Food craving in daily life: comparison of overweight and normal-weight participants with ecological momentary assessment.

BACKGROUND: The present study examined food cravings in daily life by comparing overweight and normal-weight participants right before eating events and at non-eating moments. It was hypothesised that overweight participants would have (i) more frequent, (ii) stronger and (iii) a greater variety of high-caloric palatable food cravings, and also would (iv) consume more high-caloric palatable foods, than normal-weight participants. METHODS: Ecological momentary assessment (EMA) was used to assess food craving strength and frequency, variety of specific food cravings, and food intake. Fifty-seven overweight and 43 normal-weight adult participants were assessed at eating events and at an average of eight random non-eating moments per day for 2 weeks. Foods were categorised as: high-caloric high palatable foods (HCHP), fruits and salads, staple food dishes and sandwiches, and soups and yoghurts. RESULTS: Overweight participants reported more frequent HCHP food cravings specifically at non-eating moments than did normal-weight participants. Normal-weight participants reported more food cravings for staple foods, specifically at eating events. Moreover, overweight participants craved a greater variety of HCHP foods than normal-weight participants at both eating events and random non-eating moments. No other significant between-group differences were found. CONCLUSIONS: The results highlight the importance for obesity interventions (i) to specifically target high-caloric palatable food cravings that are experienced during the day and are not tied to eating moments and (ii) to aim for a reduction in the variety of high-caloric palatable food cravings. It might be fruitful to deliver treatment aimed at reducing cravings via mobile devices because this allows for easy individual tailoring and timing of interventions.

[Cognitive therapy and interpersonal psychotherapy for major depressive disorder: how do they work, how long, and for whom?] / Cognitieve therapie en interpersoonlijke psychotherapie voor depressie: hoe werken ze, hoe lang en voor wie?

BACKGROUND: Although the effectiveness of cognitive therapy (ct) and interpersonal psychotherapy (ipt) for depression has been well established, little is known about how, how long and for whom they work.
AIM: To summarize findings from a large rct to the (differential) effects and mechanisms of change of ct/ipt for depression.
METHOD: 182 adult depressed outpatients were randomized to ct (n = 76), ipt (n = 75), or a two-month wait-list-control condition (n = 31). Primary outcome was depression severity (bdi-ii). Other outcomes were quality of life, social and general psychological functioning and various potential process measures. Interventions were compared at the end of treatment, and up to 17 months follow-up.
RESULTS: Overall, ct and ipt were both superior to the wait-list, but did not differ significantly from one another. However, the pathway through which therapeutic change occurred appeared to be different for ct and ipt, and many patients were predicted to have a clinically meaningful advantage in one of the two interventions. We did not find empirical support for the theoretical models of change.
CONCLUSION: (Long-term) outcomes of ct and ipt appear to not differ significantly. The field would benefit from further refinement of research methods to disentangle mechanisms of change, and from advances in the field of personalized medicine.

Subjective craving and event-related brain response to olfactory and visual chocolate cues in binge-eating and healthy individuals.

High-sugar/high-fat foods are related to binge-eating behaviour and especially people with low inhibitory control may encounter elevated difficulties to resist their intake. Incentive sensitization to food-related cues might lead to increased motivated attention towards these stimuli and to cue-induced craving. To investigate the combined influence of olfactory and visual stimuli on craving, inhibitory control and motivated attention, 20 healthy controls and 19 individuals with binge-eating viewed chocolate and neutral pictures, primed by chocolate or neutral odours. Subjective craving and electroencephalogram activity were recorded during the task. N2 and Late Positive Potential (LPP) amplitudes were analysed. Patients reported higher craving than controls. Subjective craving, N2 and LPP amplitudes were higher for chocolate versus neutral pictures. Patients showed a higher relative increase in N2 amplitudes to chocolate versus neutral pictures than controls. Chocolate images induced significant increases in craving, motivated attention and measures of cognitive control. Chocolate odour might potentiate the craving response to visual stimuli, especially in patients with binge-eating.

Brain dopamine and serotonin transporter binding are associated with visual attention bias for food in lean men.

