The relationship between fear of COVID-19 and food choice motives in the Iranian population.

BACKGROUND AND AIM: The long-term impact of COVID-19 on nutrition and community health is inevitably noticeable. These effects can change the nutritional behavior and lifestyle of survivors. Due to the COVID consequential fear and anxiety, the pandemic can alter the motivations for choosing, buying, and consuming food. The relationship between nutritional behavior and COVID-19 fear is the primary purpose of this research. MATERIALS & METHODS: This cross-sectional study was conducted via online and face-to-face surveys. Accessing participants was through health centers of Qazvin, Iran, and the selected centers were sampled by cluster sampling method. The study population included 331 adults aged 18 to 65. Data were collected in three sections using valid questionnaires. The Demographic Questionnaire, FCV-19S, and FCQ were used to gather demographic information, the level of fear caused by COVID-19, and food choice motivations, respectively. The statistical analyzes were performed using R software. Analysis of variance and linear regression methods were used to determine the effect of independent variables on dependent variables (p = 0.05). RESULTS: The mean score of fear of COVID-19 in the study population was 15.25 ± 5.78. Price, Mood, Natural content, Familiarity, Convenience, and Ethical concerns were significantly and positively associated with fear of COVID-19 (p<0.05). The only food motive significantly different than before during COVID-19 was Health, which was increased (p = 0.02). Sensory appeal and Health were the most important motivations for food choices before and during COVID-19. The Ethical concern was considered the least important food motivation. DISCUSSION AND CONCLUSION: Some food motivations were associated with fear of COVID-19, possibly due to their psychological nature. The increasing importance of the Health factor and Natural content motivations can relate to the advice of experts on the importance of eating healthy food to counteract COVID-19 and indicate people's preference for this training.

Enhancing cultural humility in food is medicine services: A mixed-methods investigation of patient food and dietary preferences.

Dietary inequities, influenced by sociocultural and economic factors, significantly affect health outcomes, particularly among underserved communities. To address these disparities, the Food is Medicine (FIM) movement strives to enhance access to nutritious food, provide education, and encourage behavioral changes. Boston Medical Center (BMC) 's Nourishing Our Community Program (NOCP) exemplifies this mission by offering FIM services such as an on-site food pantry, rooftop farm, and teaching kitchen. However, persistent barriers hinder the effectiveness of programs like NOCP. This quality improvement (QI) project employed mixed methods to refine existing and develop new patient-generated nutrition education materials and resources across various FIM services. METHODS: This QI project included surveys and focus groups conducted electronically and in person between January and May 2023. We analyzed the data using descriptive statistics and qualitative content analysis. RESULTS: The analysis of results revealed patient preferences and experiences regarding dietary patterns, food choices, and nutrition education. These findings enhanced existing handouts, websites, and group class curricula and forged new partnerships with local community-based organizations. CONCLUSION: Our findings underpin the importance of co-designing interventions, dynamic and multimodal resources, and cultural humility in care to meet individual needs. IMPLICATIONS: This initiative is a model for hospitals aiming to improve educational resources within FIM services and tailor content to the specific needs of diverse patient populations. This project is the first step in programmatic improvement, and continuous refinement is crucial for sustained improvements and advancing health equity at our institution.

Frequency of consumption of selected foods by people with acne vulgaris.

BACKGROUND: Acne is an inflammatory disease affecting adolescents during puberty, but also adults. Determinants of acne may include genetic predisposition as well as diet. The Western diet is rich in processed products with low nutrient density, resulting in a lack of supply of many essential minerals that are needed for the body to function properly. OBJECTIVE: The aim of this study was to assess the dietary behaviour of people with acne vulgaris and respondents' selfassessment of the severity of acne lesions after consumption of selected products. MATERIAL AND METHODS: The study was carried out by means of an online, self-administered questionnaire, a link to which was inserted in group of people struggling with acne on a social network. RESULTS: More than half of the respondents said that acne was present in their parents. Almost 91% of the women surveyed said that acne lesions were exacerbated before menstruation. Respondents were most often treated by a dermatologist. The most common foods consumed by the respondents were milk and milk products and wheat bread. The least frequently consumed products were: sultanas, cornflakes, alcohol and fizzy drinks. Statistical analysis showed a strong strength of association between consumption of white rice, fast food, omega-6-rich oils on the severity of acne lesions, while sultana consumption was very strong correlated. In addition, the study showed an almost certain correlation regarding the consumption of white flour pasta on acne lesions. CONCLUSIONS: Statistical analysis showed a relationship between the consumption of white rice, white flour pasta, fast food products, sultanas, oils rich in omega-6 fats and the exacerbation of acne lesions.

