However, the neural correlates of labels of food brand and food nature were inconsistent across studies. More future studies are needed to better understand the cognitive processing of different kinds of food labels in our brain.

Association of consumption of sugar-sweetened beverages with cognitive function among the adolescents aged 12-16 years in US, NHANES III, 1988-1994

Objective

As a major source of added sugar, the consumption of sugar-sweetened beverages (SSBs) continues to increase worldwide. The adverse health effects associated with SSBs are also risk factors for cognitive development, but studies on the relationship between SSBs and adolescents' cognitive function are limited. We used data released by the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) to explore the association between the consumption of SSBs and cognitive function among children and adolescents aged 12-16 years in the United States.

Methods and procedures

A nationally representative population sample included 1,809 adolescents aged 12-16 years who participated in the United States NHANES from 1988 to 1994 and provided samples for the dietary intake frequency questionnaire and measures of cognitive function. Binary logistic regression was used to estimate the association between the frequency of SSB consumption and scores on cognitive function tests.

Results

This study of 1,809 adolescents aged 12-16 years comprised 963 girls (weighted proportion, 48.17%) and 846 boys (weighted, 51.83%), with a weighted mean (SE) age of 13.99 (0.05) years. Compared with adolescents who intake SSBs 0-1 times per week, those who drank 4-7 times per week had better scores in arithmetic, reading, and digit span tests, with odds ratios (ORs) of 0.36 (95% CI = 0.16-0.82), 0.35 (95% CI = 0.18-0.70), and 0.19 (95% CI = 0.08-0.44), respectively. The ORs for abnormal block design scores increase with the frequency of SSB intake after being adjusted for potential confounders (P for trend 0.02). Stratified analyses showed that compared with normal or below BMI, among overweight or obese individuals, the frequency of SSB intake had significant ORs for abnormal digit span scores (OR = 4.76, 95% CI = 1.19-18.96 vs. 0.35, 95% CI = 0.10-1.25; P for interaction = 0.01).

Conclusion

The positive associations of SSBs at moderate level intake with better scores in arithmetic, reading, and digit span were observed, but no dose-response relationship was identified at the overall level. Additionally, with the increasing frequency of SSB consumption, the risk of anomalous block design scores increased among US adolescents. Further investigation is warranted to confirm the association and mechanism between SSBs and cognitive function among adolescents.

Dissecting ultra-processed foods and drinks: Do they have a potential to impact the brain?

Ultra-processed foods and drinks (UPF) are formulation of ingredients, mostly of exclusive industrial use, that result from a series of industrial processes. They usually have a low nutrient but high energy density, with a high content of saturated and trans fats, and added sugars. In addition, they have characteristic organoleptic properties, and usually contain sophisticated additives, including artificial sweeteners, to intensify their sensory qualities and imitate the appearance of minimally processed foods. In addition, recent research has warned about the presence of chemicals (e.g., bisphenol) and neo-formed contaminants in these products. UPF production and consumption growth have been spectacular in the last decades, being specially consumed in children and adolescents. UPF features have been associated with a range of adverse health effects such as overeating, the promotion of inflammatory and oxidative stress processes, gut dysbiosis, and metabolic dysfunction including problems in glucose regulation. The evidence that these UPF-related adverse health effects may have on the neural network implicated in eating behavior are discussed, including the potential impact on serotonergic and dopaminergic neurotransmission, brain integrity and function. We end this review by placing UPF in the context of current food environments, by suggesting that an increased exposure to these products through different channels, such as marketing, may contribute to the automatic recruitment of the brain regions associated with food consumption and choice, with a detrimental effect on inhibitory-related prefrontal cortices. While further research is essential, preliminary evidence point to UPF consumption as a potential detrimental factor for brain health and eating behavior.

Hyper-palatable food consumption during binge-eating episodes: A comparison of intake during binge eating and restricting

OBJECTIVE

The study aim was to elucidate the degree to which hyper-palatable foods (HPF) are consumed during binge episodes compared to restricting episodes, and to test the association between HPF intake during each episode and respective episode frequency.

