Self-identified strategies to manage intake of tempting foods: cross-sectional and prospective associations with BMI and snack intake.

OBJECTIVES: Individuals often use self-directed strategies to manage intake of tempting foods, but what these strategies are and whether they are effective is not well understood. This study assessed the frequency of use and subjective effectiveness of self-directed strategies in relation to BMI and snack intake. DESIGN: A cross-sectional and prospective study with three time points (T1: baseline, T2: 3 months and T3: 3 years). At T1, demographics, frequency of use and subjective effectiveness of forty-one identified strategies were assessed. At T2 and T3, current weight was reported, and at T2 frequency of snack intake was also recorded. SETTING: Online study in the UK. PARTICIPANTS: Data from 368 participants (Mage = 34·41 years; MBMI = 25·06 kg/m2) were used for analysis at T1, n = 170 (46·20 % of the total sample) at T2 and n = 51 (13·59 %) at T3. RESULTS: Two strategy factors were identified via principal axis factoring: (1) diet, exercise, reduction of temptations, and cognitive strategies, and (2) planning, preparation and eating style. For strategy 1, frequency of use, but not subjective effectiveness, was positively related to BMI at T1. Subjective effectiveness predicted an increase in BMI from T1 and T2 to T3. No relationship to snack intake was found. For strategy 2, frequency of use was negatively related to BMI at T1. Neither frequency of use nor subjective effectiveness were related to changes in BMI over time, but subjective effectiveness was negatively correlated with unhealthy snack intake. CONCLUSION: Self-directed strategies to reduce the intake of tempting foods are not consistently related to BMI or snack intake.

Exploring consumer beliefs about novel fortified foods: A focus group study with UK-based older and younger adult consumers.

Consuming 'nutritionally-enhanced' food products (including those that are fortified or enriched to deliver nutritional and functional properties) may help to improve overall diet quality and combat risks associated with malnutrition. However, fortification can negatively impact consumer acceptance, particularly where expected sensory properties of 'delivery' foods are affected by target ingredients. Here, we explored factors influencing consumer acceptability for six novel food products that had been fortified, including both savoury and sweet meal components (e.g., high protein dumplings, probiotic yoghurt drink). In person focus groups (25 consumers aged between 22 and 76 years old) were conducted with two stages; firstly, participants completed a blind taste test of products without awareness of fortification. Secondly, participants discussed products with awareness of additional ingredients and food properties. Reflexive thematic analysis showed that liking of sensory properties differed between foods, but informing participants about the fortification of products highlighted potential trade-offs between taste, health, price, and familiarity. Though taste and texture were generally prioritised by participants, positive perceptions of health benefits increased consumer willingness to buy, whilst both cost and uncertainty about product use were potential barriers. Trust of information was a key concern for labelling and product claims. These results highlight product features that may be optimised to support the success of fortified foods. Greater transparency when building product brands and improving consumer knowledge of fortification may also be important for longer-term consumer acceptance.

Lifetime stressor exposure, eating expectancy, and acute social stress-related eating behavior: A pre-registered study of the emotional eating cycle.

Eating behaviors in response to acute stressors are highly variable: whereas many individuals eat more following stressors, others eat less or show no change in food consumption. Understanding factors that predict individual differences in eating behaviors may help elucidate the psychosocial mechanisms underlying obesity, yet few experimental studies on this topic have been conducted to date. To address this issue, we conducted the present pre-registered study, where we investigated how lifetime stressor exposure moderates the extent to which eating expectancies enhance the learned association between stress-induced negative affect and snack intake. Participants were 44 women (30% non-White) between 18 and 50 years old (M = 27.9), with a mean body mass index of 25.6, who completed assessments of lifetime stressor exposure, eating behaviors, and eating expectancies (eating helps manage negative affect); in a subsequent visit, they were given snacks after an acute social stress task (TSST). The moderated moderation model (PROCESS model 3) yielded a significant three-way interaction. When eating expectancies were high, acute social stress-induced negative affect predicted greater M&M intake for women with very high total lifetime stressor exposure but less M&M intake for women with fewer lifetime stressors. These data thus highlight how lifetime stressor exposure interacts with eating expectancies and acute stress-induced negative affect to predict eating behavior. Replications in larger samples may help explain variability in stress-eating as well as how lifetime stressors contribute to obesity.

Associations between dietary variety, portion size and body weight: prospective evidence from UK Biobank participants.