Lunch melodies: Investigating the impact of music on emotions, hunger, liking, and psychophysiology while viewing a lunch meal.

Sensory cues like music can influence our behaviour towards food. In the present study, the effect of music on hunger, fullness, desire to eat and liking of foods, while viewing real lunch food items, was investigated. To this end, emotions and physiological measures were obtained to understand the changes in hunger, fullness, desire to eat and liking. The study aimed to examine changes in hunger, fullness, desire to eat, and liking when viewing a lunch meal under silent and varying music conditions. Additionally, the study explored the potential role of emotions to explain these changes. A crossover experimental design was employed using 50 participants (17 males and 33 females) who observed lunch food items during a silent condition (control), or while listening to either liked or disliked music. The findings demonstrate the cross-modal influence of music on hunger and food liking ratings when viewing food. Hunger ratings were higher and more negative emotions were evoked while viewing lunch food items and listening to disliked music. In contrast, in the silent and liked music conditions, which elicited more positive emotions, there were increased ratings of healthy and unhealthy food pleasantness, overall food liking, and food satisfaction. Electrophysiological measures of heart rate (HR) and skin conductance (SC) were obtained while listening to music and viewing a lunch meal. Viewing food items while listening to disliked music evoked negative emotions and significantly increased SC compared to liked music or silent conditions. Viewing the food items under the silent condition evoked positive emotions and significantly increased HR compared to listening to liked and disliked music. This study showed that the participants' emotions, hunger level, liking, and electrophysiological responses when viewing food are influenced by music that varied with liking. Results from this study may assist in enhancing dining experiences, as well as influencing food choices and satisfaction with meals.

BMI and explicit-implicit cues on food choice: The fake food buffet in the United Kingdom and Indonesia.

We examined whether people with high BMI sampled from two different countries were more susceptible to behavioural change via an implicit, rather than explicit, intervention. We measured BMI and used three types of cue interventions (implicit vs explicit healthy lifestyle cue vs neutral cue) to examine their impact on our participants' food choice using the Fake Food Buffet. Healthiness of the meal chosen was measured by the percentage of healthy food items in the meal. Portion size of their chosen meal was operationalised by the total number of food items chosen and its total calorie content was also estimated. Participants were recruited from the United Kingdom (N = 264) and Indonesia (N = 264). Our results indicated that while explicit food cues were overall more effective, implicit cues were a more effective strategy to change food choice behaviours among individuals with high BMI. Participants with high BMI were more likely to regulate the healthiness of their meal and less likely to regulate its portion size or calorie content. The efficacy of our healthy eating interventions was cross-culturally generalizable. Our study supports previous research that implicit cues of a healthy lifestyle might be a more effective behavioural change strategy for individuals with high BMI.

A picture is worth a thousand words: Framing of food choice options affects decision conflict and mid-fontal theta in food choice task.

In food choices, conflict arises when choosing between a healthy, but less tasty food item and a tasty, but less healthy food item. The underlying assumption is that people trade-off the health and taste properties of food items to reach a decision. To probe this assumption, we presented food items either as colored images (image condition, e.g. photograph of a granola bar) or as pre-matched percentages of taste and health values (text condition, e.g., 20% healthy and 80% tasty). We recorded choices, response times and electroencephalography activity to calculate mid-frontal theta power as a marker of conflict. At the behavioral level, we found higher response times for healthy compared to unhealthy choices, and for difficult compared to easy decisions in both conditions, indicating the experience of a decision conflict. At the neural level, mid-frontal theta power was higher for healthy choices than unhealthy choices and difficult choices compared to easy choices, but only in the image condition. Those results suggest that either conflict type and/or decision strategies differ between the image and text conditions. The present results can be helpful in understanding how dietary decisions can be influenced towards healthier food choices.

