Indoor nature integration for stress recovery and healthy eating: A picture experiment with plants versus green color.

AIM: Urbanized environments may stimulate unhealthy food choices and stress. Several theories explain that exposure to green nature can counter these stress effects. Since we spend most time indoors, integrating nature in the interior could be a promising health promotion tool. Hence, we tested whether the beneficial effect of nature for stress recovery is also present in indoor settings via the use of plants or green colors, and whether it is applicable on eating behavior as a new outcome. METHODS: The 92 participants (18-30y, 16% men) were divided into four groups. Each viewed a 6-min slideshow with room pictures containing either green plants, green objects, greyscale plants or greyscale objects to allow distinction between color- and plant-effects. Group differences were tested for the perceived restorativeness scale, psychological recovery and eating behavior. To allow psychological recovery testing, participants were exposed to a stressor before the picture slideshow via the Trier Social Stress Test. The change of self-reports (stress, positive and negative affect) and psychophysiology (heart rate and vagal-induced heart rate variability RMSSD) post-slideshow versus pre-slideshow was checked. Eating behavior outcomes included change in hunger, craving, and food choice (for fruits, vegetables and snacks). RESULTS: From the four picture sets, the green plants pictures were reported as most mentally restorative and appeared most beneficial for post-stressor recovery of positive affect, but not for negative affect or stress recovery. The green plants group also had higher preference for vegetables and lower preference or craving for (unhealthy) snacks. Those significant group differences were mainly due to the presence of plants and only occasionally due to the green color. CONCLUSION: Indoor green plant pictures were associated with higher mental restorativeness and healthier food choices. Integrating plants in the interior seems to be a relevant health promotion approach, while applying green colors seems less relevant.

Interventions maintaining eating Independence in nursing home residents: a multicentre qualitative study.

BACKGROUND: Despite 32 years of research and 13 reviews published in the field, no intervention can be considered a gold standard for maintaining eating performance among residents with dementia. The study aim was to highlight the interventions derived from tacit knowledge and offered daily in assisting eating by healthcare professionals (HCPs) in nursing homes (NHs). METHOD: A multicentre descriptive qualitative study was performed in 2017. Thirteen NHs admitting residents with moderate/severe functional dependence in eating mainly due to dementia, were approached. A purposeful sample of 54 HCPs involved on a daily basis in assisting residents during mealtime were interviewed in 13 focus groups. Data analysis was conducted via qualitative content analysis. RESULTS: The promotion and maintenance of eating performance for as long as possible is ensured by a set of interventions targeting three levels: (a) environmental, by 'Ritualising the mealtime experience by creating a controlled stimulated environment'; (b) social, by 'Structuring effective mealtime social interactions'; and (c) individual, by 'Individualising eating care' for each resident. CONCLUSIONS: In NHs, the eating decline is juxtaposed with complex interventions regulated on a daily basis and targeting the environment, the social interactions, and the residents' needs. Several interventions that emerged as effective, according to the experience of participants, have never been documented before; while others are in contrast to the evidence documented. This suggests the need for further studies in the field; as no conclusions regarding the best interventions have been established to date.

Learned pleasure from eating: An opportunity to promote healthy eating in children?

Across the lifespan, eating is a common everyday act driven by the search for pleasure and reinforced by experienced pleasure. Pleasure is an innate indicator of the satisfaction of physiological needs, in addition to other attributes. Pleasure from eating is also learned and contributes to the development of children's eating habits, which remain mostly stable until adulthood. Based on classical models of determinants of food consumption behaviour, we identified three dimensions of pleasure from eating learned during childhood: 1/the sensory dimension, i.e., pleasure from sensory sensations during food consumption; 2/the interpersonal dimension, i.e., pleasure from the social context of food consumption; and 3/the psychosocial dimension, i.e., pleasure from cognitive representations of food. The objective of this narrative review is to explore whether these three dimensions may play a role in promotion of healthy eating behaviour among children. Up to now, it was assumed that providing nutritional information, pointing out which types of foods are "good" or "bad" for health, would drive healthier food choices in children. Today, we know that such strategies based on a cognitive approach toward eating have a limited impact on healthy choices and can even be counter-productive, leading children to avoid healthy foods. In the context of increasing rates of childhood obesity, new perspectives are needed to build efficient interventions that might help children adopt a healthy diet. This review suggests new directions for further research to test the efficacy of novel interventions that emphasize pleasure from eating.

