Corrigendum: Home alone together: Differential links between momentary contexts and real-time loneliness among older adults from Chicago during versus before the COVID-19 pandemic.

Studies show that older adults were lonelier during versus before the COVID-19 pandemic. This may be due in part to guidelines particularly recommending that older adults stay at home, given their elevated risk of COVID-19 complications. However, little is known about the extent to which this population experienced greater intensity in momentary loneliness during versus before the pandemic, and how this relates to their real-time contexts. Here, we build upon recent findings from the Chicago Health and Activity Space in Real-Time (CHART) study that revealed associations between momentary contexts and loneliness among older adults. We analyze ecological momentary assessments (EMAs) from both pre- and during COVID-19 among a subsample of CHART respondents (N = 110 older adults age 65-88 in 2020). Pre-pandemic data were collected across three waves from April 2018-October 2019, and pandemic data were collected across three additional waves from June-September 2020. Participants responded to smartphone "pings" (five per day for 7 days per wave; N = 5,506 and N = 7,824 before and during the pandemic, respectively) by reporting their momentary loneliness and context (e.g., home). Findings from multi-level regression models suggest that respondents were lonelier in mid-2020 than in years prior, as well as when at home and alone; they were also more likely to be at home during the pandemic. However, the loneliness-inducing effects of being at home (vs. outside the home) and alone (vs. with others) were weaker during versus before COVID-19. Results provide important nuance to broader trends in loneliness among older adults during the pandemic. Specifically, older adults may have adopted new technologies to support social connectedness. It is also possible that, during a time in which social and physical distancing characterized public health guidelines, these contexts grew less isolating as they became a shared experience, or that publicly shared spaces provided fewer opportunities for social engagement.

Corrigendum: Momentary loneliness among older adults: Contextual differences and their moderation by gender and race/ethnicity.

Studies suggest that loneliness is associated with age. Among older adults, women and Black adults may be at greater risk than men and White adults, respectively. Social and physical contexts are also linked with loneliness. However, little is known about whether and how those of different genders and racial/ethnic groups may experience social and physical contexts differently in terms of their real-time loneliness, and the extent to which these differences may be explained by differential exposure or reactivity to such contexts. We examine (1) how momentary loneliness relates to (a) gender and race/ethnicity and (b) social and physical context; and the extent to which gender and racial/ethnic groups may be (2) differentially exposed to loneliness-related contexts and/or (3) differentially reacting to these contexts. Using multilevel regressions, we analyzed ecological momentary assessments from 342 community-dwelling U.S. older adults from the Chicago Health and Activity Space in Real Time study. In each of three waves of data collection, smartphone "pings" (five per day for 21 days; n = 12,744 EMAs) assessed loneliness, social context (e.g., alone, with a spouse/partner), and location/physical context (e.g., home, at work). Results revealed that men consistently reported greater loneliness intensity than women, including after adjusting for momentary physical and social context. In addition, those momentarily outside the home and/or not alone were less likely to feel lonely than their counterparts. However, the protective effect of being outside of the home (vs. home) was weaker among women and Black and Hispanic older adults, and the protective effect of being with one or more others (vs. alone) was weaker among women. Results are among the first to identify contextual effects on real-time loneliness in older adults and how these associations vary by gender and race/ethnicity. Knowledge regarding momentary variation in loneliness may inform future just-in-time adaptive loneliness interventions in older adulthood.

Moderation of associations between weight discrimination and diabetes status by psychosocial factors.

