Orthorexia Nervosa and Healthy Orthorexia in a Physically Active North American Population.

The Teruel Orthorexia Scale (TOS) defines two related but distinct constructs: Orthorexia Nervosa (OrNe), a pathological fixation on a healthy diet, and Healthy Orthorexia (HeOr), an interest in a healthy diet independent of psychopathology. Here, we (a) assessed both types of Orthorexia in a large North American sample using the TOS and (b) explored if engaging in regular physical activity was associated with a greater risk of Orthorexia. A cohort of physically active adults (n = 927; 41% men) completed the TOS, as well as the Rapid Assessment of Physical Activity (RAPA), to broadly assess aerobic physical activity level and participation in strength and/or flexibility training. As expected, scores for HeOr and OrNe differed between participants, with lower scores for Orthorexia Nervosa in our physically active non-clinical sample. Higher HeOr scores were associated with lower BMI, and this was true for both men and women. We also found that measures of Orthorexia were associated with self-reported physical activity: active adults reporting more aerobic physical activity had higher HeOr scores, with the most active men having the highest scores. Notably, adults who reported regular strength training had higher scores for both HeOr and OrNe, with men who strength trained showing higher OrNe scores than women. Here, those who participate in regular strength training are more likely to exhibit orthorexic behaviors, and this effect was more pronounced for men than women. Prior work has validated the TOS in young, primarily female samples of non-English speakers outside the United States: present data from an age-diverse, physically active, gender balanced sample support the use of TOS for measurement of Orthorexia Nervosa and Healthy Orthorexia in English speakers and suggest that more work is needed to assess potential gender differences in these constructs.

Food and non-alcoholic beverage marketing in children and adults: A systematic review and activation likelihood estimation meta-analysis of functional magnetic resonance imaging studies.

Food marketing impacts the food behaviors of children and adults, but the underpinning neural mechanisms are poorly understood. This systematic review and meta-analysis pooled evidence from neuroimaging studies of exposure to food marketing stimuli (vs. control) on brain activations in children and adults to clarify regions associated with responding. Databases were searched for articles published to March 2022. Inclusion criteria included human functional magnetic resonance imaging (fMRI) studies employing a contrast between a food marketing stimulus and a non-food/non-exposure control, published in English in a peer-reviewed journal, reporting whole brain (not Region of Interest [ROI] only) co-ordinates. Eleven studies met inclusion criteria, of which eight were included in the quantitative synthesis (Activation Likelihood Estimation [ALE] meta-analysis). Food marketing exposures (vs. controls) produced greater activation in two clusters lying across the middle occipital gyrus, lingual gyrus, and cuneus (cluster 1), and the postcentral gyrus, precentral gyrus, and the inferior parietal lobule/supramarginal gyrus (cluster 2). Brain responses to food marketing are most consistently observed in areas relating to visual processing, attention, sensorimotor activity, and emotional processing. Subgroup analyses (e.g., adults vs. children) were not possible because of the paucity of data, and sensitivity analyses highlighted some instability in the clusters; therefore, conclusions remain tentative pending further research.

What Is Food Noise? A Conceptual Model of Food Cue Reactivity.

As GLP-1 receptor agonists, like semaglutide, emerge as effective treatments for weight management, anecdotal reports from patients and clinicians alike point to a reduction in what has been colloquially termed "food noise", as patients report experiencing less rumination and obsessive preoccupation about food. In this narrative review, we discuss concepts used in studies to investigate human eating behavior that can help elucidate and define food noise, particularly food cue reactivity. We propose a conceptual model that summarizes the main factors that have been shown to determine the magnitude of the reactivity elicited by external and internal food cues and how these factors can affect short- and long-term behavioral and clinical outcomes. By integrating key research conducted in this field, the Cue-Influencer-Reactivity-Outcome (CIRO) model of food cue reactivity provides a framework that can be used in future research to design studies and interpret findings related to food noise and food cue reactivity.

Portion size affects food selection in an immersive virtual reality buffet and is related to measured intake in laboratory meals varying in portion size.

