Diet and lifestyle factors associated with cognitive performance in college students.

ObjectiveEngaging in a healthy diet and positive lifestyle behaviors have been shown to improve cognitive functioning in children and older adults, however, few have examined these factors in college-aged students. Participants: A diverse sample of 115 college students were recruited on two university campuses. Method: Completed computerized cognitive testing and an online survey about diet and lifestyle behaviors. Results: All analyses were conducted with Pearson's correlations. Higher fruit consumption was correlated with better visual memory scores. Higher seafood consumption was correlated with better learning performance. Increased fast food consumption was correlated with poorer executive functioning in resident students and poorer visual memory performance in commuter students. Increased fluid intake on testing day was correlated with better visual memory and better verbal memory performance. Conclusions: Behavioral changes such as increasing hydration, eating more fruit and fish, and eating less fast food may improve cognitive performance in college students.

Correction to: A Perfect Storm? Health Anxiety, Contamination Fears, and COVID-19: Lessons Learned from Past Pandemics and Current Challenges.

[This corrects the article DOI: 10.1007/s41811-021-00109-7.].

A Perfect Storm? Health Anxiety, Contamination Fears, and COVID-19: Lessons Learned from Past Pandemics and Current Challenges.

The novel coronavirus disease 2019 (COVID-19) rapidly spread, becoming a global pandemic with significant health, economic, and social impacts. COVID-19 has caused widespread anxiety, which at healthy levels leads to adaptive, protective behavioral changes. For some individuals, a pandemic outbreak can lead to excessive, maladaptive levels of anxiety, particularly among those with obsessive-compulsive disorder (OCD) and health anxiety. In the present paper, we review past research studies that examined anxiety in response to other disease outbreaks (including Swine Flu, Zika, and Ebola) to serve as a guide for expectable responses to COVID-19. Our review focused on the role of belief-based cognitive variables (obsessive beliefs, contamination cognitions), transdiagnostic processes (disgust sensitivity, anxiety sensitivity, an intolerance of uncertainty), social factors, and environmental/situational variables as contributing factors to excessive concerns about past pandemics. These factors in combination with unique characteristics of the virus (disease, behavioral, social and economic factors) and media consumption might enhance vulnerability to excessive anxiety about COVID-19, in line with a diathesis-stress model. COVID-19 is also unique from past pandemics due to its severity, easy transmissibility, and the nature of prescribed behavioral responses (i.e., hand washing and social distancing). We therefore discuss the ways in which COVID-19 may disproportionately affect individuals with OCD and health anxiety. We conclude with important topics for clinical and research attention to help mental health professionals respond in this time of crisis.

Optimal defaults as a strategy to improve selections from children's menus in full-service theme park dining.

An "optimal default" refers to a pre-selected default option that promotes an outcome intended to be favorable to the individual and/or society at large. Optimal defaults preserve the decision-maker's ability to opt-out of the default and choose an alternative option. This behavioral economics strategy has been shown to nudge both child and adult consumers toward healthier food selections. Full-service restaurants with children's menus are key settings for implementing this approach. The current field study manipulated children's menus at two theme park restaurants, testing the effects of three different item presentations (i.e., lower-energy-dense default, standard fare default, and free array menus). Each menu was presented to consumers for 1 week at a time, in random order. Full choice was preserved with all menu options appearing across conditions, with non-default items listed as available upon request. The restaurants tracked food orders during each of the three weeks. Results showed that positioning lower-energy-dense foods as default menu choices increased the likelihood of lower-energy-dense menu selections and decreased the likelihood that customers would "opt-out" for standard fare. There were also significant differences in total caloric value of food ordered across conditions, with the optimal default menu condition promoting the lowest potential energy intake. This study further supports the effectiveness of optimal defaults to increase healthy food choices for children.

Vegans report less bothersome vasomotor and physical menopausal symptoms than omnivores.

