Effects of traffic light labelling and increased healthy range on beverage choices from vending machines.

OBJECTIVE: To test whether traffic light labels and an increased range of healthy beverages, individually and in combination, can increase healthy beverage choices from vending machines. DESIGN: Two studies (n 558, 420) tested whether the provision of traffic light labels (green, amber and red) and an increased range of healthy beverages (from 20 % to 50 % green options), individually and in combination, could increase healthy beverage choices from a digital vending machine display. The studies used a between-subjects experimental design, and a hypothetical beverage choice, a limitation when considering real-world applicability. SETTING: Both studies utilised an online Qualtrics survey that featured a digital vending machine display. PARTICIPANTS: Both studies (n 558, 420) consisted of university students from Flinders University and individuals from a survey recruitment service. RESULTS: Featuring traffic lights did not significantly influence beverage choices (P = 0·074), while increasing the healthy range (P = 0·003, OR = 3·27), and the combination of both, did significantly increase healthier beverage choices (P < 0·001, OR = 4·83). CONCLUSIONS: The results suggest that the traffic light system and increased healthy range are not maximally effective when used on their own, and benefit greatly when combined, to increase healthy beverage choices. It was suggested that the provision of traffic light labels supplied the necessary nutritional information, and the increased healthy range offered greater opportunity to act in accordance with that information. In so doing, the present findings offer a promising pathway for reducing unhealthy beverage consumption.

The effectiveness of Go/No-Go and Stop-Signal training in reducing food consumption and choice: A systematic review and meta-analysis.

The Go/No-Go and Stop-Signal tasks have been used to reduce excess food intake via repeated pairing of food cues with response inhibition. A meta analysis of 32 studies was conducted to determine whether, and under which conditions, the Go/No-Go and Stop-Signal training tasks are effective in reducing food consumption or choice. Moderators included task parameters (e.g., number of sessions, stop signal), sample differences (e.g., age, weight), and the measure of food consumption or choice. Overall, there was a small effect for Go/No-Go and Stop-Signal training in reducing food consumption or choice, g = -0.21, CI95 = [-0.31, -0.11], p < .001, with this holding individually only for a single session of the Go/No-Go Task, g = -0.31, CI95 = [-0.45, -0.18], p < .001. Comprehensive investigation of the impact of varying moderators indicated that the effect for Go/No-Go training was robust. Nevertheless, there was significant variation in the specific parameters of the task. Overall, the present meta-analysis extends previous findings by providing comprehensive evidence that the Go/No-Go Task is effective in reducing food consumption and choice, as well as providing optimal parameter recommendations for the task.

I'll have what She's having (but not what They're having): The moderating role of group membership in the effect of social norms on food choice in an online environment.

The modern food-rich environment has contributed to the rise of unhealthy diets linked to noncommunicable diseases. Previous in-person research has found that the effect of social norms on food intake is greater when set by a perceived in-group member relative to an out-group member. Given recent increased social media use, we investigated whether this effect of group membership extends to food choices and to normative information presented remotely online. Participants (N = 179 female university students, 18-32 years) viewed a Facebook page pertaining to either their university (in-group) or a rival university (out-group). They were presented with either a healthy or an unhealthy norm via a post in which a student discussed their order at a café on the relevant campus. Food choice was assessed through an online menu where participants were asked to order one main, side, and dessert dish. As predicted, participants who viewed the healthy norm ordered a higher percentage of healthy items (especially in the desserts category) relative to those who viewed the unhealthy norm. However, this effect was significant only for those in the in-group condition; there was no such pattern for participants in the out-group condition. These findings provide insight into the role of group membership in the effect of social norms, and have practical implications regarding the design of identity-based social media health campaigns to promote healthier eating behaviours.

The role of decision-making and impulsivity in beverage consumption.