BACKGROUND: In rodents, the striatal dopamine (DA) system and the (hypo)thalamic serotonin (5-HT) system are involved in the regulation of feeding behavior. In lean humans, little is known about the relationship between these brain neurotransmitter systems and feeding. We studied the relationship between striatal DA transporters (DAT) and diencephalic 5-HT transporters (SERT), behavioral tasks and questionnaires, and food intake. METHOD: We measured striatal DAT and diencephalic SERT binding with [123I]FP-CIT SPECT in 36 lean male subjects. Visual attention bias for food (detection speed and distraction time) and degree of impulsivity were measured using response-latency-based computer tasks. Craving and emotional eating were assessed with questionnaires and ratings of hunger by means of VAS scores. Food intake was assessed through a self-reported online diet journal. RESULTS: Striatal DAT and diencephalic SERT binding negatively correlated with food detection speed (p = 0.008, r = -0.50 and p = 0.002, r = -0.57, respectively), but not with food distraction time, ratings of hunger, craving or impulsivity. Striatal DAT and diencephalic SERT binding did not correlate with free choice food intake, whereas food detection speed positively correlated with total caloric intake (p = 0.001, r = 0.60), protein intake (p = 0.01, r = 0.44), carbohydrate intake (p = 0.03, r = 0.39) and fat intake (p = 0.06, r = 0.35). CONCLUSIONS: These results indicate a role for the central 5-HT and DA system in the regulation of visual attention bias for food, which contributes to the motivation to eat, in non-obese, healthy humans. In addition, this study confirms that food detection speed, measured with the latency-based computer task, positively correlates with total food and macronutrient intake.

Picky eating and child weight status development: a longitudinal study.

BACKGROUND: Children's picky eating behaviour has been linked both to being overweight and underweight. However, the role of parenting practices in this relationship has rarely been investigated. The present study aimed to clarify the direction of the association between picky eating and weight status and to examine the moderating role of food parenting practices. METHODS: The present study comprised a longitudinal study on the effects of picky eating on child weight status within the KOALA Birth Cohort Study, the Netherlands. Mothers and their children were included in the analyses. Children's picky eating behaviour and food parenting practices were assessed at baseline (child age 5 years). Their weight status was assessed repeatedly until age 9 years. Mixed effects linear and logistic regressions were used to compare picky eaters (n = 403) and non-picky eaters (n = 621) on changes in weight status over the years. RESULTS: At baseline of age 5 years, picky eaters were slightly shorter, more often underweight and less often overweight than non-picky eaters, whereas energy intake in relation to body weight (kJ kg(-1)) was similar. Picky eaters with a normal weight at baseline had no increased risk of becoming underweight during follow-up until age 9 years, and were less likely to become overweight compared to non-picky eaters. There were no interactions with food parenting practices. The parents of picky eaters more often reported pressuring their child to eat and restrict unhealthy food intake compared to parents of non-picky eaters. CONCLUSIONS: The association between picky eating and child weight status was not influenced by parenting practices.

Clinical effectiveness of cognitive therapy v. interpersonal psychotherapy for depression: results of a randomized controlled trial.

BACKGROUND: Although both cognitive therapy (CT) and interpersonal psychotherapy (IPT) have been shown to be effective treatments for major depressive disorder (MDD), it is not clear yet whether one therapy outperforms the other with regard to severity and course of the disorder. This study examined the clinical effectiveness of CT v. IPT in a large sample of depressed patients seeking treatment in a Dutch outpatient mental health clinic. We tested whether one of the treatments was superior to the other at post-treatment and at 5 months follow-up. Furthermore, we tested whether active treatment was superior to no treatment. We also assessed whether initial depression severity moderated the effect of time and condition and tested for therapist differences. METHOD: Depressed adults (n = 182) were randomized to either CT (n = 76), IPT (n = 75) or a 2-month waiting list control (WLC) condition (n = 31). Main outcome was depression severity, measured with the Beck Depression Inventory - II (BDI-II), assessed at baseline, 2, 3, and 7 months (treatment phase) and monthly up to 5 months follow-up (8-12 months). RESULTS: No differential effects between CT and IPT were found. Both treatments exceeded response in the WLC condition, and led to considerable improvement in depression severity that was sustained up to 1 year. Baseline depression severity did not moderate the effect of time and condition. CONCLUSIONS: Within our power and time ranges, CT and IPT appeared not to differ in the treatment of depression in the acute phase and beyond.

Reward activity in satiated overweight women is decreased during unbiased viewing but increased when imagining taste: an event-related fMRI study.

OBJECTIVE: The aim of this functional magnetic resonance imaging (fMRI) study was to investigate reward-related brain activity in satiated overweight and healthy-weight participants in response to high-calorie palatable food pictures, when viewing the pictures without prior instructions (called unbiased viewing) versus imagining the taste of the shown pictures (called taste imagination). We predicted that neural activation in brain reward regions would be greater in overweight participants than in healthy-weight ones and that this difference between groups would be strongest during unbiased viewing. METHOD: Neural activation was measured using fMRI in 14 overweight (mean body mass index (BMI): 29.8 kg m(-2)) and 15 healthy-weight (mean BMI: 21.1 kg m(-2)) participants who were satiated, in response to palatable and unpalatable high-calorie and low-calorie food pictures, presented in an event-related design during two conditions: unbiased viewing (no prior instructions) versus taste imagination. RESULTS: A group × condition interaction was found in 14 brain regions involved in food reward processing during the presentation of high-calorie palatable food stimuli. During the taste imagination condition, neural activation in these regions was greater in the overweight participants than in the healthy-weight ones. Contrary to our expectations, the opposite pattern was observed during unbiased viewing: activation in reward regions in the overweight participants was reduced compared with the healthy-weight ones. In all brain reward regions except for the left amygdala, the group × condition interaction was specific to high-calorie palatable food stimuli. CONCLUSION: Greater reward activity in the overweight participants compared with the control group when imagining taste may represent an increased reward response induced by high-calorie palatable food. During unbiased viewing, reduced reward activation in the overweight participants compared with those with a healthy weight may reflect avoidance of high-calorie palatable food stimuli. Taken together, this pattern of activation may reflect ambivalence in the overweight group between desire for (in the taste imagination condition) and avoidance of (in the unbiased viewing condition) high-calorie palatable food stimuli.