Weight discrimination has adverse effects on health that include increasing the risk factors for developing type 2 diabetes. Preliminary evidence suggests a positive association between weight discrimination and diagnosed diabetes; however, it is unknown whether psychosocial resources may buffer this association. In logistic regressions stratified by gender, we examined links between weight discrimination and diabetes among a nationally representative sample of U.S. adults (the National Social Life, Health, and Aging Project; N = 2,794 adults age 50 and older in 2015-16). We also tested the extent to which trait-resilience and social support from a spouse/partner, family, and friends buffered any observed association. We adjusted for known predictors of diabetes (age, race/ethnicity, Body Mass Index) and conducted sensitivity analyses restricted to men and women with obesity. Net of covariates, in the overall sample, weight discrimination was associated with significantly greater odds of having ever had diabetes among women (OR = 2.00, 95% CI [1.15, 3.47]), but not men. Among women with obesity, weight discrimination was only significantly associated with greater odds of diabetes for those with low resilience (OR = 1.84, 95% CI [1.01, 3.35]). Among men overall, weight discrimination was associated with lower odds of diabetes for those with high family support (OR = 0.03, 95% CI [0.003, 0.25]) as well as those with high friend support (OR = 0.34, 95% CI [0.13, 0.91]); similar effects were observed in men with obesity. These novel findings evince a role for psychosocial resources in buffering associations between weight discrimination and diabetes.

Social Isolation and Worsening Health Behaviors Among Older Adults During the COVID-19 Pandemic.

OBJECTIVES: We examine the relationship between social isolation, poor health behaviors, and the perceived worsening of older adults' health behaviors following the coronavirus outbreak. We assess the extent to which psychological pathways mediate the relationship between social isolation and worsening health behaviors. METHODS: Drawing on data from the National Social Life Health and Aging Project Round 3 (2015) and its coronavirus immune disease 2019 (COVID-19) substudy (2020; N = 2,549), we use generalized linear models to explore how indicators of social isolation during the COVID-19 pandemic-infrequent in-person contact with friends and family in 2020 and decreased in-person contact with friends and family since COVID-19 started-are associated with (1) poor health behaviors (low physical activity, drinks per week, smoking, and poor sleep) in 2020 and (2) perceived worsening of health behaviors (reports of decreased physical activity, increased drinking and smoking, and feeling less rested) since the pandemic started. RESULTS: Infrequent in-person contact was not associated with poor health behaviors. Decreases in in-person contact, on the other hand, were associated with worsening health behaviors. Older adults who reported decreases in in-person contact were more likely to perceive a decrease in physical activity, an increase in drinking, and feeling less rested. Emotional well-being, particularly loneliness compared to anxiety or depressive feelings, partially mediated the relationship between perceived worsening of health behaviors and a decrease in in-person contact with friends, and to a lesser extent, with family. DISCUSSION: Our study suggests that in-person contact may play a distinct role in shaping older adults' well-being during the pandemic.

Age differences in mental health from May through August 2020 among U.S. adults: trajectories and the role of pandemic, lifestyle, and social factors.

Objectives: Using nationally representative data among U.S. adults, we assess age differences in changes in mental health both from 2018 to May 2020 and during the pandemic. We also examine factors explaining age differences in mental health.Methods: We analyzed 2018 General Social Survey data (N = 2,348; age 18-89) and three waves of COVID Response Tracking Study data (N = 2,279; age 20-94) spanning May-August 2020. Outcomes included happiness, loneliness, stress, positive affect, and negative affect.Results: U.S. adults reported greater loneliness and less happiness in May 2020 versus 2018. Only loneliness and negative affect changed significantly from May to August 2020, showing declines. Mental health trajectories did not differ significantly by age. Overall, older adults reported lower loneliness, stress, and negative affect than younger adults during 2020. Older age was associated with two factors linked with better mental health: less likelihood of COVID-19 exposure and greater satisfaction with social activities and relationships. However, none of the factors examined herein explained age differences in mental health.Conclusion: Although mental health trajectories during the pandemic were similar across ages, older adults tended to report better mental health than younger adults. Future research should identify factors that explain age differences in mental health that persisted into 2020.

Healthy versus unhealthy comfort eating for psychophysiological stress recovery in low-income Black and Latinx adults.