Soft drink and alcohol consumption have become significant public health issues. This study aimed to explore the mediating role of decision-making processes in the relationship between trait impulsivity and calorie dense beverage consumption. Participants comprised a community sample of 300 adults (aged 19-75). They completed self-report measures assessing impulsivity (SUPPS-P), reward sensitivity (RST-PQ), and participated in decision-making tasks related to risk propensity (BART), short-term strategy preference (IGT), and delay discounting rate. Beverage consumption was calculated using the BEVQ-15. Impulsivity was conceptualised within the framework of the two-factor model as consisting of rash impulsivity and reward sensitivity. Both facets of impulsivity were positively associated with both alcohol and soft drink consumption, and each independently predicted consumption of these beverages. Additionally, there was a significant interaction between rash impulsivity and reward sensitivity on soft drink consumption. Importantly, there were significant indirect effects of both rash impulsivity and reward sensitivity on soft drink consumption via delay discounting. The results support the logic of the two-factor model of impulsivity in the prediction of consumption of unhealthy beverages. Furthermore, the mediating role of delay discounting supports the hypothesis that personality traits can pass through to behaviour via decision-making processes. Further research should extend these findings to other consumption domains in both clinical and non-clinical populations.

Effectiveness of visual nudges for encouraging healthier beverage choices from vending machines.

ISSUES ADDRESSED: Research suggests visual nudging techniques can subtly encourage healthier consumption. Two experiments explored the effect of four visual primes for nudging drink choices from a vending machine display. METHODS: Participants (17-25 years) were randomly assigned to view vending machine advertising posters containing pictorial nudges of water, soft drink, general health (runner), or a text-only control, for nudging vending machine choices. Participants then selected an item from a vending machine display containing drinks only (Experiment 1; n = 164), or both drinks and snack foods (Experiment 2, n = 684). RESULTS: In both experiments, nudging condition predicted beverage choice. Specifically, the water image nudged healthier beverage choices in both experiments. However, there was no effect on food choice in Experiment 2. Furthermore, in both experiments, liking and habitual consumption of chosen items were also significant predictors of choice, but condition predicted beverage choice over and above these. CONCLUSION: A water prime may be an effective means of encouraging healthier beverage choices in a vending machine environment. SO WHAT?: Findings have the potential to inform strategies for encouraging healthier beverage choices from vending machine environments.

The relationship between inhibitory control and food consumption or choice: A systematic review and meta-analysis.

Excess consumption of unhealthy foods has become a major public health problem. Although one potential contributor to unhealthy consumption is poor inhibitory control, findings have been inconsistent. A meta-analysis of 35 studies was conducted to determine whether, and under which conditions, inhibitory control, as measured by the Go/No-Go and Stop-Signal tasks, is associated with food consumption/choice. Moderators included the type of stimuli (neutral or food-specific) used in measuring inhibitory control, sample differences (e.g., age, gender, and weight), and the measure of food consumption or choice. Overall, there was a small positive association between inhibitory control and food consumption/choice, r = .09, CI95 = [0.04, 0.14], p = .001. This held for the Stop-Signal Task in general, and for the Go/No-Go Task for children and when food consumption/choice was measured objectively. The present meta-analysis provides the first comprehensive evidence that inhibitory control, as measured by the Go/No-Go and Stop-Signal tasks, is associated with food consumption or choice, and points to inhibitory control as a potential target for reducing unhealthy food consumption.

Instagram-based priming to nudge drink choices: Subtlety is not the answer.

Instagram-based priming (e.g., subtly incorporating healthy drinks into the background of Instagram images) could potentially nudge healthier consumption behaviours. Given the negative health consequences associated with sugar-sweetened-beverage consumption, two experiments tested the effect of three sets of Instagram-based primes for nudging drink choices from a visual food and drinks display. Participants (18-25 years) were randomly assigned to view a series of Instagram advertising images (for technology, travel, or homeware products) that included a glass containing water (water prime) or cola (soft drink prime), or no drink (control). They then selected an item from the visual display containing snack foods and drinks. In Experiment 1 (n = 493) beverages were subtly incorporated into the priming images; in Experiment 2 (n = 471) beverages were made more prominent. Priming condition did not predict choice in Experiment 1 but did so in Experiment 2, where participants in the soft drink prime condition were significantly more likely to select a drink versus a food, compared to those in the water prime and control conditions. The water prime did not predict choice in either study. A greater percentage of participants noticed the beverage primes in Experiment 2 than in Experiment 1. Overall, it appears that when clearly visible, soft drinks incorporated into Instagram-style images can nudge drink choices. However, a less subtle approach may be needed to effectively encourage healthier drink choices.