'Dietary variety' has been identified as a factor associated with food intake. Whilst this relationship may have longer-term benefits for body weight management when eating low-energy, nutrient-dense foods, it may increase the risk of overconsumption (and body adiposity) when foods are high energy density. This study sought to further explore pathways underpinning the relationship between dietary variety and body weight, by considering energy density as a moderating factor and portion size as a mediating factor in this relationship. Using prospective data from the UK Biobank, dietary variety scores (DVS), cumulative portion size and energy density were derived from 24-h dietary recall questionnaires at baseline and follow-up. BMI, whole-body fat percentage and fat-free mass were included as outcomes. Contrary to predictions, linear multiple regression models found some evidence of a negative, direct association between DVS and body weight outcomes at baseline (b = -0·13). Though dietary variety was significantly associated with larger portions across time points (b = 41·86-82·64), a moderated mediation effect was not supported at baseline or follow-up (Index ≤ 0·035). Taken together, these findings provide population-level evidence to support a positive association between variety and food intake, which in turn has potential implications for body weight management, both in terms of moderating food intake and benefitting diet quality.

Ovule cell wall composition is a maternal determinant of grain size in barley.

In cereal species, grain size is influenced by growth of the ovule integuments (seed coat), the spikelet hull (lemma and palea) and the filial endosperm. Whether a highly conserved ovule tissue, the nucellus, has any impact on grain size has remained unclear. Immunolabelling revealed that the barley nucellus comprises two distinct cell types that differ in terms of cell wall homogalacturonan (HG) accumulation. Transcriptional profiling of the nucellus identified two pectin methylesterase (PME) genes, OVULE PECTIN MODIFIER 1 (OPM1) and OPM2, which are expressed in the unfertilized ovule but absent from the seed. Ovules from an opm1 opm2 mutant and plants expressing an ovule-specific pectin methylesterase inhibitor (PMEI), exhibit reduced HG accumulation. This results in changes to ovule cell size and shape and ovules that are longer than wild-type (WT) controls. At grain maturity, this is manifested as significantly longer grain. These findings indicate that cell wall composition during ovule development acts to limit ovule and seed growth. The investigation of ovule PME and PMEI activity reveals an unexpected role of maternal tissues in controlling grain growth before fertilization, one that has been lacking from models exploring improvements in grain size.

Consumer Knowledge and Acceptance of "Algae" as a Protein Alternative: A UK-Based Qualitative Study.

Overconsumption of meat has been recognised as a key contributing factor to the climate emergency. Algae (including macroalgae and microalgae) are a nutritious and sustainable food source that may be utilised as an alternative to animal-based proteins. However, little is known about the consumer awareness and acceptance of algae as a protein alternative. The aim of this qualitative study was to develop a rich and contextualised understanding of consumer beliefs about the use of algae in novel and innovative food products. A total of 34 participants from the UK assisted with our study. Each participant engaged in one focus group, with six focus groups conducted in total. Existing consumer knowledge of algae was discussed before participants explored the idea of algae-based food products. Reflexive (inductive) thematic analysis was used to analyse these data. Results showed that consumers have limited pre-existing knowledge of algae as a food source; however, participants were open to the idea of trying to consume algae. This anticipated acceptance of algae was influenced by several product attributes, including perceived novelty, edibility, healthiness, sustainability, and affordability. These findings highlight algae as a promising protein alternative to support plant-forward diets in the UK and identify key attributes to consider in future product development and marketing strategies.

A Qualitative Study Exploring Management of Food Intake in the United Kingdom During the Coronavirus Pandemic.

The coronavirus pandemic has impacted dietary quality through increased emotional eating and extended time spent at home, as well as instances of panic buying due to uncertainty over food availability. We recruited an opportunistic sample of 40 adults living in the United Kingdom (Female = 25; Mean age = 41.9 years) (SD = 14.4) without any prior history of eating disorders. Semi-structured interviews were conducted in June 2020 and focused on the impacts of the COVID-19 lockdown on eating habits and experiences of panic buying. The data were transcribed and organized using the softwares Otter and Quirkos, respectively. Reflexive thematic analysis identified positive and negative changes to eating habits. Overall, themes highlighted that effective organization was vital to manage food purchases and consumption due to a reduced shopping frequency. However, overconsumption frequently occurred due to boredom and ease of accessing energy dense foods, which had negative implications for weight and body image. After indulging, participants attempted to revert to prior eating habits and adhere to a nutritious diet. Many also expressed the importance of having enough food to feed families, which was often reported as a reason for buying extra supplies. Understanding the long-term impacts of changes to eating habits that account for the novel coronavirus context is required to preserve health and prevent unintended changes to weight.