Low-income Black and Latinx individuals are disproportionately vulnerable to chronic stress and metabolic disease. Evidence suggests that these populations engage in elevated levels of comfort eating (i.e., eating comforting food to alleviate stress), which can harm diet quality. For this reason, many interventions discourage comfort eating. However, if comfort eating does indeed buffer stress, it may be a protective health behavior, particularly if healthy foods (e.g., strawberries) buffer stress as effectively as traditional unhealthy comfort foods (e.g., brownies). By choosing healthy foods, people may be able to simultaneously improve their nutrition and reduce their stress levels, both of which have the potential to reduce health disparities among chronically stressed populations. The present study tested the efficacy of healthy and unhealthy comfort eating for improving psychophysiological stress recovery. A sample of low-income Black and Latinx individuals (N = 129) were randomly assigned to consume a healthy food (e.g., grapes), unhealthy comfort food (e.g., chips), or no food after exposure to a laboratory stressor. Throughout, we measured participants' psychophysiological stress responses, including self-reported stress, rumination, autonomic nervous system activation (i.e., electrodermal activity (EDA), heart rate variability (HRV)) and neuroendocrine responses (i.e., salivary cortisol). We compared participants' stress recovery trajectories by condition and found no significant group differences (p = 0.12 for self-reported stress; p = 0.92 for EDA; p = 0.22 for HRV, p = 1.00 for cortisol). Participants in all conditions showed decreases in self-reported stress and in cortisol post-stressor (ps < 0.01), but rates of decline did not differ by condition (i.e., healthy or unhealthy comfort food, brief no-food waiting period). Although null, these results are important because they challenge the widely-held assumption that comfort foods help people decrease stress.

Home alone together: Differential links between momentary contexts and real-time loneliness among older adults from Chicago during versus before the COVID-19 pandemic.

Studies show that older adults were lonelier during versus before the COVID-19 pandemic. This may be due in part to guidelines particularly recommending that older adults stay at home, given their elevated risk of COVID-19 complications. However, little is known about the extent to which this population experienced greater intensity in momentary loneliness during versus before the pandemic, and how this relates to their real-time contexts. Here, we build upon recent findings from the Chicago Health and Activity Space in Real-Time (CHART) study that revealed associations between momentary contexts and loneliness among older adults. We analyze ecological momentary assessments (EMAs) from both pre- and during COVID-19 among a subsample of CHART respondents (N = 110 older adults age 65-88 in 2020). Pre-pandemic data were collected across three waves from April 2018-October 2019, and pandemic data were collected across three additional waves from June-September 2020. Participants responded to smartphone "pings" (five per day for 7 days per wave; N = 5596 and N = 7826 before and during the pandemic, respectively) by reporting their momentary loneliness and context (e.g., home). Findings from multi-level regression models suggest that respondents were lonelier in mid-2020 than in years prior, as well as when at home and alone; they were also more likely to be at home during the pandemic. However, the loneliness-inducing effects of being at home (vs. outside the home) and alone (vs. with others) were weaker during versus before COVID-19. Results provide important nuance to broader trends in loneliness among older adults during the pandemic. Specifically, older adults may have adopted new technologies to support social connectedness. It is also possible that, during a time in which social and physical distancing characterized public health guidelines, these contexts grew less isolating as they became a shared experience, or that publicly shared spaces provided fewer opportunities for social engagement.

A Pavlovian Intervention to Condition Comforting Effects of Fruits.