Vending machine backgrounds: nudging healthier beverage choices.

Soft drink overconsumption is a growing public health concern. The present research investigated whether priming nudges could decrease soft drink choices from a vending machine. We compared the effect of six vending machine wraps (Mount Franklin ™ logo, Coca-Cola™ logo, picture of water, picture of soft drink, blue, red) on beverage choice against a black (control) computerised vending machine display. In two studies, young adult participants (17 - 25 years) were recruited from [removed for blind review] (Study 1, n = 142, Study 2, n = 232). Participants were randomly allocated to choose a beverage from one of the wrap conditions. They also rated how much the beverage was liked and how often it was consumed (Study 1), or rated the refreshing value, healthiness, taste, and energy of each beverage in the vending machine (Study 2). We predicted that wraps referencing water would produce healthier choices and those referencing soft drink would result in unhealthier choices. Contrary to these predictions, the type of vending machine wrap did not significantly influence beverage choice in Study 1. However, viewing the black vending machine wrap resulted in significantly more caffeine-based selections in Study 2. Other significant predictors of the choice of beverage were how often the beverages were consumed and how much they were liked (Study 1), as well as their perceptions of the taste, healthiness and refreshing value (Study 2). The finding that the black vending machine produced more caffeine-based beverage choices demonstrates, in principle, that color-based priming nudges could influence beverage choices.

#Fitmom: an experimental investigation of the effect of social media on body dissatisfaction and eating and physical activity intentions, attitudes, and behaviours among postpartum mothers.

BACKGROUND: Research has shown that body dissatisfaction is higher during the postpartum period compared to other periods of life, and strongly associated with disordered eating behaviours, which can lead to adverse health outcomes. While results from cross-sectional studies suggest that social media may play an important role in body dissatisfaction among postpartum mothers, causal inference is limited due to the observational nature of the existing research. The objective of this study is to experimentally test the effect of body-focused social media on the body dissatisfaction and eating and physical activity intentions, attitudes, and behaviours of postpartum mothers. METHODS: Postpartum mothers of infants 0-6 months (n = 132) were randomly assigned to view either body-focused social media posts (n = 65), or a control set of infant feeding tips (n = 67). ANCOVA was used to examine differences between the intervention and control group on levels of body dissatisfaction, eating and physical activity intentions, attitudes, and behaviours. There were two follow-up time points, immediately post intervention and 1-month post intervention to measure potential sustained effects of intervention. RESULTS: Exposure to body-focused social media posts resulted in higher levels of body dissatisfaction, mean difference 1.54 (p = 0.002); poorer body image, mean difference 0.41 (p = 0.007); eating attitudes, mean difference 2.26 (p = 0.025); and higher levels of restrained eating behaviours, mean difference 0.39 (p < 0.001) among the intervention group post intervention. Mothers in the intervention group also reported higher levels of inspiration to be active, mean difference 0.48 (p = 0.021) post intervention. A sustained effect was found for restrained eating, mean difference 2.03 (p < 0.001) and poorer eating attitude, mean difference 0.29 (p = 0.001) at 1-month follow-up. No sustained effects were found for any other outcomes at 1-month follow-up. CONCLUSION: Social media exposure to body-focused social media posts negatively affect postpartum mothers' body dissatisfaction and health behaviours. Further experimental research that includes an interactive social media component is needed among this population. TRIAL REGISTRATION: NCT05181280, Study ID Number: 054798. Registered 06/01/2022. Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05181280 .