METHOD

This study was a secondary analysis of data from a larger study on eating disorders. The present sample included adults (N = 147, 83% women) diagnosed with sub-threshold (41%) or full-threshold (59%) bulimia nervosa (BN). Foods consumed during binge and restricting episodes were assessed using the Eating Pathology Symptoms Inventory-Clinician Rated Version. A standardized definition of HPF developed previously was applied to foods consumed during binge and restricting episodes. A Wilcoxon matched-pairs signed-rank test was used to test the difference between total caloric intake from HPF (KcalHPF) and percentage of caloric intake from HPF (PercHPF) during binge episodes relative to restricting episodes. Four linear regression models tested HPF intake (KcalHPF and PercHPF) during both episode types (binge and restricting) as predictors of respective episode frequency.

RESULTS

There was a significant difference between median KcalHPF (1846.6 vs. 279.6; Z = -13.38, p < .001) and PercHPF during binge compared to restricting episodes (95% vs. 61%; Z = -7.35, p < .001). Regression analyses demonstrated that KcalHPF during binge episodes was significantly associated with binge episode frequency (B = 0.002; p < .001), but not PercHPF (p = .287).

DISCUSSION

Results suggest that HPF may be primarily consumed during binge episodes among individuals with BN, and may be associated with greater binge-eating frequency.

PUBLIC SIGNIFICANCE

Findings from the current study support an underlying assumption of theoretical models of binge eating, suggesting that highly rewarding, hyper-palatable foods (HPF), may constitute the vast majority of energy intake during binge-eating episodes. Additionally, a substantial amount of energy intake from HPF may occur during restricting episodes among people with bulimia nervosa. Greater HPF intake during binge eating may also be associated with binge-eating severity.

Neural Vulnerability Factors That Predict Future Weight Gain

PURPOSE OF REVIEW

The current article discusses five neural vulnerability theories for weight gain and reviews evidence from prospective studies using imaging and behavioral measures reflecting neural function, as well as randomized experiments with humans and animals that are consistent or inconsistent with these theories.

RECENT FINDINGS

Recent prospective imaging studies examining predictors of weight gain and response to obesity treatment, and repeated-measures imaging studies before and after weight gain and loss have advanced knowledge of etiologic processes and neural plasticity resulting from weight change. Overall, data provide strong support for the incentive sensitization theory of obesity and moderate support for the reward surfeit theory, inhibitory control deficit theory, and dynamic vulnerability model of obesity, which attempted to synthesize the former theories into a single etiologic model. Data provide little support for the reward deficit theory. Important directions for future studies are delineated.

Substitution of Sugar-Sweetened Beverages for Other Beverages: Can It Be the Next Step Towards Healthy Aging?

PURPOSE OF REVIEW

With the prolongation of life expectancy, the gap between lifespan and "health span," the disease-free lifespan, has been widening due to the massive burden of age-related chronic diseases and research on healthy aging has been gaining momentum. A growing body of evidence suggests that diet is a strong determinant of healthy aging and consumption of sugar-sweetened beverages (SSB), a major source of added sugars, predicts poor health outcomes in the aging population, including cardiovascular disease, diabetes, and cancer. Evidence further supports a link between sugar-sweetened beverages-triggered pathological processes and biologic factors of aging, including inflammaging, oxidative stress, and alterations in intestinal microbiota. At present, substitution of sugar-sweetened beverages with healthier alternative beverage remains the most robust strategy to limit the deleterious effects of sugar-sweetened beverages on health worldwide and may help achieve healthy longevity. The purpose of this review is to provide an overview of mechanisms by which sugar-sweetened beverages consumption may impact the physiological aging process and how a simple intervention of beverage replacement may promote healthy aging.

RECENT FINDINGS

Recent findings indicate that SSB are associated with accelerated aging phenotype and activate various adverse biological processes such as chronic inflammation, oxidative stress, insulin resistance, and gut dysbiosis. Replacing SSB with healthier beverages may be a reasonable option to reduce the burden of chronic disease in the aging population and even prolong life and healthspan.