OBJECTIVE: Perceived stress, lower fruit intake, and comfort eating are all risk factors for chronic disease. The present pilot study aimed to simultaneously mitigate all three risk factors by applying Pavlovian conditioning to change the nature of comfort eating. Specifically, stressed participants underwent a Pavlovian conditioning intervention designed to elicit comforting effects of fruit intake and thereby reduce negative mood while promoting fruit intake. METHODS: We developed a seven-dose Pavlovian conditioning intervention wherein participants temporally paired together Progressive Muscle Relaxation (unconditioned stimulus) with fruit intake (conditioned stimulus) daily for 1 week. Participants (N = 100, mean [standard deviation] age = 20.7 [4.6] years; 74% female) with moderate to high levels of baseline perceived stress were randomized to the intervention or an active explicitly unpaired control group, wherein the Progressive Muscle Relaxation and fruit intake also occurred but were not temporally paired together. After the intervention, participants' negative mood was assessed immediately before and after fruit intake to assess conditioning effects. Then, participants logged their regular food intake for 4 days using the MyFitnessPal smartphone app. RESULTS: After the intervention, fruit intake acutely improved negative mood to a greater extent among the intervention versus control group (F(1,98) = 3.99, p = .048, = 0.039). However, there was not a significant between-group difference in intake of fruit or traditional comfort foods at postintervention. CONCLUSIONS: Repeated pairing of fruit intake with a reliable distress-reducing activity led to the conditioning of comforting effects of fruit intake. Further refinement of the intervention design is necessary to translate this conditioned association to actual intake of fruit and other foods.

Momentary loneliness among older adults: Contextual differences and their moderation by gender and race/ethnicity.

RATIONALE: Studies suggest that loneliness is associated with age. Among older adults, women and Black adults may be at greater risk than men and White adults, respectively. Social and physical contexts are also linked with loneliness. However, little is known about whether and how those of different genders and racial/ethnic groups may experience social and physical contexts differently in terms of their real-time loneliness, and the extent to which these differences may be explained by differential exposure or reactivity to contexts. OBJECTIVE: We examine (1) how momentary loneliness relates to (a) gender and race/ethnicity and (b) social and physical context; and the extent to which gender and racial/ethnic groups may be (2) differentially exposed to loneliness-related contexts and/or (3) differentially reacting to these contexts. METHODS: Using multilevel regressions, we analyzed ecological momentary assessments from 342 community-dwelling U.S. older adults from the Chicago Health and Activity Space in Real Time study. In each of three waves of data collection, smartphone "pings" (five per day for 21 days; n = 12,793 EMAs) assessed loneliness, social context (e.g., alone, with a spouse/partner), and location/physical context (e.g., home, at work). RESULTS: Men consistently reported greater loneliness intensity than women, including after adjusting for momentary physical and social context. Older adults momentarily outside the home and/or not alone were less likely to feel lonely than their counterparts. However, the protective effect of being outside of the home (vs. home) was weaker among women and Black and Hispanic older adults, and the protective effect of being with one or more others (vs. alone) was weaker among women. CONCLUSIONS: Results are among the first to identify contextual effects on real-time loneliness in older adults and how these associations vary by gender and race/ethnicity. Knowledge regarding momentary variation in loneliness may inform future just-in-time adaptive loneliness interventions in older adulthood.

Obesity Status on associations between cancer-related beliefs and health behaviors in cancer survivors: Implications for patient-clinician communication.

OBJECTIVE: Associations between cancer beliefs and health behavior engagement are largely unexplored in cancer survivors, particularly among those with overweight and obesity. We investigated belief-behavior associations for cancer survivors, and whether obesity altered these associations. METHODS: Cancer survivors were identified from the National Cancer Institute HINTS Survey 5 data and classified as having had an obesity-related cancer or not. Linear and multiple logistic regression analyses examined whether cancer risk beliefs and self-efficacy predicted dining out behaviors and physical activity (PA). Restricted analyses were conducted in those with overweight or obesity. RESULTS: Low self-efficacy to take care of one's health was associated with longer sitting time in the overall sample (p = 0.04). In cancer survivors with overweight or obesity, engagement in healthier behaviors was associated with 1) feeling less overwhelmed by cancer risk recommendations and 2) believing that PA or obesity influences cancer development (both p < 0.05). Among those with overweight and obesity, associations between cancer beliefs and health behaviors were not significantly different by cancer type (obesity-related vs. not). CONCLUSIONS: Obesity altered associations between cancer risk beliefs and health behavior engagement from the overall sample. PRACTICE IMPLICATIONS: Weight status may be a useful tailoring factor when delivering health-promoting interventions for cancer survivors.