The role of rash impulsivity and sensitivity to reward in soft drink consumption.

Soft drink consumption has become a major public health issue. The present study aimed to examine the role of rash impulsivity and reward sensitivity in soft drink consumption using the two-factor model of impulsivity. Participants were a community sample of 229 adults (19-77 years). They completed self-report measures of impulsivity (SUPPS-P), reward sensitivity (RST-PQ) and beverage consumption (BEVQ-15). A principal component analysis was used to produce purer measures of rash impulsivity and reward sensitivity. Both rash impulsivity and reward sensitivity were positively associated with soft drink consumption, and each independently predicted soft drink consumption. Importantly, there was a significant interaction between the two, whereby rash impulsivity moderated the effect of reward sensitivity on soft drink consumption. The results support the logic of the two-factor model of impulsivity in the prediction of soft drink consumption. Further research should extend these findings to other consumption domains in both clinical and non-clinical populations.

The effect of item placement on snack food choices from physical and online menus.

Previous attempts to promote healthy eating using explicit techniques have not been consistently successful. We therefore investigated an implicit strategy (item placement techniques) to encourage healthy food choices in the context of snack menus. Two experimental studies compared presentation of healthy items in the top, middle, and bottom sections of a snack menu. Study 1 compared these presentations in a physical paper-based menu, while Study 2 used an online menu. Menus consisted of 8 unhealthy and 4 healthy items, arranged in three rows of four in Study 1, and one column of 12 in Study 2. In each study, participants selected one food item from one of the three experimental menus, before completing the Revised Restraint Scale (to determine dietary restraint status). In Study 1 (n = 172), item placement condition did not predict healthiness of food choice. In Study 2 (n = 182), healthy items were most popular from the first section of the menu, in comparison to the middle or last sections. Dietary restraint did not moderate the effect of item placement condition on food choice. In line with nudging principles, our results suggest that item placement techniques could be a potentially powerful tool in promoting healthy choices from online snack menus.

The predictive value of evaluative bias, attentional bias, approach bias, and self-regulatory control in soft drink consumption.

Global consumption of soft drinks has increased rapidly over the past 50 years, making this a major public health problem. Guided by dual-process models, the present study aimed to provide a comprehensive investigation of the roles of cognitive biases (evaluative, attentional, and approach biases) and self-regulatory control in soft drink consumption and choice. Participants were 128 undergraduate students (17-25 years). They completed computer-based measures of the three biases (Implicit Association Task, Dot Probe Task, and Approach Avoidance Task) and self-regulatory control (Go/no-go Task). Soft drink consumption and choice were measured using a taste test and a take home beverage choice task, respectively. Evaluative bias for soft drink cues was positively associated with the amount of soft drink consumed. Self-regulatory control was negatively correlated with amount of soft drink consumed, but only for men. There was no interaction between cognitive biases and self-regulatory control in predicting soft drink consumption or choice. Nonetheless, the results support the application of dual-process models to soft drink consumption in that automatic (evaluative bias) and controlled processes (self-regulatory control) each predicted amount of soft drink consumed, albeit independently and only for certain individuals. Future research should extend these findings to habitual soft drink consumers and to individuals who actively wish to limit their soft drink intake.

The effect of television advertising on soft drink consumption: Individual vulnerabilities in approach bias and inhibitory control.

Continual exposure to soft drink cues in the environment is thought to be a major contributor to the rising consumption of soft drinks. This study investigated the effect of one such cue, television advertising, on soft drink choice and intake. Within the context of dual-process models, we examined whether any such effects would be stronger for individuals with an automatic tendency to reach for soft drinks (approach bias) or a difficulty resisting soft drinks (poor inhibitory control). Participants (N = 127; 18-25 years) viewed television advertisements for either soft drinks or control (non-sweetened) beverages. Approach bias and inhibitory control were assessed by soft drink versions of the approach-avoidance and go/no-go tasks, respectively. Participants who had viewed the soft drink advertisements were more likely to choose a soft drink as their first drink than those who had viewed the control advertisements. This effect was stronger for participants with an approach bias for soft drinks. In addition, participants with poorer inhibitory control chose more soft drinks overall following the soft drink advertisements. Although exposure to soft drink advertisements did not affect soft drink intake in the taste test, participants with poorer inhibitory control consumed more of the soft drinks. In line with dual-process models, individuals with strong automatic tendencies or poor self-regulatory control were more responsive to television advertising for soft drinks. At a practical level, these cognitive vulnerabilities provide potential targets for intervention to help resist soft drink cues.

