The effects of acute social ostracism on subsequent snacking behavior and future body mass index in children.

BACKGROUND/OBJECTIVES: Ostracism may lead to increased food intake, yet it is unclear whether greater reactivity to ostracism contributes to higher body mass index (BMI). We investigated whether children who exhibited greater stress to social exclusion subsequently consume more energy and whether this predicts BMI 6- and 18-months later. SUBJECTS/METHODS: Children (8.5 years-old) (N = 262, males = 50.4%; Chinese = 58.4%) completed a laboratory-based manipulation of social exclusion (the Cyberball task) prior to an ad-libitum snack. Heart rate variability (HRV) was measured during the inclusion and exclusion conditions and proportionate changes were calculated as a physiological measure of exclusion-related stress. Social anxiety and social-emotional assets were also measured as moderators. RESULTS: Greater stress (as measured physiologically or by self-report) did not directly, or indirectly via energy intake, predict later BMI (at 9- and 10-years). However, among children reporting higher social anxiety, greater stress as measured by proportionate changes in HRV was associated with increased energy intake (B = 532.88, SE = 226.49, t(255) = 2.35, [CI95 = 86.85,978.92]). A significant moderated mediation was also observed (index: (b = 0.01, bootSE = 0.01, [CI95 = 0.001, 0.036]), such that among children reporting higher social anxiety, greater stress from social exclusion predicted increased energy intake from a subsequent snack, which in turn predicted higher BMI 1.5 years later. CONCLUSION: This prospective study suggests that a pattern of greater snack intake in response to heightened vulnerability to the effects of ostracism may contribute to increases in child BMI scores.

Implicit satiety goals and food-related expectations predict portion size in older adults: Findings from the BAMMBE cohort.

Portion size selection is an indicator of appetite and within younger adults, is predicted by factors such as expected satiety, liking and motivations to achieve an ideal sensation of fullness (i.e., implicit satiety goals). Currently, there is limited research available on the determinants of portion size selection within older adults. Therefore, the current study aimed to examine the relationship between individual differences in implicit satiety goals, food-related expectations, and portion size selection in older adults. Free-living older adult Singaporeans (N = 115; Nmales = 62; age: M = 66.21 years, SD = 4.78, range = 60-83 years) participated as part of the Brain, Ageing, Microbiome, Muscle, Bone, and Exercise Study (BAMMBE). Participants completed questionnaires on their subjective requirements for experiencing different states of satiety and food-related expectations (i.e., liking, how filling) as well as a computerised portion size selection task. Using a multiple regression, we found that goals to feel comfortably full (B = 3.08, SE = 1.04, t = 2.96, p = .004) and to stop hunger (B = -2.25, SE = 0.82, t = -2.75, p = .007) significantly predicted larger portion size selection (R2 = 0.24, F(4,87) = 6.74, p < .001). Larger portion sizes (R2 = 0.53, F(5,90) = 20.58, p < .001) were also predicted by greater expected satiety (B = 0.47, SE = 0.09, t = 5.15, p < .001) and lower perceptions of how filling foods are (B = -2.92, SE = 0.77, t = -3.79, p < .001) but not liking (B = -0.09, SE = 0.91, t = -0.10, p = .925) or frequency (B = -18.42, SE = 16.91, t = -1.09, p = .279) of consumption of target foods. Comparing our findings to results of studies conducted with younger adults suggests the influence of factors such as satiety related goals on portion size selection may change with ageing while the influence of other factors (e.g., expected satiety/fullness delivered by foods) may remain consistent. These findings may inform future strategies to increase/decrease portion size accordingly to ensure older adults maintain an appropriate healthy weight.

Development of a Simplified Portion Size Selection Task.

Portion size is an important determinant of energy intake and the development of easy to use and valid tools for measuring portion size are required. Standard measures, such as ad libitum designs and currently available computerized portion selection tasks (PSTs), have several limitations including only being able to capture responses to a limited number of foods, requiring participants' physical presence and logistical/technical demands. The objective of the current study was to develop and test robust and valid measures of portion size that can be readily prepared by researchers and be reliably utilized for remote online data collection. We developed and tested two simplified PSTs that could be utilized online: (1) portion size images presented simultaneously along a horizontal continuum slider and (2) multiple-choice images presented vertically. One hundred and fifty participants (M = 21.35 years old) completed both simplified PSTs, a standard computerized PST and a series of questionnaires of variables associated with portion size (e.g., hunger, food item characteristics, Three Factor Eating Questionnaire). We found average liking of foods was a significant predictor of all three tasks and cognitive restraint also predicted the two simplified PSTs. We also found significant agreement between the standard PST and estimated portion sizes derived from the simplified PSTs when accounting for average liking. Overall, we show that simplified versions of the standard PST can be used online as an analogue of estimating ideal portion size.