Effectiveness of brief nutrition interventions on dietary behaviours in adults: A systematic review.

Brief interventions are effective in improving health behaviours including alcohol intake, however the effectiveness of brief interventions targeting nutrition outcomes has not been determined. The aim of this systematic review was to determine the effectiveness of brief nutrition interventions in adults. Seven databases were searched for RCT/pseudo RCT studies published in English to April 2016, and evaluating brief interventions (i.e. single point of contact) designed to promote change in eating behaviours in healthy adults (≥18 years). Of 4849 articles identified, 45 studies met inclusion criteria. Most studies targeted fruit and/or vegetable intake (n = 21) or fat intake (n = 10), and few targeted diet quality (n = 2). Median follow-up was 3.5 months, with few studies (n = 4) measuring longer-term outcomes (≥12 months). Studies aimed to determine whether a brief intervention was more effective than another brief intervention (n = 30), and/or more effective than no intervention (n = 20), with 17 and 11 studies, respectively, reporting findings to that effect. Interventions providing education plus tailored or instructional components (e.g. feedback) were more effective than education alone or non-tailored advice. This review suggests that brief interventions, which are tailored and instructional, can improve short-term dietary behaviours, however evidence for longer-term behaviour change maintenance is limited.

Parental strategies used in the family meal session of family-based treatment for adolescent anorexia nervosa: Links with treatment outcomes.

OBJECTIVE: Examine relationships between parental mealtime strategies used in the family meal session of family-based treatment (FBT) and adolescent outcomes at EOT (session 20). METHOD: Eighteen families with an adolescent receiving FBT-AN participated. Parental strategies during videoed family meals were assessed using a family mealtime coding system. Change scores were calculated for both adolescent %EBW and EDE scores. RESULTS: Increased use of parental direct and non-direct eating prompts during the family meal was associated with greater adolescent weight gain at EOT. Use of parental mealtime strategies was not associated with any significant change in adolescent eating psychopathology at EOT. DISCUSSION: Parental verbal eating prompts during the family meal may be effective in promoting short-term weight gain. During the family meal session, parents should be encouraged to maintain a direct focus on their adolescent child's eating behaviour which may assist their child with food consumption and potential weight gain. Further research examining food-based interactions among parents and their adolescent child with AN is needed. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:433-436).

A structured literature review on the role of mindfulness, mindful eating and intuitive eating in changing eating behaviours: effectiveness and associated potential mechanisms.

The role of mindfulness, mindful eating and a newer concept of intuitive eating in modulating eating habits is an area of increasing interest. In this structured literature review, a summary of the current evidence is presented, together with details of interventions undertaken and the tools to measure outcomes. It is broad in scope given the emerging evidence base in this area. The review yielded sixty-eight publications: twenty-three interventions in obese/overweight populations; twenty-nine interventions in normal-weight populations; sixteen observational studies, three of which were carried out in overweight/obese populations. Mindfulness-based approaches appear most effective in addressing binge eating, emotional eating and eating in response to external cues. There is a lack of compelling evidence for the effectiveness of mindfulness and mindful eating in weight management. Mindfulness-based approaches may prevent weight gain. Reduced food intake was seen in some of the studies in overweight and obese populations, but this was less apparent in the studies in normal-weight populations. The evidence base for intuitive eating is limited to date and further research is needed to examine its potential in altering eating behaviours. Mindfulness appears to work by an increased awareness of internal, rather than external, cues to eat. Mindfulness and mindful eating have the potential to address problematic eating behaviours and the challenges many face with controlling their food intake. Encouraging a mindful eating approach would seem to be a positive message to be included in general weight management advice to the public.

A randomized-controlled trial focusing on socio-economic status for promoting vegetable intake among adults using a web-based nutrition intervention programme: study protocol.