Intersecting perspectives: Advocating for sustainable family meals across generations.

Adolescents in Germany eat fewer animal products than their parents, often for sustainability reasons. We investigated how adolescents differ from their parents' generation in sustainability food-choice motives, consumption of animal products, and corresponding behaviors such as advocating for and influencing decisions towards more sustainable family meals. In an online questionnaire, an educationally diverse sample of 500 adolescents (M = 17.9 years, range = 15-20) and 500 adults of their parents' generation (M = 52.2 years, range = 45-60) reported food-choice motives, their own and their family's diet style, how they advocate for sustainable food decisions at family meals (e.g., less meat), and how they influence different steps in family meal planning (e.g., grocery shopping). The two generations did not differ in sustainable food motives and mean consumption frequency of meat and animal products, but adolescents reported three times more often than their parents' generation to never eat meat. At shared family meals they advocated for eating plant-based substitutes (d = 0.27, p < 0.001) and other animal products (ß = -0.15, p = 0.02) more often than their parents' generation, but not for eating less meat. Adolescents advocated more frequently for sustainable food decisions at shared meals the more important sustainability motives were to them (ß = 0.53, p < 0.001), and the less meat (ß = -0.35, p < 0.001) and fewer other animal products (ß = -0.11, p = 0.015) they consumed. Adolescents motivated towards sustainability have the potential to impact the family's dietary choices through reverse socialization processes. These findings challenge current theories that suggest only parents influence their children, neglecting the role of adolescents as potential agents of change for improved family and planetary health.

Eating vegetables at school lunchtimes: Pilot and feasibility studies testing strategies to improve intake.

Vegetable provision at schools in the UK has increased over recent years; however children still eat few of the vegetables that are served to them. Two experimental pilot and feasibility studies implemented a vegetables-served-first (study 1) plus experiential learning (study 2) approach to increase children's (3-5 years and 4-7 years respectively) vegetable consumption at school lunchtimes. Both studies involved vegetables-served-first 10-min before the rest of the meal, with experiential learning techniques (repeated exposure, "veg-first" dinner plates, vegetable songs, videos, and nutrition education) complementing the vegetable service in study 2. Study 1 (n = 38) found that vegetables-served-first, compared with serving all foods together, increased vegetable intake by ∼12 g. Study 2 (n = 69) found that vegetable consumption depended on individual schools. Schools where vegetable intake was low showed increases in consumption during intervention weeks, whereas schools with high vegetable intake showed little change. Acceptability of interventions was found to be good for children and schools that participated, although concerns about time to serve vegetables first and COVID-related environmental restrictions reduced feasibility for some schools. Child engagement could also be improved by offering a wider variety of vegetables during repeated exposure to reduce monotony. Future research should design interventions using co-design methods including schools to suit their context best, whilst also addressing the problem with a systems approach. Interventions which focus on child learning through experience need to take account of specific school environments including curricular needs, resources available for school lunch (including both time and space), provision of food, support from teachers and parents, and the culture around eating (e.g. encouragement, pressure to eat, lunchtime competing with playtime). Joined-up systems approaches could enhance both provision and uptake of vegetables at school meals.

Diversity and practice: local decision-making practices on multi-cultural diets for British Muslim school children (BMSC) and implications for social justice.

Introduction: British Muslim School Children (BMSC) are required to follow special halal dietary requirements in accordance with their religion, which is often not accounted for in British schools. This often leaves BMSC limited to a vegetarian diet while at school, despite this not being their chosen diet or preference. This study explores the perceptions of key stakeholders regarding fairness and accessibility of school meals for BMSC, as well as discussing school food provision for those maintaining a religious diet in light of social justice. This is in the context of limited knowledge previously being explored in the North East of England regarding procurement and decision-making at a systems level to cater for BMSC. Methods: A qualitative research design was conducted. A total of 62 participants (39 BMSC, 15 parents, and 8 school and catering staff) took part in a semi-structured interview or focus group. Participants were recruited from six schools, with these schools selected based on their differing levels of BMSC in attendance. This project took place between March 2022 and October 2023. Results/discussion: Results suggested that where schools already catered for diverse food requirements, inclusive of BMSC dietary needs, food choices were still limited in the options and amount available. School and catering staff stated that cost implications contributed to their menu development process. Despite this, there was an evident willingness to learn about the cultural food options and how these can be implemented in future school menus. Suggestions discussed included an increase in the use of halal meat in order to provide a more inclusive school food experience for BMSC.