Identifying weight management clusters and examining differences in eating behaviour and psychological traits: An exploratory study.

Previous research has suggested differences in psychological traits and eating behaviours between groups of individuals with varying weight management profiles, for example, differences between individuals who have maintained weight loss compared to those who have not. However, no study has looked at differences in traits across a sample with a broad range of characteristics including variations in bodyweight and its management. Across two studies, we identified and validated weight management profiles using a clustering approach and examined trait differences across groups. Data were collected using online questionnaires (Study 1: secondary data analysis; Study 2: primary data analysis allowing for cluster validation). Cluster analysis was implemented with BMI, diet history, weight suppression (difference between highest and current weight) as primary grouping variables, and age and gender as covariates. Differences in psychological and eating behaviour traits (e.g., restraint) were explored across clusters. In study 1, 423 participants (27.21 ± 9.90 years) were grouped into 5 clusters: 'lean men', 'lean young women', 'lean middle-aged women', 'successful' and 'unsuccessful dieters'. The cluster structure was broadly replicated with two additional groups identified ('lean women without dieting' and 'very successful dieters') in study 2 with 368 participants (34.41 ± 13.63 years). In both studies, unsuccessful dieters had higher restrained and emotional eating scores than lean individuals, and in study 1, they also had higher food addiction scores than successful dieters. Individuals could be grouped in terms of their weight management profiles and differences in psychological and eating behaviour traits were evident across these groups. Considering the differences in traits between the clusters may further improve the effectiveness and adherence of weight management advice.

Adult attachment anxiety is associated with night eating syndrome in UK and US-based samples: Two cross-sectional studies.

Previous research has shown that "attachment anxiety" is a robust predictor of disinhibited eating behaviours and that this relationship is underpinned by difficulties in managing emotion. Night eating syndrome (NES), a proposed eating disorder characterized by evening hyperphagia, nocturnal awakenings to eat, and morning anorexia, is also associated with eating to manage emotion. Across two studies (N = 276 & N = 486), we considered a relationship between attachment anxiety and NES. In Study 1, we hypothesised (pre-registered) that attachment anxiety would predict NES score and that this relationship would be mediated by disinhibited eating. Participants were asked to complete questionnaire measures of attachment orientation, disinhibited eating (emotional and uncontrolled eating) and NES. Our parallel mediation model confirmed a direct relationship between attachment anxiety and NES (p < .001) and showed an indirect path via both emotional (95% CI: 0.15-0.63) and uncontrolled eating (95% CI: 0.001-0.36). In Study 2, we showed that fear of negative evaluation of eating significantly mediated a reversed relationship between attachment anxiety and NES (95% CI: 0.02-0.04). Finally, across both studies we used a novel tool to assess "eating to cope". We showed a relationship with emotional eating but failed to show a robust relationship with NES. Attachment orientation may represent a potential intervention target for night eating syndrome. Future research should consider a longitudinal approach to strengthen our understanding of directionality amongst these factors.

Multi-component food-items and eating behaviour: What do we know and what do we need to know?

Multi-component food-items are single food products that comprise more than one food class, brought together usually via some form of processing. Importantly, individual components of the food-item remain discernible and sensorially distinguishable from each other (e.g., chocolate chip cookies or 'choc ice'). Despite a sizable research literature on the formulation of such products, there lacks a concomitant research literature on the effect(s) of multi-component food-items (compared to single component food-items) on eating behaviour. Considerable previous research has investigated the effect of multiple separate food items on food intake, portion size selection and palatability. However, studies rarely use test foods that capture the physical or chemical interactions between components that are characteristic of multi-component foods. Nevertheless, previous research and relevant theory allow us to generate hypotheses about how multi-component foods may affect eating behaviour; consideration of food variety and perceived sensory complexity suggest that consumption of multi-component foods are likely to increase perceived palatability of such foods, self-selected portion size and food intake. Moreover, many (but not all) multi-component foods would be considered ultra-processed, which is a driver of food intake in and of itself. One possibility is that food components brought together as part of a multi-component food-item interact to strongly drive eating behaviour. To explore this idea, researchers will need to work across disciplines to address various practical and methodological barriers including the technical preparation of test foods.