BACKGROUND: Web-based nutritional education programmes appear to be comparable to those delivered face-to-face. However, no existing web-based nutrition education or similar programme has yet been evaluated with consideration of socio-economic status. The objective of a nutritional education programme of promoting vegetable intake designed a randomized controlled trial (RCT) is to evaluate the results of intervention and to determine how socio-economic status influences the programme effects. METHODS/DESIGN: Participants will be randomly sampled individuals (aged 30-59) stratified according national population statistics for sex, age, and household income. Participants were consented to survey participation (n = 1500), and will be randomly divided into intervention and control groups. The intervention period is 5 weeks with one step of diet-related education per week. The main outcome of the programme is dietary behaviour as eating vegetable (350 g per day, five small bowl). To encourage behavioural changes, the programme contents are prepared using behavioural theories and techniques tailored to the assumed group stages of behavioural change. In the first step, we employ the health belief model to encourage a shift from the pre-contemplative to the contemplative phase; in the second and third steps, social cognitive theory is used to encourage transition to the preparatory phase; in the fourth step, social cognitive theory and strengthening social support are used to promote progression to the execution phase; finally, in the fifth step, strengthening social capital and social support are used to promote the shift to the maintenance phase. The baseline, post intervention and follow-up survey was assessed using a self-administered questionnaire. For process evaluation, we use five items relating to programme participation and satisfaction. A follow-up survey of participants will be carried out 3 months after intervention completion. DISCUSSION: The fact that this study is an RCT with an established control group is a strong advantage. Information and communications technology is not limited by time or place. If we could show this web-based nutrition education programmes has a positive effect, it may be an appropriate tool for reaching individuals in lower socio-economic state. TRIAL REGISTRATION: Current Controlled Trials UMIN-ICDR UMIN 000019376 (Registered October 16, 2015).

Impulsivity moderates the effect of approach bias modification on healthy food consumption.

The study aimed to modify approach bias for healthy and unhealthy food and to determine its effect on subsequent food consumption. In addition, we investigated the potential moderating role of impulsivity in the effect of approach bias re-training on food consumption. Participants were 200 undergraduate women (17-26 years) who were randomly allocated to one of five conditions of an approach-avoidance task varying in the training of an approach bias for healthy food, unhealthy food, and non-food cues in a single session of 10 min. Outcome variables were approach bias for healthy and unhealthy food and the proportion of healthy relative to unhealthy snack food consumed. As predicted, approach bias for healthy food significantly increased in the 'avoid unhealthy food/approach healthy food' condition. Importantly, the effect of training on snack consumption was moderated by trait impulsivity. Participants high in impulsivity consumed a greater proportion of healthy snack food following the 'avoid unhealthy food/approach healthy food' training. This finding supports the suggestion that automatic processing of appetitive cues has a greater influence on consumption behaviour in individuals with poor self-regulatory control.

Effectiveness of Taste Lessons with and without additional experiential learning activities on children's willingness to taste vegetables.

This study assessed the effectiveness of the Dutch school programme Taste Lessons with and without additional experiential learning activities on children's willingness to taste unfamiliar vegetables. Thirty-three primary schools (877 children in grades 6-7 with a mean age of 10.3 years) participated in Taste Lessons Vegetable Menu (TLVM, lessons and extra activities), Taste Lessons (TL, lessons), or a control group. A baseline and follow-up measurement was used to assess for each child: number of four familiar and four unfamiliar vegetables tasted, quantity tasted, choice of vegetable of which to eat more, and number of vegetables willing to taste again later. Furthermore, children filled out a questionnaire on daily vegetable intake and food neophobia. Multilevel and Cox regression analyses were conducted to compare changes in the outcome measures between the three study groups. No significant intervention effects were found on willingness to taste unfamiliar vegetables. Neither were effects found on familiar vegetables, except for number of familiar vegetables tasted (p < 0.05). Furthermore, no significant intervention effects were found on daily vegetable consumption and food neophobia. These results indicate that more intensive school-based nutrition education activities are needed to increase children's willingness to taste unfamiliar vegetables and increase their vegetable intake.

Changing children's eating behaviour - A review of experimental research.