A crucial step for validating the utility of an immersive virtual reality (iVR) buffet to study eating behavior is to determine whether variations in food characteristics such as portion size (PS) are relevant predictors of food selection in an iVR buffet. We tested whether manipulating PS in an iVR buffet affects the weight of food selected, and whether this response to PS is similar to participants' measured intake when PS varies at laboratory meals. In a randomized crossover design, 91 adults (18-71 y; 64 females; BMI = 25.3 ± 5.7) used their iVR remote to select lunch and dinner portions from an iVR buffet before consuming a standardized lab meal at two visits separated by one week. The PS in the iVR buffet and lab meals varied between a standard PS and a large PS. This design enabled comparisons of PS effects between iVR and lab settings, despite the scale difference in food weight between the environments. Portion size significantly affected food selection and food intake (p < 0.001). Subjects selected an additional 350 g in iVR and consumed an additional 154 g of food in the lab meals when offered the large portion compared to the small portion. The effect of PS showed a similar percentage increase in iVR (36.5%) and lab meals (39.2%). There was no significant difference in the effect of PS between iVR and lab meals after accounting for scale differences in food weight between the environments. The response to PS was not influenced by subject characteristics such as body mass index, sex, or age. These results demonstrate the utility of iVR for replicating real-world eating behaviors and enhancing our understanding of the intricate dynamics of food-related behaviors in a variety of contexts.

The development of an immersive mixed-reality application to improve the ecological validity of eating and sensory behavior research.

Introduction: The modern eating environment has been implicated as a driving force of the obesity epidemic. Mixed reality applications may improve traditional methodological assessments of eating behavior by improving the ecological validity of the laboratory setting. Methods: Research experts evaluated the utility and ecological validity of a mixed reality application that allowed immersion within virtual environments through utilizing the passthrough cameras of the head mounted display to view and interact with real foods. An initial evaluation was conducted that involved three virtual environments: a traditional laboratory booth, a non-textured restaurant, and a full-textured restaurant. The feedback from the initial evaluation was used to create a new virtual restaurant environment and a subsequent evaluation was conducted. Results: Nearly all research experts suggested adding social cues such as people and background noise to create a more authentic and ecologically valid experience. The experts scored the new virtual restaurant environment to be more acceptable than eating or conducting research in a sensory booth but scored lower when compared to conducting research in a real-world restaurant setting. Discussion: The results of this evaluation suggest that mixed reality applications may be a new methodology to assess environmental influences of eating behavior and may be a promising direction for eating behavior and sensory science research.

Psychometric Analysis of the Rapid Eating Assessment for Participants-Short Form to Evaluate Dietary Quality in a Pre-Surgical Bariatric Population.

Dietary quality and eating behaviors are essential to evaluating bariatric surgery candidates. The Rapid Eating Assessment for Participants-Short Form (REAP-S) is a previously validated measure of dietary quality suited for use in primary care. This study aimed to evaluate the psychometric properties of the REAP-S in a pre-surgical bariatric population. This study included data from one academic medical center from August 2020 to August 2022. Variables included socio-demographics, the REAP-S, mental health, and assessments of appetitive traits. Statistical methods included Cronbach's alpha, confirmatory factor analysis (CFA), and multivariable analyses. A total of 587 adult patients were included in this analysis. The mean score for the REAP-S was 28.32 (SD: 4.02), indicative of relatively moderate dietary quality. The internal consistency of the REAP-S was moderate, with a Cronbach's alpha of 0.65. The three-factor CFA model resulted in a comparative fit index of 0.91. Race (p = 0.01), body mass index (p = 0.01), food fussiness (p < 0.0001), food responsiveness (p = 0.005), and socially desirable responses (p = 0.003) were significantly associated with the total REAP-S score. Although the REAP-S's original purpose was to assess dietary quality within a primary care population, it shows promise for application within a bariatric surgery-seeking population.

Associations between behavioral self-regulation and external food cue responsiveness (EFCR) in preschool-age children and evidence of modification by parenting style.