Smoking status related to Covid-19 mortality and disease severity in a veteran population.

INTRODUCTION: Cigarette smoking is associated with development of significant comorbidities. Patients with underlying comorbidities have been found to have worse outcomes associated with Coronavirus Disease 2019 (Covid-19). This study evaluated 30-day mortality in Covid-19 positive patients based on smoking status. METHODS: This retrospective study of veterans nationwide examined Covid-19 positive inpatients between March 2020 and January 2021. Bivariate analysis compared patients based on smoking history. Propensity score matching adjusted for age, gender, race, ethnicity, Charlson comorbidity index (0-5 and 6-19) and dexamethasone use was performed. A multivariable logistic regression with backwards elimination and Cox Proportional Hazards Ratio was utilized to determine odds of 30-day mortality. RESULTS: The study cohort consisted of 25,958 unique Covid-19 positive inpatients. There was a total of 2,995 current smokers, 12,169 former smokers, and 8,392 non-smokers. Death was experienced by 13.5% (n = 3503) of the cohort within 30 days. Former smokers (OR 1.15; 95% CI, 1.05-1.27) (HR 1.13; 95% CI, 1.03-1.23) had higher risk of 30-day mortality compared with non-smokers. Former smokers had a higher risk of death compared to current smokers (HR 1.16 95% CI 1.02-1.33). The odds of death for current vs. non-smokers did not significantly differ. CONCLUSION: Compared to veteran non-smokers with Covid-19, former, but not current smokers with Covid-19 had a significantly higher risk of 30-day mortality.

Open-source maximum a posteriori-bayesian dosing AdDS to current therapeutic drug monitoring: Adapting to the era of individualized therapy.

Recent updates in the therapeutic drug monitoring (TDM) guidelines for vancomycin have rekindled interest in maximum a posteriori-Bayesian (MAP-Bayesian) estimation of patient-specific pharmacokinetic parameters. To create a versatile infrastructure for MAP-Bayesian dosing of vancomycin or other drugs, a freely available, R-based software package, Advanced Dosing Solutions (AdDS), was created to facilitate clinical implementation of these improved TDM methods. The objective of this study was to utilize AdDS for pre- and post-processing of data in order to streamline the therapeutic management of vancomycin in healthy and obese veterans. Patients from a local Veteran Affairs hospital were utilized to compare the process of full re-estimation versus Bayesian updating of priors on healthy adult and obese patient populations for use with AdDS. Twenty-four healthy veterans were utilized to train (14/24) and test (10/24) the base pharmacokinetic model of vancomycin while comparing the effects of updated and fully re-estimated priors. This process was repeated with a total of 18 obese veterans for both training (11/18) and testing (7/18). Comparison of MAP objective function between the original and re-estimated models for healthy adults indicated that 78.6% of the subjects in the training and 70.0% of the subjects in the testing datasets had similar or improved predictions by the re-estimated model. For obese veterans, 81.8% of subjects in the training dataset and 85.7% of subjects in the testing dataset had similar or improved predictions. Re-estimation of model parameters provided more significant improvements in objective function compared with Bayesian updating, which may be a useful strategy in cases where sufficient samples and subjects are available. The generation of bespoke regimens based on patient-specific clearance and minimal sampling may improve patient care by addressing fundamental pharmacokinetic differences in healthy and obese veteran populations.

Testing an online measure of portion size selection: a pilot study concerned with the measurement of ideal portion size.

BACKGROUND: Portion size is known to be a key driver of food intake. As consumed portions are often pre-planned, 'ideal portion size'-an individual's preferred meal size selected prior to eating-has been identified as a strong predictor of actual consumption. However, assessments of ideal portion size have predominantly relied on laboratory-based computer tasks, limiting use online. Therefore, this cross-sectional study sought to pilot test the validity of a web-based tool to measure ideal portion size. METHODS: In an online study (N = 48), participants responded to images of a range of foods. Each food was photographed in a series of different portions and loaded into an 'image carousel' that would allow participants to change the size of the displayed portion by moving a slider left-to-right. Using this image carousel, participants selected their ideal portion size. They also completed measures of expected satiety and expected satiation and self-reported their age and body mass index (BMI). A non-parametric correlation matrix was used to explore associations between ideal portion size and identified predictors of food intake. RESULTS: Supporting convergent validity of this measure, ideal portion size was significantly correlated with expected satiety (rs = .480) and expected satiation (rs = -.310) after controlling for effects of baseline hunger and fullness, consistent with past research. Similarly, supporting divergent validity of this measure, ideal portion size was not significantly correlated with age (rs = -.032) or BMI (rs = -.111,). CONCLUSIONS: Pilot results support the validity of this web-based portion size selection tool used to measure ideal portion size, though further research is needed to validate use with comparisons to actual food intake.