OBJECTIVES: Lifestyle modifications that may reduce menopausal symptoms have generated much interest. The vegetarian diet has been associated with a lower risk of chronic disease as well as a more healthy hormonal milieu. Our objective in this cross-sectional study was to survey peri- and postmenopausal women to investigate menopausal symptoms and dietary pattern. STUDY DESIGN: Survey distribution in 2015-2016 was aimed at female vegans, vegetarians, and omnivores between the ages of 45 and 80 years, who were active on senior and vegetarian social networking websites and at vegan restaurants and events. MAIN OUTCOME MEASURES: We investigated vasomotor and physical symptoms as measured by the Menopause-specific Quality of Life Questionnaire (MENQOL) and dietary pattern classified by animal protein intakes reported in response to food frequency questions. RESULTS: Out of 754 participants who completed the survey, 604 reported they were perimenopausal (n = 121) or postmenopausal (n = 483), of whom 539 also completed the food frequency questions. We compared vasomotor and physical symptoms in omnivores (n = 304, consumed meat and/or poultry at least monthly) and vegans (n = 125, abstained from all animal proteins) using general linear models; covariates included age, exercise, hormone replacement therapy, presence of reproductive organs, and age at menopause. Among perimenopausal women, vegans reported less bothersome vasomotor (p < 0.01) and physical symptoms (p < 0.01) than omnivores. For both symptom types, more vegetables and less flesh food were associated with less bothersome symptoms (p values < 0.05). CONCLUSION: Eating a plant-based diet may be helpful for women in menopausal transition who prefer a natural means to manage their symptoms.

The Application of Optimal Defaults to Improve Elementary School Lunch Selections: Proof of Concept.

BACKGROUND: In this study, we applied behavioral economics to optimize elementary school lunch choices via parent-driven decisions. Specifically, this experiment tested an optimal defaults paradigm, examining whether strategically manipulating the health value of a default menu could be co-opted to improve school-based lunch selections. METHODS: The design was a randomized comparison of optimal versus suboptimal (standard) default lunch menus for all first-graders in a school district for a period of 1 week. We hypothesized that making the default lunch option healthier, while providing parents the opportunity to access and choose from the standard school menu for their child, would yield more frequent selection of healthier items than when the default option was suboptimal. RESULTS: Overall, 127 (93%) first-grade children's families participated. Among those families randomized to receive the nutritionally optimized default menu, all but one remained with these options; of those parents randomized to the standard menu (suboptimal default), all parents remained with these options (Χ2 = 123.06, df = 1, p < .001). CONCLUSIONS: The mere positioning of choices, without restricting options, significantly affected which menu items the children received during the test period. Results are proof of concept for a strategy to increase health-promoting school lunch content, procedures, and policies.

Effect of default menus on food selection and consumption in a college dining hall simulation study.

OBJECTIVE: To test an obesity prevention strategy derived from behavioural economics (optimal defaults plus delay), focused on changing the college dining hall service method. DESIGN: After a uniform pre-load, participants attended an experimental lunch in groups randomized to one of three conditions: a nutrient-dense, lower-fat/energy lunch as an optimal default (OD); a less-nutrient-dense, higher-fat/energy lunch as a suboptimal default (SD); or a free array (FA) lunch. In the OD condition, students were presented a menu depicting healthier vegetarian and omnivore foods as default, with opt-out alternatives (SD menu) available on request with a 15 min wait. In the SD condition, the same menu format was used with the positioning of food items switched. In the FA condition, all choices were presented in uniform fonts and were available immediately. SETTING: Private rooms designed to provide a small version of a college dining hall, on two campuses of a Northeastern US university. SUBJECTS: First-year college students (n 129). RESULTS: There was a significant main effect for condition on percentage of optimal choices selected, with 94 % of food choices in the OD condition optimal, 47 % in the FA condition optimal and none in the SD condition optimal. Similarly, energy intake for those in the SD condition significantly exceeded that in the FA condition, which exceeded that in the OD condition. CONCLUSIONS: Presenting menu items as optimal defaults with a delay had a significant impact on choice and consumption, suggesting that further research into its long-term applicability is warranted.

The application of defaults to optimize parents' health-based choices for children.