Decreased behavioral regulation is hypothesized to be a risk factor for excess weight gain among children, possibly via reduced appetite-specific regulation. Little research has specifically focused on behavioral regulation and food cue responsiveness, a conditioned precursor to eating, at a young age. This study examined the association between behavioral regulation and external food cue responsiveness among preschool-age children and explored if a more structured parenting style moderated that association. Baseline data from a prospective study on media use among preschool-age children (n = 83) in Northern New England were used. Parents reported on three domains of children's behavioral regulation (attentional focusing, inhibitory control, and emotional self-regulation), the children's external food cue responsiveness (EFCR), and their parenting styles (authoritative and permissive) via validated questionnaires. Mean age among children was 4.31 (SD 0.91) years, 57% of children were male, 89% were non-Hispanic white, and 26.2% had overweight or obesity. In a series of adjusted linear regression models, lower attentional focusing (standardized ß, ßs = -0.35, p = 0.001), inhibitory control (ßs = -0.30, p = 0.008), and emotional self-regulation (standardized beta, ßs = -0.38, p < 0.001) were each significantly associated with greater EFCR. In exploratory analyses, a more structured parenting style (more authoritative or less permissive) mitigated the associations between inhibitory control and EFCR (Bonferroni-adjusted p-interaction < 0.017). Findings support that lower attentional focusing, inhibitory control, and emotional self-regulation relate to greater ECFR in preschool-age children. The association between inhibitory control and EFCR may be modified by parenting style. Further research is needed to understand if children's responsiveness to external food cues may account for reported associations between lower behavioral regulation and adiposity gain over time.

Corrigendum: Differential neural reward reactivity in response to food advertising medium in children.

[This corrects the article DOI: 10.3389/fnins.2023.1052384.].

Differential neural reward reactivity in response to food advertising medium in children.

Introduction: Food cues including food advertisements (ads) activate brain regions related to motivation and reward. These responses are known to correlate with eating behaviors and future weight gain. The objective of this study was to compare brain responses to food ads by different types of ad mediums, dynamic (video) and static (images), to better understand how medium type impacts food cue response. Methods: Children aged 9-12 years old were recruited to complete a functional magnetic resonance imaging (fMRI) paradigm that included both food and non-food dynamic and static ads. Anatomical and functional images were preprocessed using the fMRIPrep pipeline. A whole-brain analysis and a targeted region-of-interest (ROI) analysis for reward regions (nucleus accumbens, orbitofrontal cortex, amygdala, insula, hypothalamus, ventral tegmental area, substantia nigra) were conducted. Individual neural responses to dynamic and static conditions were compared using a paired t-test. Linear mixed-effects models were then constructed to test the differential response by ad condition after controlling for age, sex, BMI-z, physical activity, and % of kcal consumed of a participant's estimated energy expenditure in the pre-load prior to the MRI scan. Results: A total of 115 children (mean=10.9 years) completed the fMRI paradigm. From the ROI analyses, the right and left hemispheres of the amygdala and insula, and the right hemisphere of the ventral tegmental area and substantia nigra showed significantly higher responses for the dynamic food ad medium after controlling for covariates and a false discovery rate correction. From the whole-brain analysis, 21 clusters showed significant differential responses between food ad medium including the precuneus, middle temporal gyrus, superior temporal gyrus, and inferior frontal gyrus, and all regions remained significant after controlling for covariates. Discussion: Advertising medium has unique effects on neural response to food cues. Further research is needed to understand how this differential activation by ad medium ultimately affects eating behaviors and weight outcomes.

User engagement with a popular food brand before, during and after a multi-day interactive marketing campaign on a popular live streaming platform.

OBJECTIVE: To assess viewer engagement of a food advertising campaign on the live streaming platform Twitch.tv, a social media platform that allows creators to live stream content and communicate with their audience in real time. DESIGN: Observational analysis of chat comments across the Twitch platform containing the word 'Wendy's' or 'Wendys' during a 5-day ad campaign compared with two 5-day non-campaign time periods. Comments were categorised as positive, negative or neutral in how their sentiment pertained to the brand Wendy's. SETTING: Twitch chatrooms. PARTICIPANTS: None. RESULTS: There were significantly more chatroom messages related to the Wendy's brand during the campaign period. When considering all messages, the proportion of messages was statistically different (x2 = 1417·41, P < 0·001) across time periods, with a higher proportion of neutral and positive messages and a lower proportion of negative messages during the campaign compared with the comparison periods. Additionally, the proportion of negative messages following the campaign was lower than before the campaign. When considering only positive and negative messages, the proportion of messages was statistically different (x2 = 366·38, P < 0·001) across each time period with a higher proportion of positive messages and a lower proportion of negative messages during the campaign when compared with the other time periods. Additionally, there was a higher proportion of positive messages and a lower portion of negative messages following the campaign when compared with before the campaign. CONCLUSIONS: This study demonstrates the impact and sustained impact of a fast-food brand ad campaign on brand engagement on the live streaming platform Twitch.

The food and beverage cues in digital marketing model: special considerations of social media, gaming, and livestreaming environments for food marketing and eating behavior research.