Molecular responses to chilling in a warming climate and their impacts on plant reproductive development and yield.

Responses to prolonged winter chilling are universal in temperate plants which use seasonal temperature cues in the seed, vegetative and reproductive phases to align development with the earth's orbit. Climate change is driving a decline in reliable winter chill and affecting the sub-tropical extent of cultivation for temperate over-wintering crops. Here we explore molecular aspects of plant responses to winter chill including seasonal bud break and flowering, and how variation in the intensity of winter chilling or de-vernalisation can lead to effects on post-chilling plant development, including that of structures necessary for crop yields.

Societal factors contributing to infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae in a veteran population.

BACKGROUND: Veterans have a higher incidence of sexually transmitted infections (STIs) compared to the general population. The objective of this study is to evaluate the association of societal factors on the risk of chlamydia or gonorrhea. METHODS: This retrospective cohort study evaluated data from Veteran Health Administration. Patients tested for chlamydia or gonorrhea between January 2009 and January 2019 were included. Descriptive statistics and regression were used to evaluate societal factors. RESULTS: A total of 1,232,173 tests for chlamydia or gonorrhea were performed. There were 51,987 (4.2%) positive cases with 74.18% for chlamydia and 24.96% for gonorrhea. In 13.6% of veterans with reported military sexual trauma, there was no difference in risk of positivity (p = 0.39). Veterans with a history of combat had lower odds of testing positive (OR, 0.94; 95% CI, 0.91-0.97). Tests in veterans who were married had a 24% less chance of positivity (OR, 0.76; 95% CI, 0.74-0.79) compared to tests in divorced veterans. Positive number of cases increased each year. CONCLUSION: Sexually transmitted infections are a growing concern. Gender, age, ethnicity, marital status, and race are societal identifiers which influence likelihood of STI acquisition.

APETALA2 functions as a temporal factor together with BLADE-ON-PETIOLE2 and MADS29 to control flower and grain development in barley.

Cereal grain develops from fertilised florets. Alterations in floret and grain development greatly influence grain yield and quality. Despite this, little is known about the underlying genetic control of these processes, especially in key temperate cereals such as barley and wheat. Using a combination of near-isogenic mutant comparisons, gene editing and genetic analyses, we reveal that HvAPETALA2 (HvAP2) controls floret organ identity, floret boundaries, and maternal tissue differentiation and elimination during grain development. These new roles of HvAP2 correlate with changes in grain size and HvAP2-dependent expression of specific HvMADS-box genes, including the B-sister gene, HvMADS29 Consistent with this, gene editing demonstrates that HvMADS29 shares roles with HvAP2 in maternal tissue differentiation. We also discovered that a gain-of-function HvAP2 allele masks changes in floret organ identity and grain size due to loss of barley LAXATUM.A/BLADE-ON-PETIOLE2 (HvBOP2) gene function. Taken together, we reveal novel pleiotropic roles and regulatory interactions for an AP2-like gene controlling floret and grain development in a temperate cereal.

Reconsidering a role for attachment in eating disorder management in the context of paediatric diabetes.

We suggest a reconsideration of the role of 'attachment orientation' in the context of eating disorders and paediatric diabetes. Attachment orientation is a psychological construct that describes a relatively stable set of expectations and behaviours an individual relies upon in managing relationships. There is considerable evidence of an association between attachment orientation and the development and maintenance of disordered eating in individuals without diabetes, though evidence is more scant in populations with diabetes. We discuss the underpinning theory and critically examine the existing literature for the relationship between attachment orientation and disordered eating in paediatric diabetes. Finally, we draw on adjacent literatures to highlight potential future directions for research should this area be revisited. Overall, we contextualise our discussion in terms of patient-centred, holistic care that addresses the mind and body (i.e., our discussion of attachment orientation assumes a psycho-biological approach).

Genome-wide association study reveals the genetic complexity of fructan accumulation patterns in barley grain.