A mHealth intervention to preserve and promote ideal cardiovascular health in college students: Design and protocol of a cluster randomized controlled trial.

BACKGROUND: Cardiovascular disease (CVD) remains the leading cause of death globally. Seven health factors are associated with ideal cardiovascular health: being a non-smoker; not overweight; physically active; having a healthy diet; and normal blood pressure; fasting plasma glucose and cholesterol. Whereas approximately half of U.S. youth have ideal levels in at least 5 of the 7 components of cardiovascular health, this proportion falls to 16% by adulthood. OBJECTIVE: We will evaluate whether the NUYou cardiovascular mHealth intervention is more effective than an active comparator to promote cardiovascular health during the transition to young adulthood. METHODS: 302 incoming freshmen at a midwest university will be cluster randomized by dormitory into one of two mHealth intervention groups: 1) Cardiovascular Health (CVH), addressing behaviors related to CVD risk; or 2) Whole Health (WH), addressing behaviors unrelated to CVD. Both groups will receive smartphone applications, co-designed with students to help them manage time, interact with other participants via social media, and report health behaviors weekly. The CVH group will also have self-monitoring features to track their risk behaviors. Cardiovascular health will be assessed at the beginning of freshman year and the end of freshman and sophomore years. Linear mixed models will be used to compare groups on a composite of the seven cardiovascular-related health factors. SIGNIFICANCE: This is the first entirely technology-mediated multiple health behavior change intervention delivered to college students to promote cardiovascular health. Findings will inform the potential for primordial prevention in young adulthood. TRIAL REGISTRATION NUMBER: clinicaltrials.gov #NCT02496728.

Cookie or clementine? Psychophysiological stress reactivity and recovery after eating healthy and unhealthy comfort foods.

Many people eat unhealthy foods that are high in calories, fat, or sugar when feeling stressed, yet little is known about whether this unhealthy comfort eating actually comforts. Additionally, prior research has not tested whether healthy comfort eating of fruits and vegetables might also alleviate stress, or whether comfort eating during the stress anticipation phase versus immediately after a stressful event is more beneficial for stress relief. The present experiment tested whether unhealthy and healthy comfort eating reduce acute psychophysiological responses to a socially evaluative stressor. Participants (N = 150 healthy women) underwent the Trier Social Stress Test in the lab and were randomly assigned to one of five conditions according to a 2 (food type: unhealthy vs. healthy) x 2 (eating timing: during stress anticipation vs. after the stressor) + 1 (no food control) between-subjects design. Stress outcomes included mood, cognitive appraisals, rumination, salivary cortisol, heart rate variability, and pre-ejection period. Unhealthy and healthy comfort eating did not dampen reactivity or enhance recovery of psychophysiological stress compared to control, and no differences in reactivity or recovery were found by comfort food type. Findings suggest that by replacing unhealthy comfort foods with fruits and vegetables, women will not be sacrificing any stress-reducing benefits and can inherently improve the quality of their diet while avoiding potential drawbacks of unhealthy comfort eating (e.g., links with abdominal obesity).

Taking a Stand: The Effects of Standing Desks on Task Performance and Engagement.

Time spent sitting is associated with negative health outcomes, motivating some individuals to adopt standing desk workstations. This study represents the first investigation of the effects of standing desk use on reading comprehension and creativity. In a counterbalanced, within-subjects design, 96 participants completed reading comprehension and creativity tasks while both sitting and standing. Participants self-reported their mood during the tasks and also responded to measures of expended effort and task difficulty. In addition, participants indicated whether they expected that they would perform better on work-relevant tasks while sitting or standing. Despite participants' beliefs that they would perform worse on most tasks while standing, body position did not affect reading comprehension or creativity performance, nor did it affect perceptions of effort or difficulty. Mood was also unaffected by position, with a few exceptions: Participants exhibited greater task engagement (i.e., interest, enthusiasm, and alertness) and less comfort while standing rather than sitting. In sum, performance and psychological experience as related to task completion were nearly entirely uninfluenced by acute (~30-min) standing desk use.