Optimal defaults is a compelling model from behavioral economics and the psychology of human decision-making, designed to shape or "nudge" choices in a positive direction without fundamentally restricting options. The current study aimed to test the effectiveness of optimal (less obesogenic) defaults and parent empowerment priming on health-based decisions with parent-child (ages 3-8) dyads in a community-based setting. Two proof-of-concept experiments (one on breakfast food selections and one on activity choice) were conducted comparing the main and interactive effects of optimal versus suboptimal defaults, and parent empowerment priming versus neutral priming, on parents' health-related choices for their children. We hypothesized that in each experiment, making the default option more optimal will lead to more frequent health-oriented choices, and that priming parents to be the ultimate decision-makers on behalf of their child's health will potentiate this effect. Results show that in both studies, default condition, but not priming condition or the interaction between default and priming, significantly predicted choice (healthier vs. less healthy option). There was also a significant main effect for default condition (and no effect for priming condition or the interaction term) on the quantity of healthier food children consumed in the breakfast experiment. These pilot studies demonstrate that optimal defaults can be practicably implemented to improve parents' food and activity choices for young children. Results can inform policies and practices pertaining to obesogenic environmental factors in school, restaurant, and home environments.

Adherence as a predictor of weight loss in a commonly used smartphone application.

As adherence to weight loss interventions has been shown in prior research to be crucial in achieving weight reduction, we were interested in examining whether this held true for individuals attempting to lose weight using smartphone applications. Archived data from an international community sample of 7633 overweight men and women using Noom, a smartphone-based behavioural weight loss program, were used to test the hypotheses that there would be significant weight loss after using the application for three months and that greater self-monitoring adherence would be positively associated with weight loss outcomes. An average 1.92 BMI points were lost after using Noom for three months, and for every 10% increase in adherence there was a decrease of 2.59 BMI points (ß=-1.36kg, SE=.24, p<.001). Our results provide preliminary evidence suggesting that smartphone application use is linked to significant short-term weight loss and that this weight loss is associated with adherence.

Feeding Strategies Derived from Behavioral Economics and Psychology Can Increase Vegetable Intake in Children as Part of a Home-Based Intervention: Results of a Pilot Study.

BACKGROUND: Behavioral economics and psychology have been applied to altering food choice, but most studies have not measured food intake under free-living conditions. OBJECTIVES: To test the effects of a strategy that pairs positive stimuli (ie, stickers and cartoon packaging) with vegetables and presents them as the default snack. DESIGN: A randomized controlled trial was conducted with children who reported consumption of fewer than two servings of vegetables daily. Children (aged 3 to 5 years) in both control (n=12) and treatment (n=12) groups received a week's supply of plainly packaged (ie, generic) vegetables, presented by parents as a free choice with an alternative snack (granola bar), during baseline (Week 1) and follow-up (Week 4). During Weeks 2 and 3, the control group continued to receive generic packages of vegetables presented as a free choice, but the treatment group received vegetables packaged in containers with favorite cartoon characters and stickers inside, presented by parents as the default choice. Children in the treatment group were allowed to opt out of the vegetables and request the granola bar after an imposed 5-minute wait. STATISTICAL ANALYSIS: General Linear Model repeated measures analysis of variance was conducted to compare vegetable and granola bar intake between control and treatment groups across the 4-week study. Both within- and between-subjects models were tested. RESULTS: A time×treatment interaction on vegetable intake was significant. The treatment group increased vegetable intake from baseline to Week 2 relative to control (P<0.01), but the effects were not sustained at Week 4 when the treatment was removed. Granola bar intake decreased in the treatment group at Week 2 (P≤0.001) and Week 3 (P≤0.005) relative to baseline. CONCLUSIONS: Parents were able to administer feeding practices derived from behavioral economics and psychology in the home to increase children's vegetable intake and decrease intake of a high-energy-density snack. Additional studies are needed to test the long-term sustainability of these practices.

Investigation of lifestyle choices of individuals following a vegan diet for health and ethical reasons.