"That Looks Like My Kitchen!" - Personalized context by usage frequency and familiarity influences consumer perception and liking of chicken nuggets in VR.

Restoring relevant context during consumer sensory testing using virtual reality (VR) technologies may facilitate evaluations reflective of real-world experiences, enabling reliable data collection to better predict product success. Prior research has applied the same consumption scenario to all participants without accounting for variations in individual consumption habits. Thus, a consumption scenario of low personal relevance can lead to misleading conclusions. This study aimed to investigate how personal relevance (usage frequency and similarity) of a consumption environment influences consumer perception and acceptance during product evaluations. Using a VR system, 63 consumers evaluated four commercial frozen chicken nuggets in three virtual environments one week apart: sensory booth, high-relevance kitchen, and low-relevance kitchen. Participants assessed the products virtually on overall liking, Check-All-That-Apply (CATA) on 20 attributes, and purchase intent. They also completed a virtual presence and engagement questionnaire after testing. Results found better product discrimination in both kitchen environments compared to the booth as demonstrated in more post-hoc statistical subgroups (p's < 0.05) on liking and purchase intent. Additionally, more significant product differences were found among CATA attributes in the kitchens. CATA penalty-lift analyses indicated that sensory attributes had more pronounced positive and negative impacts on liking in the high relevance kitchen, followed by the low relevance kitchen, and lastly the booth. Consumers were equally present and engaged during testing across conditions (p's > 0.05). Results suggest providing a personally relevant consumption environment via VR technologies for consumer testing generated more discriminating data that can improve the quality of consumer insights.

Early-life diet does not affect preference for fish in herring gulls (Larus argentatus).

Urban populations of herring gulls (Larus argentatus) are increasing and causing human-wildlife conflict by exploiting anthropogenic resources. Gulls that breed in urban areas rely on varying amounts of terrestrial anthropogenic foods (e.g., domestic refuse, agricultural and commercial waste) to feed themselves. However, with the onset of hatching, many parent gulls switch to sourcing more marine than anthropogenic or terrestrial foods to provision their chicks. Although anthropogenic foods may meet chick calorific requirements for growth and development, some such foods (e.g., bread) may have lower levels of protein and other key nutrients compared to marine foods. However, whether this parental switch in chick diet is driven by chicks' preference for marine foods, or whether chicks' food preferences are shaped by the food types provisioned by their parents, remains untested. This study tests whether chick food preferences can be influenced by their provisioned diet by experimentally manipulating the ratio of time for which anthropogenic and marine foods were available (80:20 and vice versa) in the rearing diets of two treatment groups of rescued herring gull chicks. Each diet was randomly assigned to each of the 27 captive-reared chicks for the duration of the study. We tested chicks' individual food preferences throughout their development in captivity using food arrays with four food choices (fish, cat food, mussels and brown bread). Regardless of the dietary treatment group, we found that all chicks preferred fish and almost all refused to eat most of the bread offered. Our findings suggest that early-life diet, manipulated by the ratio of time the different foods were available, did not influence gull chicks' food preferences. Instead, chicks developed a strong and persistent preference for marine foods, which appears to match adult gulls' dietary switch to marine foods upon chick hatching and may reinforce the provisioning of marine foods during chick development. However, whether chicks in the wild would refuse provisioned foods, and to a sufficient extent to influence parental provisioning, requires further study. Longitudinal studies of urban animal populations that track wild individuals' food preferences and foraging specialisations throughout life are required to shed light on the development and use of anthropogenic resource exploitation.