Comfort eating, psychological stress, and depressive symptoms in young adult women.

Little is known about whether comfort eating actually functions to reduce psychological stress. In addition, the effectiveness of comfort eating may be particularly relevant in the context of depression, but no study has tested whether comfort eating processes might depend on severity of depressive symptomology. This study tested 1) whether greater comfort eating statistically buffers the relationship between adverse life events and perceived psychological stress at age 18-19, and 2) whether potential stress-buffering effects may differ by level of depressive symptoms. These relationships were examined in the NHLBI Growth and Health Study, comprising 2379 young adult women. Participants self-reported experiences with adverse life events, their perceived psychological stress, and whether they tended to eat more while experiencing certain negative emotions. As hypothesized, the relationship between adverse life events and perceived stress depended on comfort eating status (p = .033). The effect of adverse events on perceived stress was attenuated among comfort eaters compared to non-comfort eaters (p = .004), but this buffering effect was not shown in participants with an elevated level of depressive symptoms. In conclusion, among young adult women without high depressive symptoms, comfort eaters may experience reduced perceived stress compared to those who do not engage in this behavior. Intervention researchers should also consider the possible benefits of comfort eating.

An experimental field study of weight salience and food choice.

Laboratory research has found that individuals will consume more calories and make unhealthy food choices when in the presence of an overweight individual, sometimes even regardless of what that individual is eating. This study expanded these laboratory paradigms to the field to examine how weight salience influences eating in the real world. More specifically, we tested the threshold of the effect of weight salience of food choice to see if a more subtle weight cue (e.g., images) would be sufficient to affect food choice. Attendees (N = 262) at Obesity Week 2013, a weight-salient environment, viewed slideshows containing an image of an overweight individual, an image of a thin individual, or no image (text only), and then selected from complimentary snacks. Results of ordinal logistic regression analysis showed that participants who viewed the image of the overweight individual had higher odds of selecting the higher calorie snack compared to those who viewed the image of the thin individual (OR = 1.77, 95% CI = [1.04, 3.04]), or no image (OR = 2.42, 95% CI = [1.29, 4.54]). Perceiver BMI category did not moderate the influence of image on food choice, as these results occurred regardless of participant BMI. These findings suggest that in the context of societal weight salience, weight-related cues alone may promote unhealthy eating in the general public.

Weight bias in 2001 versus 2013: contradictory attitudes among obesity researchers and health professionals.

OBJECTIVES: To assess levels of two types of anti-fat bias in obesity specialists, explicit bias, or consciously accessible anti-fat attitudes, and implicit bias, or attitudes that are activated outside of conscious awareness, were examined. This study also assessed changes over time by comparing levels of bias in 2013 to published data from 2001. METHODS: In 232 attendees at the ObesityWeek 2013 conference, we measured explicit anti-fat bias and conducted the Implicit Association Test. These data were compared to those from a study conducted at the 2001 meeting of this group. RESULTS: Participants exhibited significant implicit and explicit anti-fat/pro-thin bias. Positivity of professional experience with obesity, but not type of professional experience, was correlated with lower explicit anti-fat bias. Compared to 2001, the 2013 sample had lower levels of implicit bias and higher levels of explicit bias. CONCLUSIONS: Although implicit anti-fat attitudes appeared to decrease from 2001 to 2013, explicit anti-fat attitudes increased. Future research should examine whether increasing positive experiences with obese patients reduces anti-fat bias among health professionals. Together, these results suggest that despite the current climate of widespread anti-fat bias, there are pathways toward understanding and ameliorating this bias.