The effects of the form of sugar (solid vs. beverage) on body weight and fMRI activation: A randomized controlled pilot study

Objective

To test if sugar sweetened beverages (SSBs) and sugar sweetened solids (SSSs) have differential effects on body weight and reward processing in the brain.

Methods

In a single blind randomized controlled pilot trial (RCT), twenty participants with BMI between 20 and 40 kg/m² were randomized to consume a 20 fluid ounce soda (SSB, 248 kcal) or the equivalent in solid form (SSS; similar to thick gelatin or gummy candy) daily. At baseline and day 28, fasting body weight and fed-state BOLD fMRI of the brain were assessed. Differences in fMRI signals between views of low-fat (LF (<30%)) high sugar (HS (>30%)) food, and non-food images were calculated in brain regions implicated in energy homeostasis, taste, and reward.

Results

All participants in the SSB (6F 4M; 8 Caucasian; 36±14 y, 28.2±5.5 kg/m²; Mean±SD) and SSS (3F 7M; 6 Caucasian; 39±12; 26.3±4.4) groups completed the study. Weight change was 0.27±0.78 kg between SSB and SSS participants. Changes in the fMRI response to LF/HS foods in reward, homeostatic and taste regions tended to not be different between the groups over the four weeks. However, activation of the right substantia nigra increased following the SSB but decreased activation following the SSS in response to LF/HS foods over 28 days (-0.32±0.12). Ratings of wanting for LF/HS foods were correlated with activation in several brain regions, including the OFC.

Conclusions

Change in weight was modest between the groups in this study. Daily consumption of a SSB over 28 days led to mixed responses to LF/HS foods in areas of the brain associated with reward. Ratings of wanting are correlated with fMRI activation inside an MRI scanner.

An Exploration of the Role of Sugar-Sweetened Beverage in Promoting Obesity and Health Disparities

PURPOSE OF REVIEW

The mechanistic role of sugar-sweetened beverage (SSB) in the etiology of obesity is undetermined. We address whether, compared to other foods, does consumption of SSB (1) automatically lead to failure to compensate for the energy it contains? (2) fail to elicit homeostatic hormone responses? (3) promote hedonic eating through activation of the brain's reward pathways? We followed the evidence to address: (4) Would restriction of targeted marketing of SSB and other unhealthy foods to vulnerable populations decrease their prevalence of obesity?

RECENT FINDINGS

The data are lacking to demonstrate that SSB consumption promotes body weight gain compared with isocaloric consumption of other beverages or foods and that this is linked to its failure to elicit adequate homeostatic hormone responses. However, more recent data have linked body weight gain to reward activation in the brain to palatable food cues and suggest that sweet tastes and SSB consumption heightens the reward response to food cues. Studies investigating the specificity of these responses have not been conducted. Nevertheless, the current data provide a biological basis to the body of evidence demonstrating that the targeted marketing (real life palatable food cues) of SSB and other unhealthy foods to vulnerable populations, including children and people of color and low socioeconomic status, is increasing their risk for obesity. While the mechanisms for the association between SSB consumption and body weight gain cannot be identified, current scientific evidence strongly suggests that proactive environmental measures to reduce exposure to palatable food cues in the form of targeting marketing will decrease the risk of obesity in vulnerable populations.

The concept of "food addiction" helps inform the understanding of overeating and obesity: YES

Addictive substances such as opiates and other drugs are highly reinforcing and some (but not all) individuals consume them compulsively. Highly processed (HP) foods have unnaturally high concentrations of refined carbohydrates and fat. These foods are highly reinforcing and some (but not all) individuals consume them compulsively. HP foods, like addictive substances, are more effective in activating reward-related neural systems than minimally processed foods. More importantly, HP foods are associated with the behavioral indicators of addiction: diminished control over consumption, strong craving, continued use despite negative consequences, and repeated failed attempts to reduce or eliminate intake. Thus, HP foods are key in addictive patterns of food intake. Like addictive drugs, HP foods are complex, human-made substances designed to effectively deliver reinforcing ingredients (e.g., refined carbohydrates, fat). Withdrawal and tolerance are not necessary for an addiction classification; however, HP foods can trigger both these processes. On a public health level, the negative consequences of HP foods are high, even for those without clinically relevant levels of addictive eating. The recognition that some foods can be addictive will inform clinical obesity treatment and underscore the importance of environmentally focused policy interventions.