Digital marketing to children, teens, and adults contributes to substantial exposure to cues and persuasive messages that drive the overconsumption of energy dense foods and sugary beverages. Previous food marketing research has focused on traditional media, but less is known about how marketing techniques translate within digital platforms, such as social media, livestreaming, and gaming. Building upon previous theories and models, we propose a new model entitled food and beverage cues in digital marketing (FBCDM). The FBCDM model specifies key marking elements and marketing integration strategies that are common on digital platforms and are hypothesized to enhance the effects of advertising and incentive sensitization process. FBCDM also categorizes measurable outcomes into three domains that include brand, food, and social outcomes. Additionally, repeated marketing exposure and the resulting outcomes are hypothesized to have long term consequences related to consumer markets, consumption behavior, culture, and health. We include a discussion of what is currently known about digital marketing exposure within the outcome domains, and we highlight gaps in research including the long-term consequences of digital marketing exposure. The FBCDM model provides a conceptual framework to guide future research to examine the digital marketing of food and beverages to children and adolescents in order to inform government and industry policies that restrict the aggressive marketing of products associated with obesity and adverse diet related outcomes.

Loss of control eating in children is associated with altered cortical and subcortical brain structure.

Introduction: Loss of control (LOC) eating is the perceived inability to control how much is eaten, regardless of actual amount consumed. Childhood LOC-eating is a risk factor for the development of binge-eating disorder (BED), but its neurobiological basis is poorly understood. Studies in children with BED have shown both increased gray matter volume in regions related to top-down cognitive control (e.g., dorsolateral prefrontal cortex) and reward-related decision making (e.g., orbital frontal cortex) relative to healthy controls. However, no studies have examined brain structure in children with LOC-eating. To identify potential neurobiological precursors of BED, we conducted secondary analysis of five studies that conducted T1 MPRAGE scans. Methods: A total of 143, 7-12-year-old children (M = 8.9 years, 70 boys) were included in the study, 26% of which (n = 37) reported LOC-eating (semi-structured interview). Age, sex, and obesity status did not differ by LOC-eating. Differences between children with and without LOC were examined for gray matter volume, cortical thickness, gyrification, sulci depth, and cortical complexity after adjusting for age, sex, total intercranial volume, weight status, and study. Results: Children with LOC, relative to those without, had greater gray matter volume in right orbital frontal cortex but lower gray matter volume in right parahippocampal gyrus, left CA4/dentate gyrus, and left cerebellar lobule VI. While there were no differences in cortical thickness or gyrification, children with LOC-eating had great sulci depth in left anterior cingulate cortex and cuneus and greater cortical complexity in right insular cortex. Discussion: Together, this indicates that children with LOC-eating have structural differences in regions related to cognitive control, reward-related decision-making, and regulation of eating behaviors.

Could dietary creatine intake modulate overweight elderly's selective attention and inhibitory function?

Aims: There is evidence that both aging and increased adiposity may impact creatine levels in the brain, and brain creatine levels are important for cognition. The aim of this study was to assess correlation between dietary creatine intake and cognition in in elderly women with overweight. Methods: Twenty seven overweight women over 60 years of age who were part of a larger study participated in an Eriksen Flanker Task (EFT) to asssess cognitive performance. Additionally, diet was assessed over 5 days via daily diary nutritional recalls and the estimate of the daily amount of creatine was calculated. Results: In the EFT when incongruente stimulus were presented there was a significant diferences between those with low and high intake of creatine (-35.3 ± 5.84; p < 0.001). Similarly, reaction time to answer incongruent stimulus (r = -0.383; p = 0.004) and the percent of correct answers (r = 0.743; p < 0.001) showed weak to strong correlations with self-reported daily creatine intake. Conclusions: In conclusion, our results suggest that in elderly women with overweight that dietary intake of creatine may influence cognitive ability. Clinical Implications: Our findings support the idea that intake of dietary creatine may be an important factor for cognition in older adults.

Use of a brief, retrospective Comprehensive Feeding Practices Questionnaire in a bariatric-surgery seeking adult population.