Nutrient clustering, NOVA classification, and nutrient profiling: How do they overlap, and what do they predict about food palatability?

We compared the performance of three food categorisation metrics in predicting palatability (taste pleasantness) using a dataset of 52 foods, each rated virtually (online) by 72-224 participants familiar with the foods in question, as described in Appetite 193 (2024) 107124. The metrics were nutrient clustering, NOVA, and nutrient profiling. The first two of these metrics were developed to identify, respectively: 'hyper-palatable' foods (HPFs); and ultra-processed foods (UPFs), which are claimed to be 'made to be hyper-palatable'. The third metric categorises foods as high fat, sugar, salt (HFSS) foods versus non-HFSS foods. There were overlaps, but also significant differences, in categorisation of the foods by the three metrics: of the 52 foods, 35 (67%) were categorised as HPF, and/or UPF, and/or HFSS, and 17 (33%) were categorised as none of these. There was no significant difference in measured palatability between HPFs and non-HPFs, nor between UPFs and non-UPFs (p ≥ 0.412). HFSS foods were significantly more palatable than non-HFSS foods (p = 0.049). None of the metrics significantly predicted food reward (desire to eat). These results do not support the use of hypothetical combinations of food ingredients as proxies for palatability, as done explicitly by the nutrient clustering and NOVA metrics. To discover what aspects of food composition predict palatability requires measuring the palatability of a wide range of foods that differ in composition, as we do here.

Exploring culinary diversity to enhance Mediterranean diet adherence: A randomized controlled trial.

We Investigated how promoting diverse, healthy food options affects long-term dietary choices. We hypothesized that encouraging exploration of nutritious plant-based foods would lead to lasting improvements in diet. Participants (N = 211) were randomly assigned into two groups for a 6-week intervention: The fixed menu group was given the same large menu every week, while the changing menu group received a new small menu each week. At the end of the intervention both groups were exposed to the same menu suggestions. Food diversity evaluation was based on weekly reports collected during the intervention. Self-reported adherence to Mediterranean diet components was assessed using the I-MEDAS screener. The proportion of plant-based foods in participants' diets was estimated using a 0-100% scale based on self-report. Both items were evaluated using online questionnaires given to participants at baseline, at the end of the intervention, as well as three and six months after the intervention concluded. Results mean(SD) demonstrated that participants in fixed menu group explored a significantly wider array of items 26.33(11.64) than those in the changing menus group [19.79(10.29), t(202) = 4.25, p < 0.001, Cohen's d = 0.60]. A repeated measures analysis of covariance rmANCOVA revealed that short-term increase in I-MEDAS and PBD score were noted in both groups; however, only participants with the fixed menu sustained this increase at months follow-up [diff = 1.50, t(132) = 4.50, p < 0.001 Our findings suggest that manipulating the rate of exposure to food suggestions may affect overall dietary variety. It seems that early presentation with options may increase overall dietary variety and may even support longer-term habits. This study contributes to developing effective interventions and highlights the challenge of promoting exploratory behavior in nutrition.

The effectiveness of personalised food choice advice tailored to an individual's socio-demographic, cognitive characteristics, and sensory preferences.

Personalised dietary advice has become increasingly popular, currently however most approaches are based on an individual's genetic and phenotypic profile whilst largely ignoring other determinants such as socio economic and cognitive variables. This paper provides novel insights by testing the effectiveness of personalised healthy eating advice concurrently tailored to an individual's socio-demographic group, cognitive characteristics, and sensory preferences. We first used existing data to build a synthetic dataset based on information from 3654 households (Study 1a), and then developed a cluster model to identify individuals characterised by similar socio-demographic, cognitive, and sensory aspects (Study 1b). Finally, in Study 2 we used the characteristics of 8 clusters to build 8 separate personalised food choice advice and assess their ability to motivate the increased consumption of fruit and vegetables and decreased intakes of saturated fat and sugar. We presented 218 participants with either generic UK Government "EatWell" advice, advice that was tailored to their allocated cluster (matched personalised), or advice tailored to a different cluster (unmatched personalised). Results showed that, when compared to generic advice, participants that received matched personalised advice were significantly more likely to indicate they would change their diet. Participants were similarly motivated to increase vegetable consumption and decrease saturated fat intake when they received unmatched personalised advice, potentially highlighting the power of providing alternative food choices. Overall, this study demonstrated that the power of personalizing food choice advice, based on a combination of individual characteristics, can be more effective than current approaches in motivating dietary change. Our study also emphasizes the viability of addressing population health through automatically delivered web-based personalised advice.