Differences in brain structure and function in children with the FTO obesity-risk allele

OBJECTIVE

Noncoding alleles of the fat mass and obesity-associated (FTO) gene have been associated with obesity risk, yet the underlying mechanisms remain unknown. Risk allele carriers show alterations in brain structure and function, but previous studies have not disassociated the effects of genotype from those of body mass index (BMI).

METHODS

Differences in brain structure and function were examined in children without obesity grouped by their number of copies (0,1,2) of the FTO obesity-risk single-nucleotide polymorphism (SNP) rs1421085. One hundred five 5- to 10-year-olds (5th-95th percentile body fat) were eligible to participate. Usable scans were obtained from 93 participants (15 CC [homozygous risk], 31 CT [heterozygous] and 47 TT [homozygous low risk]).

RESULTS

Homozygous C allele carriers (CCs) showed greater grey matter volume in the cerebellum and temporal fusiform gyrus. CCs also demonstrated increased bilateral cerebellar white matter fibre density and increased resting-state functional connectivity between the bilateral cerebellum and regions in the frontotemporal cortices.

CONCLUSIONS

This is the first study to examine brain structure and function related to FTO alleles in young children not yet manifesting obesity. This study lends support to the notion that the cerebellum may be involved in FTO-related risk for obesity, yet replication and further longitudinal study are required.

Fructose vs glucose decreased liking/wanting and subsequent intake of high-energy foods in young women

Recent research on the health impacts of added sugar has prompted the comparison of the effects of its 2 major components: glucose and fructose. Fructose was identified as a risk factor for obesity and metabolic syndrome. However, because of the differences in metabolic responses and responsivity of reward circuitry to palatable food, it is unknown if glucose and fructose induce similar appetite-related responses in humans with varying weights. This study compared the behavioral responses to food in young women of a healthy weight (n = 31) and with excess weight (n = 28). We hypothesized that (1) the inhibitory effect of glucose (vs fructose) on food-related responses would be greater in subjects of a healthy weight than in those with overweight/obesity and (2) subjects with overweight/obesity would exhibit a stronger preference for food than subjects with a healthy weight. After an overnight fast, the subjects ingested a glucose or equienergetic fructose beverage on 2 separate days, respectively. Then, they completed liking and wanting ratings and 2 decision-making tasks followed by ad libitum food intake. The results revealed that fructose reduced both liking and wanting for food in subjects with overweight/obesity and also decreased energy intake in all subjects. Relative to the healthy-weight group, subjects with overweight/obesity preferred the immediate reward. Moreover, only in the healthy-weight group were liking and wanting scores for food positively associated with actual food consumption. Overall, fructose (vs glucose) showed an acute inhibitory effect on appetite-related responses in subjects with excess weight.