The proportion of individuals choosing to follow a vegan diet has increased in recent years. The choice is made for different reasons, primarily concern for animals (ethics) and health, which may impact both specific food choices and other lifestyle behaviors linked to health outcomes. To determine the extent to which the reason for following a vegan diet was associated with health behaviors, we conducted an online survey recruiting an international sample of 246 individuals who reported adhering to a vegan diet. We hypothesized that compared to those following the diet for ethical reasons, those doing so for health reasons would consume foods with higher nutritional value and engage in other healthier lifestyle behaviors. Our hypotheses were partially supported in that those citing health reasons (n = 45) reported eating more fruit (U = 3503.00, p = 0.02) and fewer sweets (U = 3347.00, p <0.01) than did those citing ethical reasons (n = 201). Individuals endorsing ethical reasons reported being on the diet longer (U = 3137.00, p <0.01), and more frequent consumption of soy (U = 2936.00, p <0.01), foods rich in vitamin D (U = 3441.00, p = 0.01), high-polyphenol beverages (U = 3124.50, p <0.01), and vitamin supplements (vitamin D: χ(2)=4.65, p = 0.04; vitamin B12: χ(2)=4.46, p = 0.03) than did those endorsing health reasons. As these factors may affect outcome in studies investigating the impact of vegan diets on health, they should be taken into account when studying persons following a vegan diet.

Vegans report less stress and anxiety than omnivores.

OBJECTIVE: Studies investigating mood in vegetarian diets have yielded conflicting results, either demonstrating risk for mental disorders or mood protection. Our objective was to investigate mood, as well as factors that potentially impact mood in vegans (VG), vegetarians (VEG), and omnivores (OMN). METHODS: We surveyed mood, diet, and lifestyle factors in a broad geographic online sample of adult VG (n = 283), VEG (n = 109), and OMN (n = 228) who were recruited via diet-related social networks. Mood was measured with the Depression Anxiety Stress Scale-21 (DASS-21). RESULTS: The sample was mostly female (78.5%), and age was inversely correlated with all DASS scores (p < 0.05). Mean DASS-A (anxiety) and DASS-S (stress) scores differed by group (F(2,616) = 4.73, p = 0.009, η(2) = 0.015, and F(2, 615) = 8.23, p < 0.001, η(2) = 0.026, respectively), with VG scores lower than OMN scores, indicating less mood disturbance. Analyses of covariance were conducted by gender, adjusting for age. Anxiety scores were different in males only (F(2,128) = 5.39, p = 0.006, η(p)(2) = 0.078) and lower anxiety in males was related to a vegan diet and daily fruit and vegetable intake. Mean stress scores were different in females only (F(2,476) = 3.82, p = 0.023, η(p)(2) = 0.016) and lower stress in females was related to a vegan diet and lower daily intake of sweets. DISCUSSION: A strict plant-based diet does not appear to negatively impact mood, in fact, reduction of animal food intake may have mood benefits. The improved mood domains were not consistent with those found in other studies, which may be due to methodological differences.

Child disinhibition, parent restriction, and child body mass index in low-income preschool families.

OBJECTIVE: To examine both unique and interactive effects of parent restrictive feeding and child disinhibited eating behavior on child body mass index (BMI) in low-income Latino and African American preschoolers. METHODS: The sample included 229 parent-child pairs, the majority of whom were low-income and Latino (57%) or African American (25%). Parents completed self-report measures, and researchers collected anthropometric data. RESULTS: Multiple regression analysis indicated a restriction-disinhibition interaction; high restriction/high disinhibition predicted higher BMI, and high restriction/low disinhibition predicted lower BMI. CONCLUSIONS AND IMPLICATIONS: Although limited by the observational, cross-sectional design, results indicate that parent and child behaviors interact to produce maladaptive weight outcomes, and practitioners should consider both when counseling families.

Optimal Defaults in the Prevention of Pediatric Obesity: From Platform to Practice.

The term "optimal defaults" refers to imparting pre-selected choices which are designed to produce a desired behavior change. The concept is attractive to policymakers because it steers people toward desirable behaviors while preserving free choice through the ability to opt out. It has been found to be a powerful behavioral determinant in areas such as pension plan enrollment, organ donation, and green energy utilization. We discuss how optimal defaults can be applied to pediatric obesity prevention in several domains including public policy, institutional, private sector, and home environment. Although there are obstacles to overcome in implementing optimal defaults, it is a promising component to incorporate in a multi-level strategy for preventing pediatric obesity.