Dutch consumers' attitude towards industrial food processing.

Industrial food processing and its possible adverse effects on health are widely debated in scientific literature and media. There is not much known about consumers' attitudes towards the processing of foods. Therefore, a questionnaire (n = 463) was distributed and interviews (n = 11) were conducted with Dutch consumers to evaluate the attitudes and associations towards industrial food processing and to assess opinions about communications on food processing and health. The results showed that 51% of the respondents had a neutral, 23% had a positive, and 26% had a negative attitude towards food processing. Respondents with a background in food by profession or education (n = 159) had more frequently a positive attitude towards food processing (P = 0.008). Respondents and interviewees pointed out both positive and negative associations with industrial processing: additives, artificial, not fresh, low nutritional value, unnatural, but also palatability, food safety, shelf life, and convenience. The questionnaire showed that 70% of the respondents thought food processing had a (slightly) negative health effect. Most interviewees indicated that when doing groceries, food processing per se is not relevant in food choices, although some critically inspected the ingredients. Furthermore, interviewees indicated that communication about food and health is scattered and complex. They would like to gain easy and straightforward information from a central source. From the questionnaire respondents, 60% indicated that they would like to have more information about food processing. In conclusion, most Dutch consumers in this study have a neutral and nuanced attitude towards industrial food processing. A connection with food via profession or education showed a more positive attitude, which may indicate the importance of knowledge and the need for clear communication about nutrition, ingredients, and food processing.

Effects of busy mindset on preference for high-calorie foods.

More people feel busier than ever. Recognising busyness as an environmental factor that influences food preferences is essential when considering health-related decisions. This research investigates how the subjective perception of busyness-which is referred to as a busy mindset-affects consumers' food preferences via two studies. Study 1 was a laboratory experiment conducted using a manipulation method with 135 undergraduate student participants. Study 2 used an online self-report questionnaire to repeat the findings of Study 1 and including 209 social participants. The results from the two studies showed that a busy mindset induced individuals to prefer high-calorie foods, and energy expenditure efficiency mediated this effect. Moreover, the subjective perception of busyness increased individuals' estimated need for calories and induced them to prefer high-calorie foods over high-nutrition or hedonic foods. These findings suggest that food preferences in the busy mindset have potential implications for individuals' food consumption.

Taste sensitivities mediate differential snack choices across BMI groups: a study with New Zealand young male individuals.

OBJECTIVE: This study aimed to: 1) test for the link between snack choices and BMI using a novel sensory-based classification method; and 2) elucidate the role of gustatory sensitivity in orienting snack choices. METHODS: The study employed a dual approach involving sensory and nutritional assessments. Ninety-eight European male individuals were tested for gustatory sensitivities to sweetness, saltiness, umami, and lipid perception. Participant food intake was measured over 4 days. A separate cohort of 327 participants categorized the recorded snacks based on taste patterns, enabling profiling of snack choices across body-weight groups. RESULTS: Results showed clear differentiations in snack choices across the BMI groups: Individuals with a higher BMI consumed more "Sweet" and "Sweet+Fat" snacks and less "Savory" snacks compared with the lower-BMI group (p < 0.05). Mediation analyses confirmed a significant effect of gustatory sensitivity, showing that the greater choice for "Sweet" and "Sweet+Fat" snacks among those with a higher BMI was mediated by sensitivities to sweetness and lipid perception (p = 0.008-0.044). CONCLUSIONS: Our study revealed that gustatory sensitivity can mediate the relationship between BMI and energy consumption from different snacks. These findings highlight the significance of taste perception in shaping snack choice, suggesting potential strategies for interventions aimed at addressing gustatory sensitivity to promote healthier dietary preferences.