The interactive effect of hunger and impulsivity on food intake and purchase in a virtual supermarket.

OBJECTIVE: It has been shown repeatedly that impulsivity, obesity and food intake are related; obese people are more impulsive than lean people and impulsive people eat more than less impulsive people. The relation between impulsivity and food intake might be state dependent; hunger motivates food seeking behaviour and food consumption, especially of high caloric food. Difficulties to overrule automatic behavioural tendencies might make impulsive people more susceptible to the effects of hunger on food selection. Therefore, they are expected to increase their intake more than low impulsive people when feeling hungry. STUDY 1: Fifty-seven female participants were randomly assigned to a hunger or sated condition. Response inhibition (a measure of impulsivity) and food intake were measured. Results show that impulsive participants ate significantly more, but only when feeling hungry. STUDY 2: Ninety-four undergraduate students participated. Hunger, response inhibition and the purchase of food in a virtual supermarket were measured. The same interaction was found: impulsive participants bought most calories, especially from snack food, but only when feeling hungry. CONCLUSION: Hunger and impulsivity interact in their influence on consumption. These data suggest that reducing hunger during calorie restricting diets is important for successful weight loss, particularly for the impulsive dieters.

The environment influences whether high-fat foods are associated with palatable or with unhealthy.

This study investigated whether relatively automatic evaluations of food differ between situations and between obese people and lean controls. These evaluations were assessed in the affective priming paradigm (APP) -- a response latency based measure for associations. In Experiment 1, we either focused participants (33 obese and 26 lean controls) on the palatability (restaurant condition) or on the healthiness (health condition) of food, prior to the APP. Independent of weight-status, relatively automatic evaluations of food were based on palatability in the restaurant condition, and on health in the health condition. So, the current focus of attention can shape the way foods are evaluated relatively automatically. In Experiment 2, craving was induced in participants (27 obese and 29 lean controls). Unexpectedly, the craving induction did not achieve its goal of focusing on the palatability of food in general, but just for low-fat foods, possibly because of the health-emphasizing environment -- a hospital. Interestingly, obese people showed a stronger palatability priming effect with increasing levels of initial craving. For normal weight controls the effect was in the same direction, but missed significance. In our environment, palatability of food may be too salient, and health may not be salient enough, influencing automatic food-evaluations.

Early associations with food in anorexia nervosa patients and obese people assessed in the affective priming paradigm.

Two experiments are reported that used the affective priming paradigm (Fazio, R. H., Sanbonmatsu, D. M., Powell, M. C., & Kardess, F. R. (1986). On the automatic activation of attitudes. Journal of Personality and Social Psychology, 50, 229-238) to uncover associations with food at a relatively automatic level. Experiment 1 tested the hypothesis that anorexia nervosa (AN; n=22) patients would show less sensitivity to the palatability of foods than unrestrained lean controls (n=27). Results indeed suggested that AN patients did not display a liking of palatable foods over unpalatable foods, whereas unrestrained controls did. Experiment 2 tested the hypothesis that obese people (n=27) would show more sensitivity to the palatability of (high-fat) palatable foods than unrestrained lean controls (n=27) would. However, results suggested that the priming effect was based on health concerns, in that participants showed a preference for low-fat palatable foods over high-fat palatable foods. Average speed of responding and context are discussed as variables influencing the affective priming effect. Taken together, results suggest that food evaluations at a relatively automatic level are controlled by an interaction between participant characteristics, stimuli characteristics, and the specific context.

At first sight: how do restrained eaters evaluate high-fat palatable foods?

Two experiments tested the hypothesis that restrained eaters display a greater liking for high-fat palatable foods, than do unrestrained eaters. This hypothesis was tested in the affective priming paradigm and in the extrinsic affective Simon task . Both paradigms were successful in uncovering food likes and dislikes, and both showed that participants were able to evaluate the palatability of foods relatively automatically. However, contrary to the hypothesis, food likes were not substantially affected by fat content, nor were they affected by restraint-status. Restrained and unrestrained eaters may like high-fat palatable foods to the same extent, but may differ in their craving for these foods.