Confirmatory factor analysis of the Children's Eating Behaviour Questionnaire in a low-income sample.

Although pediatric obesity is prevalent in low-income and African American and Hispanic communities, validated measures of child eating habits are lacking for these communities. In this study, confirmatory factor analysis was used to validate the hypothesized 7-factor structure of the Children's Eating Behaviour Questionnaire (CEBQ). The sample included 229 parent-child pairs, the majority low-income and Hispanic (57%) or African American (25%). The a priori structure of the CEBQ failed to replicate. Exploratory factor analysis revealed 3 factors: Disinhibition, Food interest, and Undereating, none predicting child BMI. Although limited by the observational, cross-sectional design, results indicate that the CEBQ needs additional study.

The role of family variables in fruit and vegetable consumption in pre-school children.

ABSTRACT: Most Americans, including children, continue to eat fewer fruit and vegetables than is recommended, putting themselves at increased risk of various health conditions. The aim of this study was to evaluate the relative importance of several family environment variables (food availability and accessibility, modelling of food consumption, parenting style, and family mealtime environment) in predicting children's consumption of fruit and vegetables in a sample of pre-school children from low income, predominantly ethnic minority families. Two hundred and twenty-nine primary caregivers and their pre-school children were recruited from Head Start programmes in New York and New Jersey. Caregivers gave their consent to the study, completed a series of paper and pencil questionnaires, and had both their height and weight and their children's height and weight measured. Higher availability, accessibility, and parental modelling were associated with higher consumption of fruit and vegetables in children. Availability and Accessibility were the best predictors, but Parental Modelling significantly enhanced prediction over the other variables. Public health interventions should be geared toward helping poorer families increase the availability of fruit and vegetables in their homes, advising parents on how to make them accessible, and encouraging parents to model their consumption. FUNDING: RLG receives research funding from Covidien.

Food cues in children's television programs.

We examined the nutritional content of and characters' attitudes toward foods depicted in Public Broadcasting System (PBS) television programs aimed at children under age 5. Two-hundred and forty-five episodes from 10 programs were rated, totaling 136 h. There was almost twice the total airtime for depictions of unhealthy (321.03 min) versus healthy (184.72 min) foods, and significantly higher ratings for excessive consumption and valuing (characters' expressions of endorsement) of unhealthy versus healthy foods. Unhealthy foods were shown being valued significantly more than they were shown resulting in negative consequences. Our findings suggest concern for how foods are presented on children's television programs.

An instrument for assessing coping with temptation: psychometric properties of the alcohol abuse coping response inventory.

In the current study, we examined psychometric properties of The Alcohol Abuse Coping Response Inventory (AACRI), a modification of the Coping with Temptation Inventory for recovering alcoholics. It demonstrated good internal reliability. Three internally consistent factors were identified, one behavioral factor, and two cognitive factors. The measure did not demonstrate adequate concurrent validity. As expected, cognitive coping responses were more predictive of later relapse than behavioral coping responses, and a combination of the two was most predictive of later relapse. In the incremental validity analysis, situational confidence was found to be most predictive of relapse outcome, while the AACRI cognitive coping subscale demonstrated adequate incremental validity. The AACRI was found to have incremental validity over the Coping Behaviours Inventory.

The relationship of spinal cord injury trauma to alcohol misuse: a study of monozygotic twins.

BACKGROUND: Substance misuse frequently is correlated with serious trauma such as spinal cord injury (SCI). Two hypotheses to this effect are (a) substance abuse predates injury and is a risk factor or trigger for serious injury such as SCI; or (b)substance abuse begins postinjury, and alcohol or other drugs are used to ameliorate the physical and emotional distress that result from SCI. METHODS: To test these two hypotheses, 1 4 pairs of monozygotic twins, in which 1 of each pair had sustained an SCI, were studied. The twin without SCI was used as a control for preinjury substance misuse status for the twin with SCI. RESULTS: No significant differences between SCI and non-SCI co-twins' substance use patterns were found. CONCLUSION: These findings suggest that drinking patterns might not be significantly affected by SCI and that substance misuse might precede injury.