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Interventions to promote healthy eating choices when dining out: A systematic review of reviews.
Wright, B, Bragge, P
British journal of health psychology. 2018;(2):278-295
Abstract
PURPOSE To synthesize review research pertaining to the effectiveness of interventions in dining-out settings to reduce food/calorie consumption. METHODS A rapid review methodology was employed to focus on synthesized research. A comprehensive search for peer-reviewed systematic reviews from 2010 to 2015 yielded 1,847 citations. Following screening, ten systematic reviews were included. RESULTS The 10 included systematic reviews identified 183 primary studies evaluating evidence in three behavioural intervention areas: social models/norms, manipulation of size, and provision of health information. Three systematic reviews evaluating the use of social models/norms found this was an effective intervention for influencing food intake. Five systematic reviews that assessed manipulation of portion/dishware/cutlery size found a small-to-moderate effect on food consumption. Three systematic reviews looked at the provision of health information, which was not effective alone; however, in combination with contextual or interpretive material such as traffic lights or exercise equivalence, this was shown to reduce calorie consumption. One systematic review covered two topic areas. CONCLUSIONS The results indicate that policies or interventions that aim to improve healthy choices or consumption when dining out would benefit from harnessing social norms and positive positioning of social identity. Furthermore, provision of health information should always be accompanied by an interpretative guide, such as traffic lights. Manipulation of plate/portion/cutlery size may be effective; however, the effect size is small and further research is required to investigate whether this effect is retained in overweight or obese populations. Statement of contribution What is already known on this subject? Eating behaviours (food choices, consumption) have played a role in the obesity epidemic. Behavioural 'nudges' have tried to increase healthier eating choices. What does this study add? Social norms and modelling have a strong influence in both directions on how much people consume. Provision of nutritional information needs to be paired with interpretative aids (e.g., traffic lights). Manipulation of portion size is less effective in overweight populations.
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The persuasive effect of advergames promoting unhealthy foods among children: A meta-analysis.
Folkvord, F, van 't Riet, J
Appetite. 2018;:245-251
Abstract
Multiple studies have examined the effects of advergames promoting unhealthy foods on eating behavior among children. Although the individual results of the existing studies suggest that advergames have a significant influence on (predictors of) eating behavior, a lack of clarity concerning the size of the effect may impede policy actions. Therefore, a meta-analysis was conducted to examine the strength of the effect of playing advergames that promote unhealthy foods on (predictors of) eating behavior among children. Five electronic databases were searched for relevant publications (Web of Science, PsychInfo, Pubmed, JSTOR, and SCOPUS). Fifteen articles were considered eligible for inclusion and analyzed in the meta-analysis. Employing a random-effects model to estimate the composite effect of advergames yielded a small-to-moderate and significant effect of g = 0.30. Results showed that advergames promoting unhealthy foods induced unhealthy eating behavior among children. Although only a limited number of studies were included, this meta-analysis supports public health policy action that seeks to reduce children's exposure to unhealthy digital food marketing. Stricter regulation to protect children against new forms of (online) marketing techniques that promote unhealthy foods should be developed and implemented.
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The impact of replacing sugar- by artificially-sweetened beverages on brain and behavioral responses to food viewing - An exploratory study.
Crézé, C, Notter-Bielser, ML, Knebel, JF, Campos, V, Tappy, L, Murray, M, Toepel, U
Appetite. 2018;:160-168
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Several studies indicate that the outcome of nutritional and lifestyle interventions can be linked to brain 'signatures' in terms of neural reactivity to food cues. However, 'dieting' is often considered in a rather broad sense, and no study so far investigated modulations in brain responses to food cues occurring over an intervention specifically aiming to reduce sugar intake. We studied neural activity and liking in response to visual food cues in 14 intensive consumers of sugar-sweetened beverages before and after a 3-month replacement period by artificially-sweetened equivalents. Each time, participants were presented with images of solid foods differing in fat content and taste quality while high-density electroencephalography was recorded. Contrary to our hypotheses, there was no significant weight loss over the intervention period and no changes were observed in food liking or in neural activity in regions subserving salience and reward attribution. However, neural activity in response to high-fat, sweet foods was significantly reduced from pre-to post-intervention in prefrontal regions often linked to impulse control. This decrease in activity was associated with weight loss failure, suggesting an impairment in individuals' ability to exert control and adjust their solid food intake over the intervention period. Our findings highlight the need to implement multidisciplinary approaches when aiming to help individuals lose body weight.