Development and preliminary validation of the Anticipated Effects of Food Scale

Expectancy theory has been widely applied in substance use research but has received less attention in eating behavior research. Measuring food expectancies, or the anticipated outcomes of eating specific foods, holds theoretical and practical promise for investigations into nonhomeostatic eating behavior. The current study developed and assessed the psychometric properties of a novel measure of positively and negatively valenced highly (e.g., sweets, salty snacks, fast foods, sugary drinks) and minimally (e.g., fruits, vegetables) processed food expectancies. The Anticipated Effects of Food Scale (AEFS) was adapted from a self-report of alcohol expectancies, piloted for item generation/retention and readability, and preliminarily validated in an adult sample (N = 247; Mage = 36.84; 53.3% male; 74.5% White). Consistent with the substance expectancies literature, AEFS positive highly processed food expectancies were associated with greater added sugars intake, r = .17, p = .009, and food addiction symptoms, r = .56, p < .001. Of note, AEFS negative minimally processed food expectancies were robustly associated with food addiction symptoms, r = .81, p < .001, and, together with AEFS positive highly processed food expectancies, explained 67% of the variance in food addiction symptoms. Furthermore, AEFS food expectancies demonstrated incremental validity with food addiction symptoms above and beyond general eating expectancies. The AEFS seems to be a psychometrically sound measure and can be used to investigate cognitive-affective mechanisms implicated in highly processed food intake and food addiction. Moreover, the present results provide new insight into potential food expectancy challenge intervention approaches for preventing nonhomeostatic eating behavior. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Rethinking Food Reward

The conscious perception of the hedonic sensory properties of caloric foods is commonly believed to guide our dietary choices. Current and traditional models implicate the consciously perceived hedonic qualities of food as driving overeating, whereas subliminal signals arising from the gut would curb our uncontrolled desire for calories. Here we review recent animal and human studies that support a markedly different model for food reward. These findings reveal in particular the existence of subcortical body-to-brain neural pathways linking gastrointestinal nutrient sensors to the brain's reward regions. Unexpectedly, consciously perceptible hedonic qualities appear to play a less relevant, and mostly transient, role in food reinforcement. In this model, gut-brain reward pathways bypass cranial taste and aroma sensory receptors and the cortical networks that give rise to flavor perception. They instead reinforce behaviors independently of the cognitive processes that support overt insights into the nature of our dietary decisions.

Development of the Highly Processed Food Withdrawal Scale for Children

INTRODUCTION

Highly processed foods (with added fats and/or refined carbohydrates) may trigger an addictive-like process, including withdrawal when these foods are reduced. Withdrawal is marked by affective, cognitive, and physical symptoms that may hinder dietary change. A recently developed scale of highly processed food withdrawal in adults (ProWS) provides evidence for this construct. Children commonly consume highly processed foods, but no measures currently exist to examine highly processed food withdrawal in children. The purpose of this study was to develop a measure (ProWS-C) to assess for signs of highly processed food withdrawal in children.

METHODS

Parents who had recently attempted to reduce their child's highly processed food consumption were recruited through an online crowdsourcing platform. 304 parents (56.9% mothers) reported on their 3-11-year-old children (63.8% male). The ProWS-C was designed to reflect parents' observations of child behavior. Internal consistency and validity were evaluated using the Dimensional Yale Food Addiction Scale Version 2.0 for Children (dYFAS-C 2.0.), Children's Food Neophobia Scale-Modified (CFNS), and body mass index (BMI) silhouettes.

RESULTS

Exploratory factor analysis revealed a one-factor structure with 21 items (α = 0.94). The ProWS-C demonstrated convergent validity with more child food addiction symptoms (r = 0.55, p < 0.001) and higher child BMI (r = 0.24, p < 0.001) and discriminant validity with child food neophobia (r = -0.10, p = 0.08). The ProWS-C was associated with less success in reducing child highly processed food intake independent of child addictive-like eating and BMI (p = 0.001).

DISCUSSION

The ProWS-C provides preliminary evidence for highly processed food withdrawal in children and appears to be a psychometrically sound tool for assessing parent-reported withdrawal symptoms in children. Illuminating specific challenges families face when reducing highly processed foods may improve parents' ability to help their children make sustainable dietary changes.