The interest in children's eating behaviours and how to change them has been growing in recent years. This review examines the following questions: What strategies have been used to change children's eating behaviours? Have their effects been experimentally demonstrated? And, are the effects transient or enduring? Medline and Cab abstract (Ovid) and Web of Science (Thomson Reuters) were used to identify the experimental studies. A total of 120 experimental studies were identified and they are presented grouped within these 11 topics; parental control, reward, social facilitation, cooking programs, school gardens, sensory education, availability and accessibility, choice architecture and nudging, branding and food packaging, preparation and serving style, and offering a choice. In conclusion, controlling strategies for changing children's eating behaviour in a positive direction appear to be counterproductive. Hands-on approaches such as gardening and cooking programs may encourage greater vegetable consumption and may have a larger effect compared to nutrition education. Providing children with free, accessible fruits and vegetables have been experimentally shown to positively affect long-term eating behaviour. The authors recommend future research to examine how taste and palatability can positively affect children's attitudes and eating behaviour.

An exploratory study of Mindfulness Based Stress Reduction for emotional eating.

Emotional eating is an important predictor of weight loss and weight regain after weight loss. This two part study's primary aim was to explore changes in emotional eating in a general population of individuals taking the Mindfulness Based Stress Reduction (MBSR) program, with a secondary aim to explore whether changes in mindfulness predicted changes in emotional eating. Self-reported survey data exploring these questions were collected before and after the intervention for two sequential studies (Study 1 and Study 2). While there were no control groups for either study, in both studies emotional eating scores following the MBSR were significantly lower than scores prior to taking the MBSR (p < 0.001; p < 0.001) In Study 2, changes in mindfulness were correlated with changes in emotional eating (r = 0.317, p = 0.004). These results suggest that MBSR may be an effective intervention for emotional eating, and that further research is warranted to examine effects on weight loss and maintenance.

An examination of the role of autonomous versus controlled motivation in predicting inpatient treatment outcome for anorexia nervosa.

OBJECTIVE: We explored the effect of autonomous and controlled motivation on outcomes for patients undergoing inpatient treatment for Anorexia Nervosa (AN). METHOD: Data on 80 patients with AN were available for the start of treatment, and for 49 at end of treatment. Patients completed measures of autonomous and controlled motivation, eating disorder symptoms and attitudes, and comorbid psychopathology at the start and end of treatment. RESULTS: Patients showed significant improvements on eating symptoms and comorbid psychopathology over the course of treatment. Autonomous motivation was a significant predictor of change in severity of eating symptoms and attitudes such that patients with higher pre-treatment levels of autonomous motivation showed larger post-treatment reductions on these indices. No such effects were associated with controlled motivation. DISCUSSION: This study highlights a relationship between autonomous motivation and outcome in an inpatient setting. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:626-629).

Effect of adapted interpersonal psychotherapy versus health education on mood and eating in the laboratory among adolescent girls with loss of control eating.

OBJECTIVE: Interpersonal psychotherapy (IPT) is aimed at improving negative affect that is purported to contribute to the development and maintenance of loss-of-control (LOC) eating. Although youth who report LOC over eating tend to consume more snack-foods than those without LOC, it is unknown if IPT impacts objective energy intake. METHODS: To test if IPT improves mood and eating in the laboratory, we examined a sample of 88 girls with LOC eating who were randomized to either IPT (n = 46) or a standard-of-care health education (HE) group program. At baseline, and 6-month (follow-up 1) and 1-year (follow-up 2) following the initiation of the groups, girls consumed lunch from a multi-item meal with an instruction designed to model a LOC episode. Girls also reported mood state immediately before each meal. RESULTS: Girls in IPT experienced no significant changes in pre-meal state depressive affect, while girls in HE experienced a non-significant improvement by follow-up 1 and then returned to baseline by follow-up 2 (p < .04). We found no significant group difference for changes in total intake relative to girls' daily energy needs (p's ≥ .25). However, IPT reduced, while HE increased, the percentage of daily energy needs consumed from snack-foods by follow-up 2 (p = .04). Within-groups, HE increased their snack food intake from follow-up 1 to follow-up 2 (p = .01). CONCLUSIONS: In adolescent girls with LOC, IPT did not change total intake at the test meal and was associated with reduced snack-food intake. Data are required to determine if IPT effectively prevents excess weight gain in the longer-term. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:490-498).

Regulating food consumption: Action messages can help or hurt.