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Altered Eating Attitudes in Nursing Home Residents and Its Relationship with their Cognitive and Nutritional Status.
María Pérez-Sánchez, C, Nicolás Torres, D, Hernández Morante, JJ
The journal of nutrition, health & aging. 2018;(7):869-875
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BACKGROUND although eating disorders are usually linked to young adolescents, these mental disorders can also appear in the elderly, especially in those living in nursing homes, which might be associated or not with the cognitive decline; however, there are few data regarding elderly subjects. OBJECTIVES the objective of the present work was to evaluate the presence of abnormal eating attitudes in nursing home residents and its relation with several cognitive, nutritional and psychological factors that could be influencing their nutritional state. DESIGN AND SETTING a observational experimental study was carried out at several nursing homes of Murcia, Spain. SUBJECTS 139 nursing home residents. METHODS EAT-26 test was used to screen classic eating disorders (anorexia and bulimia). Blandford's scale was employed to determine aversive eating attitudes. Moreover, subjective appetite sensations, body image perception, nutritional (MNA and diet composition) and biochemical data were also evaluated. RESULTS 33% of the subjects had malnutrition. No subject showed symptoms of anorexia or bulimia; however, subjects with cognitive decline frequently showed aversive feeding behaviours (21.6%). Albumin values were significantly lower in subjects with cognitive impairment. CONCLUSIONS our data showed a clear relation between cognitive impairment and altered eating attitudes, which was reflected by both biochemical (albumin) and nutritional parameters, while no classic eating disorder was observed in residents with normal cognitive-status. These data confirm the need to strengthen our efforts towards maintaining the nutritional status of the subjects with cognitive impairment.
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The effect of sugar-sweetened beverage price increases and educational messages on beverage purchasing behavior among adults.
Blake, MR, Lancsar, E, Peeters, A, Backholer, K
Appetite. 2018;:156-162
Abstract
There is a paucity of evidence regarding the impact of sugar sweetened beverage (SSB) price increases on beverage consumption, using individual-level data, for the population overall and for different socioeconomic groups. This study aimed to predict the impact of altered beverage prices and educational messages on consumer purchasing behavior. 2020 adults representative of the Australian population by age, gender and income completed a discrete choice experiment online in 2016. Each subject completed 20 choice scenarios in a hypothetical convenience store setting where subjects chose between seven SSB and non-SSB beverage options or a no beverage option. Beverage prices and volumes varied between scenarios. Half of participants (n = 1012) were randomly exposed to an educational poster discouraging SSB consumption prior to completing choice scenarios. We used discrete choice models to predict purchases under several policy proposals, overall and for income and SSB consumption frequency sub-groups. Compared to baseline prices, a 10% SSB price increase was predicted to reduce SSB purchases by 15.0% [95%CI -15.2, -14.7], and increase purchases of non-SSBs by +11.0% [95%CI 10.8, 11.2] and no beverage by +15.5% [95%CI 15.1, 15.9]. Effects were greater with a 20% SSB price increase. Across all policy scenarios, the highest income quintile had a similar absolute and slightly greater relative decrease in SSB purchases compared to the lowest quintile. Educational poster exposure reduced SSB choice for all groups, with a greater reduction in the lower compared to higher income group, and additively increased response to price changes. Our results support the use of population-wide SSB pricing and educational interventions to reduce demand across all income groups.
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Guided imagery targeting exercise, food cravings, and stress: a multi-modal randomized feasibility trial.