Parental feeding practices in childhood have been shown to contribute to childhood eating habits, behaviors, and weight status. Less understood is the longitudinal impact of parental feeding practices on these variables in adulthood. Therefore, the aim of the present work was to validate a modified, brief, Comprehensive Feeding Practices Questionnaire (CFPQ) reformatted to account for retrospective recollections of parental feeding practices experienced in childhood among a sample of adults with obesity. Adults (n = 719, mean age = 44.3 years, mean BMI = 47.1 kg/m2) completed a modified, brief, retrospective CFPQ containing seven pre-defined subscales of the original CFPQ. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) procedures were used to evaluate survey factor structure and associations with gender, BMI, and self-reported race. An EFA derived six-factor model demonstrated better model fit and reliability than the originally proposed seven-factor model. Gender and self-reported race were not correlated with subscales of the brief, retrospective, CFPQ, while BMI was positively correlated with the Food as Reward subscale. This six-factor, brief, retrospective, CFPQ can be used to provide insight into the potential origins of individual eating behaviors, and warrants use in future work attempting to clarify the relationships between parental feeding practices and eating behaviors in adulthood.

Associations between adolescent and young adult External Food Cue Responsiveness (EFCR) and brand recall, product craving and product purchasing in the livestreaming food marketing environment.

OBJECTIVE: To evaluate the utility of three validated food responsiveness scales in measuring recall of, and responsiveness to, food marketing exposure on social media. DESIGN: Cross-sectional survey among adolescents and adults who used the social media platform Twitch.tv (Twitch). Responsiveness to food marketing was self-reported as craving or purchasing any brands participants observed on Twitch. Participants completed three validated scales of food responsiveness: the revised 18-question Three Factor Eating Questionnaire (TFEQ), the external eating subscale of the Dutch Eating Behavior Questionnaire (DEBQ) and the External Food Cue Responsiveness (EFCR) scale. Adjusted linear regression models assessed the predictive ability of each scale on recall and responsiveness outcomes. SETTING: Online survey. PARTICIPANTS: Five hundred and sixty-eight Twitch users (90·1 % male, 60·6 % White, 43·7 % aged 18-24, 25·9 % under 18). RESULTS: In separate adjusted linear regression models, scores on the TFEQ were not related to any outcome, while DEBQ scores related to product cravings (OR: 1·10, 95 % CI 1·01, 1·19, P = 0·02). In contrast, scores on the EFCR scale were significantly associated with higher brand recall (incident rate ratio: 1·42, 95 % CI 1·20, 1·68, P < 0·001), product craving (OR: 3·93, 95 % CI 2·22, 7·17, P < 0·001) and purchasing behaviour (OR: 3·97, 95 % CI 1·99, 8·26, P < 0·001). A subset of three EFCR scale items related to influencer marketing were similarly associated with each outcome with greater precision in the point estimates than the overall EFCR. CONCLUSIONS: The EFCR scale predicted recall of and responsiveness to food marketing via Twitch, suggesting its utility in monitoring the effects of food marketing on social media.

Influence of exclusive breastfeeding on hippocampal structure, satiety responsiveness, and weight status.

Longer exclusive breastfeeding duration has been associated with differences in neural development, better satiety responsiveness, and decreased risk for childhood obesity. Given hippocampus sensitivity to diet and potential role in the integration of satiety signals, hippocampus may play a role in these relationships. We conducted a secondary analysis of 149, 7-11-year-olds (73 males) who participated in one of five studies that assessed neural responses to food cues. Hippocampal grey matter volume was extracted from structural scans using CAT12, weight status was assessed using age- and sex-adjusted body mass index (%BMIp85 ), and parents reported exclusive breastfeeding duration and satiety responsiveness (Children's Eating Behaviour Questionnaire). Separate path models for left and right hippocampus tested: (1) the direct effect of exclusive breastfeeding on satiety responsiveness and its indirect effect through hippocampal grey matter volume; (2) the direct effect of hippocampal grey matter volume on %BMIp85 and its indirect effect through satiety responsiveness. %BMIp85 was adjusted for maternal education, yearly income, and premature birth while hippocampal grey matter volume was adjusted for total intercranial volume, age, and study from which data were extracted. Longer exclusive breastfeeding duration was associated with greater bilateral hippocampal grey matter volumes. In addition, better satiety responsiveness and greater left hippocampal grey matter volume were both associated with lower %BMIp85 . However, hippocampal grey matter volumes were not associated with satiety responsiveness. Although no relationship was found between breastfeeding and child weight status, these results highlight the potential impact of exclusive breastfeeding duration on the hippocampal structure.