The impact of elevated body mass on brain responses during appetitive prediction error in postpartum women

Repeated exposure to highly palatable foods and elevated weight promote: 1) insensitivity to punishment in striatal regions and, 2) increased willingness to work for food. We hypothesized that BMI would be positively associated with negative prediction error BOLD response in the occipital cortex. Additionally, we postulated that food reinforcement value would be negatively associated with negative prediction error BOLD response in the orbital frontal cortex and amygdala. Postpartum women (n = 47; BMI = 25.5 ± 5.1) were 'trained' to associate specific cues paired to either a highly palatable milkshake or a sub-palatable milkshake. We then violated these cue-taste pairings in 40% of the trials by showing a palatable cue followed by the sub-palatable taste (negative prediction error). Contrary to our hypotheses, during negative prediction error (mismatched cue-taste) versus matched palatable cue-taste, women showed increased BOLD response in the central operculum (pFWE = 0.002; k = 1680; MNI: -57, -7,14) and postcentral gyrus (pFWE = 0.006, k = 1219; MNI: 62, -8,18). When comparing the matched sub-palatable cue-taste to the negative prediction error trials, BOLD response increased in the postcentral gyrus (r = -0.60, pFWE = 0.008), putamen (r = -0.55, pFWE = 0.02), and insula (r = -0.50, pFWE = 0.01). Similarly, viewing the palatable cue vs sub-palatable cue was related to BOLD response in the putamen (pFWE = 0.025, k = 53; MNI: -20, 6, -8) and the insula (pFWE = 0.04, k = 19, MNI:38, -12, -6). Neither BMI at 6-month postpartum nor food reinforcement value was related to BOLD response. The insula and putamen appear to encode for visual food cue processing, and the gustatory and somatosensory cortices appear to encode negative prediction errors. Differential response in the somatosensory cortex to the matched cue-taste pairs to negative prediction error may indicate that a palatable cue may dull aversive qualities in the stimulus.

Neural vulnerability factors for obesity

Multiple theories identify neural vulnerability factors that may increase risk for overeating and weight gain. Early cross-sectional neuroimaging studies were unable to determine whether aberrant neural responsivity was a risk factor for or a consequence of overeating. More recent obesity risk, prospective, repeated-measures, and experimental neuroimaging studies with humans have advanced knowledge of etiologic processes and neural plasticity resulting from overeating. Herein, we review evidence from these more rigorous human neuroimaging studies, in conjunction with behavioral measures reflecting neural function, as well as experiments with animals that investigated neural vulnerability theories for overeating. Findings provide support for the reward surfeit theory that posits that individuals at risk for obesity initially show hyper-responsivity of reward circuitry to high-calorie food tastes, which theoretically drives elevated intake of such foods. However, findings provide little support for the reward deficit theory that postulates that individuals at risk for obesity show an initial hypo-responsivity of reward circuitry that motives overeating. Further, results provide support for the incentive sensitization and dynamic vulnerability theories that propose that overconsumption of high-calorie foods results in increased reward and attention region responsivity to cues that are associated with hedonic reward from intake of these high-calorie foods via conditioning, as well as a simultaneous decrease in reward region responsivity to high-calorie food tastes. However, there is little evidence that this induced reduction in reward region response to high-calorie food tastes drives an escalation in overeating. Finally, results provide support for the theory that an initial deficit in inhibitory control and a bias for immediate reward contribute to overconsumption of high-calorie foods. Findings imply that interventions that reduce reward and attention region responsivity to food cues and increase inhibitory control should reduce overeating and excessive weight gain, an intervention theory that is receiving support in randomized trials.

Individual differences in appeal of energy dense foods predicts lower body mass change during adolescence