Giacobbi, P, Long, D, Nolan, R, Shawley, S, Johnson, K, Misra, R
Journal of behavioral medicine. 2018;(1):87-98
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The purpose of this randomized wait-list controlled trial was to test the feasibility and preliminary efficacy of a guided imagery based multi-behavior intervention intended to address psychological stress, food cravings, and physical activity. Personalized guided imagery scripts were created and participants were instructed to practice guided imagery every day for 35 consecutive days. Of 48 women who enrolled, we report comparisons between 16 randomized to treatment with 19 who were wait-listed (overall Mage = 45.50; Mbodymassindex = 31.43). Study completers reported 89% compliance with practicing guided imagery during the intervention. A significant time-by-group interaction was observed with reductions in food cravings and increases in physical activity compared with wait-list controls. Telephone-based multi-behavior interventions that utilize guided imagery to address food cravings and exercise behavior appear to be acceptable for overweight and obese women. Future phone-based guided imagery research testing this skill to address multiple health behaviors is justified.
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From cookies to carrots; the effect of inhibitory control training on children's snack selections.
Porter, L, Bailey-Jones, C, Priudokaite, G, Allen, S, Wood, K, Stiles, K, Parvin, O, Javaid, M, Verbruggen, F, Lawrence, NS
Appetite. 2018;:111-123
Abstract
Children consume too much sugar and not enough fruit and vegetables, increasing their risk of adverse health outcomes. Inhibitory control training (ICT) reduces children's and adults' intake of energy-dense foods in both laboratory and real-life settings. However, no studies have yet examined whether ICT can increase healthy food choice when energy-dense options are also available. We investigated whether a food-specific Go/No-Go task could influence the food choices of children aged 4-11, as measured by a hypothetical food choice task using healthy and unhealthy food images printed on cards. Participants played either an active game (healthy foods = 100% go, unhealthy foods = 100% no-go; Studies 1 & 2), a food control game (both healthy and unhealthy foods = 50% go, 50% no-go; Studies 1 & 2) or a non-food control game (sports equipment = 100% go, technology = 100% no-go; Study 2 only) followed by the choice task. In Study 2, food card choices were also measured before training to examine change in choices. A post-training real food choice task was added to check that choices made in the card-based task were representative of choices made when faced with real healthy and unhealthy foods. Overall, the active group chose the greatest number of healthy food cards. Study 2 confirmed that this was due to increases in healthy food card choice in this group only. Active group participants chose a greater number of healthy foods in the real food choice task compared to children in the non-food control group only. The results are discussed with reference to methodological issues and the development of future healthy eating interventions.
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Effect of price and information on the food choices of women university students in Saudi Arabia: An experimental study.
Halimic, A, Gage, H, Raats, M, Williams, P
Appetite. 2018;:175-182
Abstract
OBJECTIVE To explore the impact of price manipulation and healthy eating information on intended food choices. DESIGN Health information was provided to a random half of subjects (vs. information on Saudi agriculture). Each subject chose from the same lunch menu, containing two healthy and two unhealthy entrees, deserts and beverages, on five occasions. Reference case prices were 5, 3 and 2 Saudi Arabian Reals (SARs). Prices of healthy and unhealthy items were manipulated up (taxed) and down (subsidized) by 1 SAR in four menu variations (random order); subjects were given a budget enabling full choice within any menu. The number of healthy food choices were compared with different price combinations, and between information groups. Linear regression modelling explored the effect of relative prices of healthy/unhealthy options and information on number of healthy choices controlling for dietary behaviours and hunger levels. SETTING University campus, Saudi Arabia, 2013. SUBJECTS 99 women students. RESULTS In the reference case, 49.5% of choices were for healthy items. When the price of healthy items was reduced, 58.5% of selections were healthy; 57.2% when the price of unhealthy items rose. In regression modelling, reducing the price of healthy items and increasing the price of unhealthy items increased the number of healthy choices by 5% and 6% respectively. Students reporting a less healthy usual diet selected significantly fewer healthy items. Providing healthy eating information was not a significant influence. CONCLUSION Price manipulation offers potential for altering behaviours to combat rising youth obesity in Saudi Arabia.