Manipulating the sensation of feeling fat: The role of alexithymia, interoceptive sensibility and perfectionism.

OBJECTIVE: Feeling fat reflects difficulties in processing emotions and is an important aspect of body image and eating disorders. The current study aimed to develop a novel social comparison manipulation to induce feeling fat and to explore personality traits that may increase an individual's vulnerability. METHODS: At time 1, 254 healthy females (24.14 years, BMI = 23.77) completed the feeling fat subscale of the Body Attitudes Questionnaire, as well as self-report measures of alexithymia, interoceptive sensibility, physical appearance comparison and perfectionism online. At time 2, a subset of 107 participants (22.39 years, BMI = 23.85) were randomly assigned to a condition: negative social comparison, positive social comparison, negative general, or neutral (as a control). RESULTS: At time 1, greater tendency to feel fat was significantly associated with difficulty identifying and describing feelings (alexithymia), poorer interoceptive sensibility, higher socially-prescribed perfectionism, and greater engagement in physical appearance comparisons. At time 2, participants in the negative social comparison condition reported significantly greater increases in feeling fat compared to the control condition, but only when they were also high in alexithymia or socially-prescribed perfectionism. DISCUSSION: Current findings provide new insights into the potential mechanisms underpinning feeling fat and highlight how a novel social comparison manipulation can be used to induce the sensation of feeling fat.

Effect of food variety on intake of a meal: a systematic review and meta-analysis.

BACKGROUND: Many studies have shown that food variety-the presence of multiple foods and/or sensory characteristics within and across meals-increases intake. However, studies report mixed findings, and effect size remains unclear. OBJECTIVES: A systematic review and meta-analysis were conducted to 1) synthesize data across experimental studies that examined effects of variety on total meal intake, relative to a control condition with comparatively less variety; 2) quantify support for this effect; and 3) assist in the identification of important moderating factors (registration: CRD42019153585). METHODS: In November 2019, we searched the following databases for relevant experimental studies, published in English from 1980, with human participants: PubMed, Cochrane Library, Web of Science, ClinicalTrials.gov, PsycINFO, and OpenGrey. This search was updated in September 2020. Means, standard deviations, and sample sizes were extracted from included articles, and Hedges' g was used to calculate effect sizes. Risk of bias was assessed using the Cochrane Collaboration's tool. RESULTS: Of 7259 references identified in an initial search, 34 articles consisting of 37 studies contained sufficient information for review, and data from 30 studies (39 comparisons) were included in the meta-analysis. Results from a random-effects model showed a significant small to medium effect of variety on intake (in weight and energy), with greater variety being associated with increased consumption (Hedges' g = 0.405; 95% CI: 0.259, 0.552). However, heterogeneity was considerable across studies (I2 = 84%), and this was unexplained by subgroup analyses based on form of variety, test foods, sensory characteristics, age, sex, and body weight. CONCLUSIONS: Our findings support the conclusion that variety is a robust driver of food intake. However, risk of bias was high across studies, and this review highlights methodologic limitations of studies. It is recommended that further attention is given to the development of preregistered, well-powered randomized controlled studies in eating behavior research.

The use of repetitive transcranial magnetic stimulation (rTMS) following traumatic brain injury (TBI): A scoping review.

There is continued interest in developing effective and innovative treatment approaches to manage and improve outcomes after traumatic brain injury (TBI). Included in this, is the potential use of repetitive transcranial magnetic stimulation (rTMS), a neuromodulatory tool currently recommended by the National Institute for Health and Care Excellence as a treatment for depression. This review considers the application of rTMS after TBI, focussing on its therapeutic efficacy for a broad range of sequalae, whether an optimal and safe rTMS protocol can be determined, and recommendations for future clinical and research work. Five research databases (MEDLINE, CINAHL, PsychINFO, SCOPUS, and Web of Science) were electronically searched, identifying 30 empirical studies (single and multiple subject case reports; randomized controlled trials) for the full review. Evidence suggests that rTMS has the potential to be an efficacious therapeutic intervention for multiple symptoms after TBI, including depression, dizziness, central pain, and visual neglect. However, the picture is less encouraging for prolonged disorders of consciousness and mixed for cognitive outcomes. Overall, rTMS was well-tolerated by patients, although some incidents of side effects and seizures have been reported. Recommendations are made for more comprehensive guidelines and sufficient reporting of rTMS parameters and procedures.

Consumer perception of food variety in the UK: an exploratory mixed-methods analysis.