Prevalence and comparisons of alcohol, candy, energy drink, snack, soda, and restaurant brand and product marketing on Twitch, Facebook Gaming and YouTube Gaming.

OBJECTIVE: To compare and evaluate the prevalence of food and beverage marketing on the livestreaming platforms Twitch, Facebook Gaming and YouTube Gaming, as well as examine growth of food and beverage marketing on these platforms over a 17-month period of data collection. DESIGN: Cross-sectional data were analysed across three livestreaming platforms and six food and beverage categories: alcohol, candy, energy drinks, snacks, sodas and restaurants. SETTING: Stream titles of livestreamed events as well as corresponding hours watched on Twitch, Facebook Gaming and YouTube Gaming. PARTICIPANTS: None. RESULTS: There were significant differences between the use of food and beverage brand mentions in stream titles across all three studied platforms (P < 0·05), as well as hours watched across platforms (P < 0·05). Energy drinks dominated food and beverage brand mentions across platforms, followed by restaurants, soda and snacks. All platforms demonstrated growth over the 17-month data collection period. Post-hoc analyses revealed that the COVID-19 pandemic impacted both immediate and sustained growth across all platforms, with the greatest impact observed on the Twitch platform. CONCLUSIONS: Food and beverage marketing as measured through stream titles is widely prevalent across the three most popular livestreaming platforms, particularly for energy drinks. Food marketing on these platforms experienced growth over the past 17 months which was accelerated substantially by the COVID-19 pandemic. Future work should assess the sustained impact this growth may have on marketing practices and eating behaviour.

Twitch user perceptions, attitudes and behaviours in relation to food and beverage marketing on Twitch compared with YouTube.

Influencer marketing may be amplified on livestreaming platforms (e.g., Twitch) compared with asynchronous social media (e.g., YouTube). However, food and beverage marketing on Twitch has not been evaluated at a user level. The present study aimed to compare users' self-reported exposure to food marketing and associated attitudes, consumption and purchasing behaviours on Twitch compared with YouTube. A survey administered via social media was completed by 621 Twitch users (90 % male, 64 % white, 69 % under 25 years old). Of respondents, 72 % recalled observing at least one food or beverage advertisement on Twitch. There were significant differences in the recall of specific brands advertised on Twitch (P < 0⋅01). After observing advertised products, 14 % reported craving the product and 8 % reported purchasing one. In chat rooms, 56 % observed conversations related to food and 25 % participated in such conversations. There were significant differences in the number of users who consumed various products while watching Twitch (P < 0⋅01). Of users who frequented YouTube (n 273), 65 % reported negative emotions when encountering advertising on YouTube compared with 40 % on Twitch (P < 0⋅01). A higher proportion felt Twitch's advertising primarily supported content creators (79 v. 54 %, P < 0⋅01), while a higher proportion felt that YouTube's advertising primarily supported the platform (49 v. 66 %, P < 0⋅01). The findings support that food marketing exposures on Twitch are noticeable, less bothersome to users and influence consumption and purchasing behaviours. Future studies are needed to examine how the livestreaming environment may enhance advertising effectiveness relative to asynchronous platforms.

Differences in preferred fat level, sweetener type, and amount of added sugar in chocolate milk in a choice task relate to physical activity and orthorexia.

Fluid dairy milk consumption has decreased over the last 4 decades, and this drop has accelerated with the introduction of many competing beverage alternatives, such as plant-based milks and bottled water. Conversely, flavored milk sales remain strong, but many adults avoid flavored milk because of concerns about added sugar and calories and/or excessive sweetness. Here we used two discrete choice experiments to assess interest for a dark chocolate milk drink in adults, and explored whether there might be a consumer segment who prefers a more bitter, lower sugar chocolate milk. Adults were recruited from the Mid-Atlantic region of the United States for two conjoint analysis studies. In a general population cohort (n = 735), type of sweetener was the most important attribute (24%), followed by milk fat (19%), grams of added sugar (16%), front of pack messaging (15%), package type (12%), carton size (8%), and protein content (6%). Attribute importance was relatively consistent in a second study with a younger, more physically active cohort (n = 1017). Product choices in the active cohort were related to orthorexia and physically activity scores, indicating revealed preferences in a choice task are reflective of personal lifestyle and eating behavior. In both cohorts, three consistent consumer segments were identified and characterized: the calorie conscious, the average consumer, and the natural eaters. These data can help uncover lifestyle differences between adult consumers that impact their food product choices.