Highly energy dense foods are often synonymous with high palatability, excess intake and weight gain. However, food preferences show individual differences. Food preferences are closely related to food intake, which can impact weight change over time. We examined whether the energy density of food images rated as appetizing and unappetizing foods related to baseline BMI and change in BMI over 3-year follow-up (n = 117; 45% Male, Baseline BMI: 21.1 ± 1.9. Participants completed hedonic visual analog scales (-100 to 100) ratings of 103 food images, and reported dietary intake at baseline, and had their height and weight directly measured over 3-year follow-up. Energy density (ED) of the food depicted in each image was calculated. For each participant, food images (kcal/g) were categorized into appetizing (32 images) and unappetizing foods (32 images) based on each individual's hedonic ratings. We observed significant interaction between energy density and hedonic value driven by an inverse relation between unappetizing food energy density and BMI change (p = 0.008). Specifically, participants who rated higher energy dense foods as unappetizing showed less weight gain (β= -0.83; p = 0.00052). There was no significant relation between the energy density of appetizing foods and weight change (p = 0.67), suggesting that dislike of highly energy dense foods more strongly associates with lower weight gain than preference for low energy dense foods. Post-hoc analyses revealed that individuals with a higher preference for low energy density foods showed less weight gain over 3-years (β = - 0.007, p = 0.02). Results support the idea that individual hedonic ratings for foods varying in energy density is a determinant of weight change in adolescents and may represent an important intervention target for obesity prevention programs.

Validation of the Spanish Version of the Yale Food Addiction Scale 2.0 (YFAS 2.0) and Clinical Correlates in a Sample of Eating Disorder, Gambling Disorder, and Healthy Control Participants

Aims: Due to the increasing evidence of shared vulnerabilities between addictive behaviors and excessive food intake, the concept of food addiction in specific clinical populations has become a topic of scientific interest. The aim of this study was to validate the Yale Food Addiction Scale (YFAS) 2.0 in a Spanish sample. We also sought to explore food addiction and its clinical correlates in eating disorder (ED) and gambling disorder (GD) patients. Methods: The sample included 301 clinical cases (135 ED and 166 GD), diagnosed according to DSM-5 criteria, and 152 healthy controls (HC) recruited from the general population. Results: Food addiction was more prevalent in patients with ED, than in patients with GD and HC (77.8, 7.8, and 3.3%, respectively). Food addiction severity was associated with higher BMI, psychopathology and specific personality traits, such as higher harm avoidance, and lower self-directedness. The psychometrical properties of the Spanish version of the YFAS 2.0 were excellent with good convergent validity. Moreover, it obtained good accuracy in discriminating between diagnostic subtypes. Conclusions: Our results provide empirical support for the use of the Spanish YFAS 2.0 as a reliable and valid tool to assess food addiction among several clinical populations (namely ED and GD). The prevalence of food addiction is heterogeneous between disorders. Common risk factors such as high levels of psychopathology and low self-directedness appear to be present in individuals with food addiction.

Whey Protein Supplementation Improves Body Composition and Cardiovascular Risk Factors in Overweight and Obese Patients: A Systematic Review and Meta-Analysis

BACKGROUND

Previous literature shows possible benefits of whey protein supplementation in promoting weight loss. However, most studies do not have enough power to show beneficial effects on body composition and cardiovascular disease (CVD) risk factors. This meta-analysis evaluated effects of whey protein in individuals who are overweight and obese.

METHODS

We comprehensively searched the databases of MEDLINE, Embase, and Cochrane databases. The inclusion criteria were published randomized control trials (RCTs) comparing whey protein supplementation to placebo or controls in individuals who are overweight or obese. The primary outcome was the differences in the change in body composition (body weight, waist circumference, total fat mass, body lean mass). We also examined the changes in CVD risk factors as secondary outcomes. We calculated pooled mean difference (MD) with 95% confidence intervals (CIs) using a random effects model.

RESULTS

Nine RCTs were included in the meta-analysis. There was a significant reduction of body weight (MD = 0.56, 95% CI: 0.30-0.81), lean mass (MD = 0.77, 95% CI: 0.59-0.96), and fat mass (MD = 1.12, 95% CI: 0.77-1.47) favoring the whey protein group. There were improvements in multiple CVD risk factors including levels of systolic blood pressure, diastolic blood pressure, glucose, high-density lipoprotein, and total cholesterol (all p values <0.05).

CONCLUSIONS

Whey protein supplementation seems to improve body weight, total fat mass, and some CVD risk factors in overweight and obese patients. Further studies regarding optimal dosage and duration of whey protein supplementation would be helpful to assess potential favorable effects in individuals who are overweight or obese.