The food craving experience: Thoughts, images and resistance as predictors of craving intensity and consumption.

The Elaborated-Intrusion Theory of Desire (Kavanagh, Andrade, & May, 2005) suggests that cravings are made up of two distinct stages whereby an initial, seemingly spontaneous craving-related thought is sufficiently intrusive and pleasant for it then to be elaborated with vivid mental imagery. Previous questionnaire studies have investigated the craving experience with a particular focus on the role of imagery. The present study sought to provide a fuller account of the craving process by investigating the role of craving-related thoughts alongside imagery in predicting craving intensity. Further, the present study sought to investigate predictors of craving-related consumption, including spontaneous strategies used to resist cravings. Two-hundred and forty-nine women completed an online questionnaire which asked about their most recent food craving experience. Results showed that around a third of participants reported craving-related thoughts and about half reported craving-related imagery. Craving-related imagery appeared to be a more important predictor of craving intensity than craving-related thoughts; however, neither predicted craving-related consumption. One resistance strategy, 'recognised it was just a thought', was successful in decreasing the likelihood of eating in response to craving. Theoretical and practical implications are discussed in the context of the Elaborated-Intrusion Theory.

Pumpkin is "yucky"!: A prospective study of overt and covert restriction in the development of young children's food preferences.

The aim of the study was to investigate maternal feeding strategies as prospective predictors of young children's food preferences. Participants were 106 mother - child dyads with data collected when children were aged 4 (Time 1) and then again at 6 years old (Time 2). Mothers completed an initial questionnaire at Time 1 which contained measures of restrictive and covert feeding strategies. Children were interviewed concerning their food preferences and had their height and weight measured at Time 1 and again two years later (Time 2). Longitudinal regression results showed that Time 1 parental restrictive feeding predicted decreased child-reported preferences for fruit and vegetables and increased preferences for salty food and sweets at Time 2. Conversely, Time 1 parental covert control predicted greater child-reported preferences for fruit and vegetables over time. The results provide longitudinal evidence of the negative impact of restrictive feeding, and of the positive impact of covert control, on the development of young children's food preferences.

The effect of snack consumption on physical activity: A test of the Compensatory Health Beliefs Model.

The Compensatory Health Beliefs Model proposes that individuals may believe that an unhealthy behaviour can be compensated for by subsequent engagement in a healthy behaviour. The present study aimed to test this proposition, specifically by examining the influence of snack consumption (healthy, unhealthy) on type of activity selected (physical, sedentary). A sample of 100 female undergraduate students (Mage = 20.41 years) were randomly assigned to consume either healthy or unhealthy snacks of comparable nutritional value. To assess potential compensatory behaviour, participants were then given the choice to engage in either a physical activity (exercise on a treadmill) or a sedentary activity (a game on an iPad). Results showed that a significantly higher proportion of participants who consumed the unhealthy snacks selected the physical activity as opposed to the sedentary activity. Perceived healthiness of the snacks, but not perceived caloric intake, mediated the relationship between snack type and activity selection. The findings provide empirical evidence for compensation proposed by the Compensatory Health Beliefs Model, whereby an unhealthy behaviour (unhealthy snack consumption) led to subsequent engagement in a healthy behaviour (physical activity).

It's all in the timing: The effect of a healthy food cue on food choices from a pictorial menu.