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Prolonged Exposure to Monosodium Glutamate in Healthy Young Adults Decreases Perceived Umami Taste and Diminishes Appetite for Savory Foods.
Noel, CA, Finlayson, G, Dando, R
The Journal of nutrition. 2018;(6):980-988
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BACKGROUND Research suggests that increased consumption of sweet, salt, or fat is associated with diminished perceived taste intensity and shifted preferences for the respective stimulus. It is unknown whether a similar effect occurs with the consumption of umami. OBJECTIVE The aim of the study was to investigate the influence of habitual exposure to umami stimuli on umami taste perception, hedonics, and satiety. METHODS Fifty-eight healthy men (n = 16) and women (n = 42) participated in a parallel-group, randomized controlled study. The normal-weight [mean ± SD body mass index (kg/m2): 21.8 ± 2.2] group of young adults (mean ± SD age: 22.7 ± 6.2 y) consumed vegetable broth daily for 4 wk. The broth for the treatment group (n = 28) was supplemented with 3.8 g monosodium glutamate (MSG), whereas the control group (n = 30) consumed a sodium-matched broth without MSG. Perceived umami taste intensity and discrimination in MSG solutions; liking, wanting, and preference of a variety of umami-rich foods; satiation and satiety from an ad libitum meal; and anthropometric measures were evaluated at baseline and at week 4. General linear models assessed the effect of treatment on change from baseline for all outcomes and tested for effect modification of sex. RESULTS Relative to controls, increased consumption of MSG for 4 wk diminished umami taste in women (8.4 units on generalized Labeled Magnitude Scale; 95% CI: -13.8, -3.1 units; P = 0.013). The desire for and intake of savory foods decreased after MSG treatment in both sexes with an ad libitum meal (desire: -7.7 units; 95% CI: -13.7, -1.7 units; P = 0.04; intake: -36 g; 95% CI: -91, 19 g; P = 0.04). CONCLUSION Our results highlight that a month-long diet high in umami stimuli attenuates perceived umami taste and appetite for savory foods in a young, healthy population. Our findings contribute to the understanding of food choice, a factor in the development and maintenance of obesity, as well as the etiology of protein-related health conditions such as osteoporosis and kidney disease. This study is registered at www.clinicaltrials.gov as NCT03010930.
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Effect of default menus on food selection and consumption in a college dining hall simulation study.
Radnitz, C, Loeb, KL, Keller, KL, Boutelle, K, Schwartz, MB, Todd, L, Marcus, S
Public health nutrition. 2018;(7):1359-1369
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OBJECTIVE To test an obesity prevention strategy derived from behavioural economics (optimal defaults plus delay), focused on changing the college dining hall service method. DESIGN After a uniform pre-load, participants attended an experimental lunch in groups randomized to one of three conditions: a nutrient-dense, lower-fat/energy lunch as an optimal default (OD); a less-nutrient-dense, higher-fat/energy lunch as a suboptimal default (SD); or a free array (FA) lunch. In the OD condition, students were presented a menu depicting healthier vegetarian and omnivore foods as default, with opt-out alternatives (SD menu) available on request with a 15 min wait. In the SD condition, the same menu format was used with the positioning of food items switched. In the FA condition, all choices were presented in uniform fonts and were available immediately. SETTING Private rooms designed to provide a small version of a college dining hall, on two campuses of a Northeastern US university. SUBJECTS First-year college students (n 129). RESULTS There was a significant main effect for condition on percentage of optimal choices selected, with 94 % of food choices in the OD condition optimal, 47 % in the FA condition optimal and none in the SD condition optimal. Similarly, energy intake for those in the SD condition significantly exceeded that in the FA condition, which exceeded that in the OD condition. CONCLUSIONS Presenting menu items as optimal defaults with a delay had a significant impact on choice and consumption, suggesting that further research into its long-term applicability is warranted.