OBJECTIVE: Previous research suggests that messages promoting active behavior change may inadvertently increase food consumption by promoting a general goal to act. We suggest that this is only the case for active-approach behaviors and that messages promoting active-avoidance behaviors may be used to effectively decrease food consumption. METHODS: Participants were presented with healthy eating messages pretested to vary on the dimensions of direction (approach vs. avoid) and amount (action vs. inaction) of behavior. After viewing the messages, participants selected and consumed a healthy or unhealthy snack during a taste test. RESULTS: There were no differences in snack selection (healthy vs. unhealthy) across message conditions. For messages promoting more active behavior, however, there was a significant difference in snack consumption such that participants viewing active-approach messages consumed significantly more food than participants viewing active-avoidance messages. This happened regardless of whether participants selected a healthy or unhealthy snack. For messages promoting less active behavior there was no difference in consumption between approach and avoidance based messages. CONCLUSIONS: These findings suggest that when viewing health messages that promote active behavior change, individuals are sensitive to the direction of action advocated by the message (approach vs. avoidance) and modulate consumption accordingly.

Evaluation of adherence by elderly nursing home patients to regular consumption of apple compote enriched with protein and soluble fiber.

BACKGROUND: An increase in daily doses of protein and fiber for the elderly is relevant in preventing sarcopenia and preserving intestinal balance. However, such intake of supplements is often compromised by the lack of adherence among the elderly. OBJECTIVES: The main objective was to evaluate the perception of the hedonic qualities of compote enriched with NUTRALYS(®) pea protein, NUTRALYS(®)W hydrolyzed wheat gluten and NUTRIOSE(®) soluble fiber and the changes in that perception due to repeated consumption. The secondary objectives were to evaluate the evolution in the quantity of compote eaten, satisfaction with consumption and any changes in fatigue, digestive comfort and digestive tolerance when eating compote every other day for 3 weeks. METHOD: An observational study was conducted in nursing homes on volunteers aged 70-90 years. The compote was proposed as a lunchtime dessert every two days for a period of three consecutive weeks. All criteria were evaluated at days D0 and/or D1, D7, D15 and D21, except for the amount of compote eaten, evaluated after each meal at which it was served. RESULTS: When first tasted, the compote was judged 'rather pleasant' to 'very pleasant' by 91.6 % and this rating held up at 79.2 % (p = 0.1797) after 1 week, 83.3 % (p = 0.3173) after 2 weeks and 79.2 % (p = 0.2568) after 3 weeks. Average consumption of compote was stable and varied between a maximum of 79.5 % of the total quantity at inclusion to a minimum of 61.5 % recorded on D17. The other parameters did not change significantly. CONCLUSION: Pea protein, hydrolyzed wheat gluten and soluble fiber seem to provide an appropriate form of protein and fiber supplementation in the diets of elderly people in nursing homes.

Portrayals of Eating and Drinking in Popular American TV Programs: A Comparison of Scripted and Unscripted Shows.

This study investigated portrayals of eating and drinking behaviors in popular American TV programs and compared scripted and unscripted (i.e., reality) shows. Through a content analysis of 95 episodes, the prevalence and nature of food/alcohol consumption that accompanied depictions of eating and drinking behaviors in 461 scenes were measured. Various foods were portrayed, but only 9% of foods portrayed were healthy (e.g., low in calories/fat content, such as fruits, vegetables, etc.). Approximately half of eating or drinking scenes either were accompanied by alcohol or contained solely alcoholic beverages. Significant differences between the scripted and unscripted shows were also found.

Psychosocial predictors of emotional eating and their weight-loss treatment-induced changes in women with obesity.