The cortical amygdala consolidates a socially transmitted long-term memory.

Social communication guides decision-making, which is essential for survival. Social transmission of food preference (STFP) is an ecologically relevant memory paradigm in which an animal learns a desirable food odour from another animal in a social context, creating a long-term memory1,2. How food-preference memory is acquired, consolidated and stored is unclear. Here we show that the posteromedial nucleus of the cortical amygdala (COApm) serves as a computational centre in long-term STFP memory consolidation by integrating social and sensory olfactory inputs. Blocking synaptic signalling by the COApm-based circuit selectively abolished STFP memory consolidation without impairing memory acquisition, storage or recall. COApm-mediated STFP memory consolidation depends on synaptic inputs from the accessory olfactory bulb and on synaptic outputs to the anterior olfactory nucleus. STFP memory consolidation requires protein synthesis, suggesting a gene-expression mechanism. Deep single-cell and spatially resolved transcriptomics revealed robust but distinct gene-expression signatures induced by STFP memory formation in the COApm that are consistent with synapse restructuring. Our data thus define a neural circuit for the consolidation of a socially communicated long-term memory, thereby mechanistically distinguishing protein-synthesis-dependent memory consolidation from memory acquisition, storage or retrieval.

Online retail nudges to help parents with lower-income choose healthy beverages for their children: A randomized clinical trial.

BACKGROUND: Nudges offer a promising tool to reduce sugary drink intake among children who are most at risk for diet-related disease. OBJECTIVE: To examine the impact of online store nudges on purchases of sugary drinks for children in lower-income households. METHODS: Caregivers with lower-income were recruited to an online shopping experiment and instructed to spend $10-$30 on three beverages for their child aged 1-5 years. Participants were randomized to navigate an online supermarket in its standard version (n = 1106) or a version with nudges (n = 1135), including a product placement nudge (i.e. placing healthy beverages in prominent positions) and a swap nudge (i.e. offering a swap of water, plain milk and/or 100% fruit juice upon selection of sugary drinks). RESULTS: On average, participants purchased 1887 (SD = 2113) and 620 (SD = 1528) calories from sugary drinks per basket in the control and experimental conditions, respectively. Model-based results indicate that those in the experimental condition purchased 1267 (95% CI: 1419, 1114) fewer calories from sugary drinks, and fewer grams of total sugar (ß = -253.5 g (95% CI: -286.3, -220.6)) and added sugar (ß = -287.8 g (95% CI: -323.1, -252.5)) purchased from sugary drinks. CONCLUSION: Nudges may be an effective, acceptable, scalable strategy for leading caregivers in lower-income households to purchase fewer sugary drinks for their children.

Network spillover effects associated with the ChooseWell 365 workplace randomized controlled trial to promote healthy food choices.

Food choices are closely linked to culture, social relationships, and health. Because many adults spend up to half their time at work, the workplace provides a venue for changing population health-related behaviors and norms. It is unknown whether the effects of a workplace intervention to improve health behaviors might spread beyond participating employees due to social influence. ChooseWell 365 was a randomized controlled trial testing a 12-month healthy eating intervention grounded in principles of behavioral economics. This intervention leveraged an existing cafeteria traffic-light labeling system (green = healthy; red = unhealthy) in a large hospital workplace and demonstrated significant improvements in healthy food choices by employees in the intervention vs. control group. The current study used data from over 29 million dyadic purchasing events during the trial to test whether social ties to a trial participant co-worker (n = 299 intervention, n = 302 control) influenced the workplace food choices of non-participants (n = 7900). There was robust evidence that non-participants who were socially tied to more intervention group participants made healthier workplace food purchases overall, and purchased a greater proportion of healthy (i.e., green) food and beverages, and fewer unhealthy (i.e., red) beverages and modest evidence that the benefit of being tied to intervention participants was greater than being tied to control participants. Although individual-level effect sizes were small, a range of consistent findings indicated that this light-touch intervention yielded spillover effects of healthy eating behaviors on non-participants. Results suggest that workplace healthy eating interventions could have population benefits extending beyond participants.