The contemporary food-rich environment has been consistently linked to unhealthy eating. Emerging research suggests that changing the presentation context of unhealthy foods by introducing a subtle nudge in the form of a healthy food cue may promote healthier dietary choices. This study investigated the effect of the timing of a healthy food cue (before or simultaneously with food options) on food choices. Participants (n = 210) were presented with a pictorial café-style menu displaying a healthy food cue (basket of fruit and vegetables) either on the menu cover or inside the menu, or they received a control menu. Participants were asked to make one choice from each of three menu sections (meals, beverages, afters), and then completed a measure of dietary restraint. As predicted, participants chose a greater proportion of healthy food from the healthy-cue-before menu compared to both the healthy-cue-simultaneous and control menus. Furthermore, this effect was stronger for restrained eaters. The findings demonstrate that the timing of presentation of a healthy food cue is critical, and could be used to inform the design of menus in real-world environments, such as cafés and fast-food outlets, to promote healthier dietary choices.

Can attentional bias modification inoculate people to withstand exposure to real-world food cues?

Two experiments investigated whether attentional bias modification can inoculate people to withstand exposure to real-world appetitive food cues, namely television advertisements for chocolate products. Using a modified dot probe task, undergraduate women were trained to direct their attention toward (attend) or away from (avoid) chocolate pictures. Experiment 1 (N = 178) consisted of one training session; Experiment 2 (N = 161) included 5 weekly sessions. Following training, participants viewed television advertisements of chocolate or control products. They then took part in a so-called taste test as a measure of chocolate consumption. Attentional bias for chocolate was measured before training and after viewing the advertisements, and in Experiment 2 also at 24-h and 1-week follow-up. In Experiment 2, but not Experiment 1, participants in the avoid condition showed a significant reduction in attentional bias for chocolate, regardless of whether they had been exposed to advertisements for chocolate or control products. However, this inoculation effect on attentional bias did not generalise to chocolate intake. Future research involving more extensive attentional re-training may be needed to ascertain whether the inoculation effect on attentional bias can extend to consumption, and thus help people withstand exposure to real-world palatable food cues.

Eating in the absence of hunger in young children: The role of maternal feeding strategies.

Restrictive feeding strategies have been associated with increased eating in the absence of hunger in a small number of studies of young girls. The aim of the present study was to examine a broader range of maternal feeding styles and eating in the absence of hunger in both girls and boys aged 3-5 years old. Participants were 184 mother-child dyads. Mothers completed a questionnaire containing measures of feeding strategies (Restriction, Pressure to Eat and Covert Control). Children consumed a lunch meal and then completed the Eating in the Absence of Hunger protocol. For girls, restrictive feeding was associated with increased eating in the absence of hunger. For boys, pressure to eat more was negatively associated with eating in the absence of hunger. Covert control was not associated with eating in the absence of hunger. Overall, the findings suggest that maternal feeding practices have a differential effect on the eating behaviours of girls and boys. In addition, results from this study indicate that controlling maternal feeding strategies, such as restrictive feeding, have a detrimental impact on young children's eating behaviours and may interfere with their ability to self-regulate eating.

"That's enough now!": A prospective study of the effects of maternal control on children's snack intake.

The aim of this study was to investigate maternal feeding strategies as prospective predictors of young children's snack intake. Participants were 252 mothers of children aged 3-11 years old who completed questionnaire measures of parent feeding strategies (Restriction and Covert Control) and reported on their child's healthy and unhealthy snack intake at two time points separated by three years. Longitudinal regression models showed no prediction of healthy snack food intake. However, Time 1 parental restrictive feeding predicted greater unhealthy snack intake at Time 2, while Time 1 covert feeding strategies predicted lower unhealthy snack intake at Time 2. Structural equation modeling showed that these associations were independent of known covariates that influence children's snack intake (child and parent weight, education level and SES). The results provide longitudinal evidence for the negative impact of restrictive parent feeding strategies on children's snack intake and highlight the importance of dissuading parents from using this type of feeding control. Instead, parents should be encouraged to use more covert feeding strategies that are associated with less unhealthy snack intake over the longer term.