PURPOSE: This study aimed at assessing whether psychosocial predictors of controlled eating and weight loss also predict emotional eating, and how differing weight-loss treatment methods affect those variables. METHODS: Women with obesity (M = 47.8 ± 7.9 years; BMI = 35.4 ± 3.3 kg/m(2)) were randomized into groups of either phone-supported self-help (Self-Help; n = 50) or in-person contact (Personal Contact; n = 53) intended to increase exercise, improve eating behaviors, and reduce weight over 6 months. RESULTS: A multiple regression analysis indicated that at baseline mood, self-regulating eating, body satisfaction, and eating-related self-efficacy significantly predicted emotional eating (R (2) = 0.35), with mood and self-efficacy as independent predictors. Improvements over 6 months on each psychosocial measure were significantly greater in the Personal Contact group. Changes in mood, self-regulation, body satisfaction, and self-efficacy significantly predicted emotional eating change (R (2) = 0.38), with all variables except self-regulation change being an independent predictor. Decreased emotional eating was significantly associated with weight loss. CONCLUSION: Findings suggest that weight-loss interventions should target specific psychosocial factors to improve emotional eating. The administration of cognitive-behavioral methods through personal contact might be more beneficial for those improvements than self-help formats.

Nutrition Information In Community Newspapers: Goal Framing, Story Origins, and Topics.

Obesity rates are high in the rural United States. Because small communities often have few health care practitioners, nutrition news in community newspapers may be a useful source of information. This content analysis of a random sample of 164 nutrition stories from 10 community newspapers in the rural West North Central Midwest was guided by concepts from goal-framing theory. Locally generated stories comprised nearly half of the sample, suggesting that nutrition is a salient topic in many rural communities. Hedonic frames related to food enjoyment were twice as frequent as health improvement frames. Results suggest food promotion was the most common topic of nutrition stories, with guidelines for a healthy diet appearing about half as often. Stories about a healthy diet and food promotion were most often written locally. Findings are discussed with recommendations for improvement of community news coverage of nutrition.

Improvement in emotional eating associated with an enhanced body image in obese women: mediation by weight-management treatments' effects on self-efficacy to resist emotional cues to eating.

AIMS: To assess effects of cognitive-behavioural weight-loss treatments on self-efficacy to control emotionally cued eating and whether those changes mediate relationships between body satisfaction and emotional eating. BACKGROUND: Emotional eating is common, especially in women with obesity. A better understanding of relationships of its psychosocial correlates might benefit behavioural weight-loss treatments. DESIGN: A field-based, quantitative study incorporated two theoretically derived weight-loss treatments using repeated measures analyses that employed validated surveys. METHODS: Women with obesity volunteered for a community-based weight-loss study and were assigned to either a treatment of a manual plus phone support (n = 47), or in-person contacts emphasizing self-regulation (n = 48), over 6 months. Both emphasized physical activity, healthy eating and building self-efficacy for enabling the health-behaviour changes. Data were collected between 2013-2014. Multiple regression analyses assessed predictors of self-efficacy change. Mixed-model analysis of variances assessed treatment differences in psychosocial changes. Mediation analyses assessed mediation of the relationships between body satisfaction and emotional eating changes. RESULTS: Changes in Overall mood and Self-regulation significantly predicted change in Self-efficacy to control emotionally cued eating. Changes in Body satisfaction, Emotional eating, Mood, Self-regulating eating and Self-efficacy were significant overall, and each significantly greater in the in-person treatment. Self-efficacy significantly mediated the relationship between changes in Body satisfaction and Emotional eating total (and Emotional eating when depressed or anxious, but not when frustrated/angry). CONCLUSION: Results clarified mediation of the dynamic relationship between body satisfaction and emotional eating, which might enable behavioural weight-loss treatments to better-address emotional eating.

Mind over platter: pre-meal planning and the control of meal size in humans.

It is widely accepted that meal size is governed by psychological and physiological processes that generate fullness towards the end of a meal. However, observations of natural eating behaviour suggest that this preoccupation with within-meal events may be misplaced and that the role of immediate post-ingestive feedback (for example, gastric stretch) has been overstated. This review considers the proposition that the locus of control is more likely to be expressed in decisions about portion size, before a meal begins. Consistent with this idea, we have discovered that people are extremely adept at estimating the 'expected satiety' and 'expected satiation' of different foods. These expectations are learned over time and they are highly correlated with the number of calories that end up on our plate. Indeed, across a range of foods, the large variation in expected satiety/satiation may be a more important determinant of meal size than relatively subtle differences in palatability. Building on related advances, it would also appear that memory for portion size has an important role in generating satiety after a meal has been consumed. Together, these findings expose the importance of planning and episodic memory in the control of appetite and food intake in humans.