BACKGROUND: 'Food variety' is a key term that is frequently used in dietary guidelines around the world. Consuming a variety of foods - be it within a meal, across meals, or as part of the whole diet - is one factor that has been shown to increase food intake. However, little is known about consumer understanding of variety, and this may be a potential barrier to the success of dietary guidelines in today's 'obesogenic' environment. This research sought to explore 1) consumer recognition of different forms of variety, and 2) consumer definitions of variety. METHODS: In an online study (N = 240), participants were asked to discuss a range of photographs depicting different forms of variety, and to directly define the term 'food variety'. They were unaware of the research aim. RESULTS: Using a mixed methods approach, directed content analysis of these data showed that individuals referenced multiple forms of variety in the presence of food photographs. However, when asked to define variety, participants tended to only discuss variety in the context of the whole diet. CONCLUSIONS: These findings emphasise a need to educate consumers about variety to encourage adherence to dietary guidelines and help consumers better manage their own food intake.

Optimizing measurement for neurobehavioural rehabilitation services: A multisite comparison study and response to UKROC.

To evaluate the efficacy of neurobehavioural rehabilitation (NbR) programmes, services should employ valid, reliable assessment tools; the ability to detect change on repeated assessment is a particular requirement. The United Kingdom Rehabilitation Outcomes Collaborative (UKROC) requires neurorehabilitation services to collect data using a standardized basket of measures, but the responsiveness and usefulness of using these in the context of NbR remains unknown. Anonymous data collected at two assessments for 123 people were examined using multiple methods to determine responsiveness of four outcome measures routinely used in NbR (HoNOS-ABI, FIM + FAM UK, MPAI-4, SASNOS). Predictive validity of two measures of rehabilitation complexity (RCS-E, SRS) regarding the extent of difference scores on these outcome measures at reassessment was also determined. All four outcome measures demonstrated responsiveness, with higher levels for SASNOS and MPAI-4 when only participants categorized as "most likely to change" at first assessment were analyzed. Predictive validity of the RCS-E and SRS in estimating the extent of change was variable. SRS was only predictive of improvement on the MPAI-4 whilst RCS-E was not predictive at all. Recommendations are made regarding ideal characteristics of NbR outcome measures, along with the need to develop measures of rehabilitation complexity specifically conceptualized for these programmes.

A serial mediation model of the relationship between alexithymia and BMI: The role of negative affect, negative urgency and emotional eating.

Difficulty identifying and describing emotions (alexithymia) has been related to impulsiveness and negative affect, emotional eating and obesity. However, previous research findings concerning the relationship between alexithymia and obesity have been mixed and inconsistent, raising the possibility that the relationship is indirect and mediated by multiple unknown factors. The aim of the study was to comprehensively explore the potential pathways between alexithymia and obesity via a novel theoretical model, and for the first time, incorporate negative affect, impulsiveness (negative urgency) and emotional eating as potential mediating factors. Two questionnaire-based studies were conducted; the first as an exploratory analysis within a student sample (N = 125), and the second as a self-replication within a more representative general population sample (N = 342). Study One revealed that difficulty identifying feelings predicted Body Mass Index (BMI) both directly (B = 0.1694, CI = 0.0194-0.3194) and indirectly via negative urgency and emotional eating (B = 0.0074, CI = 0.0001-0.0315). In contrast, Study Two revealed that alexithymia predicted BMI indirectly via negative affect (when depression was included in the model; B = 0.0335, CI = 0.0019-0.0660) or negative urgency (when anxiety was included in the model; B = 0.0021, CI = 0.0001-0.0066). Our findings provide partial support for the hypothesised model and offer original insight into the relationship between alexithymia and obesity. Additionally, our findings highlight important methodological considerations for future research and suggest that ways to address an individual's ability to identify, describe and regulate emotions should be considered when designing interventions to assist weight loss and management.

Getting to the heart of the matter: Does aberrant interoceptive processing contribute towards emotional eating?

According to estimates from Public Health England, by 2034 70% of adults are expected to be overweight or obese, therefore understanding the underpinning aetiology is a priority. Eating in response to negative affect contributes towards obesity, however, little is known about the underlying mechanisms. Evidence that visceral afferent signals contribute towards the experience of emotion is accumulating rapidly, with the emergence of new influential models of 'active inference'. No longer viewed as a 'bottom up' process, new interoceptive facets based on 'top down' predictions have been proposed, although at present it is unclear which aspects of interoception contribute to aberrant eating behaviour and obesity. Study one examined the link between eating behaviour, body mass index and the novel interoceptive indices; interoceptive metacognitive awareness (IAw) and interoceptive prediction error (IPE), as well as the traditional measures; interoceptive accuracy (IAc) and interoceptive sensibility (IS). The dissociation between these interoceptive indices was confirmed. Emotional eaters were characterised by a heightened interoceptive signal but reduced meta-cognitive awareness of their interoceptive abilities. In addition, emotional eating correlated with IPE; effects that could not be accounted for by differences in anxiety and depression. Study two confirmed the positive association between interoceptive accuracy and emotional eating using a novel unbiased heartbeat discrimination task based on the method of constant stimuli. Results reveal new and important mechanistic insights into the processes that may underlie problematic affect regulation in overweight populations.