We profiled the grain oligosaccharide content of 154 two-row spring barley genotypes and quantified 27 compounds, mainly inulin- and neoseries-type fructans, showing differential abundance. Clustering revealed two profile groups where the 'high' set contained greater amounts of sugar monomers, sucrose, and overall fructans, but lower fructosylraffinose. A genome-wide association study (GWAS) identified a significant association for the variability of two fructan types: neoseries-DP7 and inulin-DP9, which showed increased strength when applying a novel compound ratio-GWAS approach. Gene models within this region included three known fructan biosynthesis genes (fructan:fructan 1-fructosyltransferase, sucrose:sucrose 1-fructosyltransferase, and sucrose:fructan 6-fructosyltransferase). Two other genes in this region, 6(G)-fructosyltransferase and vacuolar invertase1, have not previously been linked to fructan biosynthesis and showed expression patterns distinct from those of the other three genes, including exclusive expression of 6(G)-fructosyltransferase in outer grain tissues at the storage phase. From exome capture data, several single nucleotide polymorphisms related to inulin- and neoseries-type fructan variability were identified in fructan:fructan 1-fructosyltransferase and 6(G)-fructosyltransferase genes. Co-expression analyses uncovered potential regulators of fructan biosynthesis including transcription factors. Our results provide the first scientific evidence for the distinct biosynthesis of neoseries-type fructans during barley grain maturation and reveal novel gene candidates likely to be involved in the differential biosynthesis of various types of fructan in barley.

Effect of food variety on intake of a meal: a systematic review and meta-analysis.

BACKGROUND: Many studies have shown that food variety-the presence of multiple foods and/or sensory characteristics within and across meals-increases intake. However, studies report mixed findings, and effect size remains unclear. OBJECTIVES: A systematic review and meta-analysis were conducted to 1) synthesize data across experimental studies that examined effects of variety on total meal intake, relative to a control condition with comparatively less variety; 2) quantify support for this effect; and 3) assist in the identification of important moderating factors (registration: CRD42019153585). METHODS: In November 2019, we searched the following databases for relevant experimental studies, published in English from 1980, with human participants: PubMed, Cochrane Library, Web of Science, ClinicalTrials.gov, PsycINFO, and OpenGrey. This search was updated in September 2020. Means, standard deviations, and sample sizes were extracted from included articles, and Hedges' g was used to calculate effect sizes. Risk of bias was assessed using the Cochrane Collaboration's tool. RESULTS: Of 7259 references identified in an initial search, 34 articles consisting of 37 studies contained sufficient information for review, and data from 30 studies (39 comparisons) were included in the meta-analysis. Results from a random-effects model showed a significant small to medium effect of variety on intake (in weight and energy), with greater variety being associated with increased consumption (Hedges' g = 0.405; 95% CI: 0.259, 0.552). However, heterogeneity was considerable across studies (I2 = 84%), and this was unexplained by subgroup analyses based on form of variety, test foods, sensory characteristics, age, sex, and body weight. CONCLUSIONS: Our findings support the conclusion that variety is a robust driver of food intake. However, risk of bias was high across studies, and this review highlights methodologic limitations of studies. It is recommended that further attention is given to the development of preregistered, well-powered randomized controlled studies in eating behavior research.

An investigation of consumers' use of 'dessert-only' food retail outlets: a mixed-methods study.

OBJECTIVE: To understand how consumers use 'dessert-only' retail food outlets which represent one of the UK's top ten growing retail business categories and a high-street source of energy-dense, low nutrient foods. DESIGN: Responses to open-ended questions about dessert-only restaurant usage and closed-ended questions about demographic information including frequency of use and BMI were collected. SETTING: Online questionnaire launched from the UK. PARTICIPANTS: Totally, 203 participants (female = 153; mean age = 33·5 years (sd = 14·2); mean BMI = 25·05 kg/m2 (sd = 5·29)) assisted with the study. RESULTS: Quantitative results showed that participants used dessert-only restaurants infrequently, and qualitative results showed that they regarded a visit as a treat. Many participants also described ways that they modified their eating pattern to accommodate a visit. Thematic analysis also showed that consumer visits were influenced by properties of the foods on offer, opportunities for socialisation (especially with children) as well as convenience, price and a perceived relaxation of meal-time 'rules'. CONCLUSIONS: Despite some media opinion, this type of food retail outlet is being used somewhat judiciously by consumers. A fruitful public health focus may be on the management of treats within the broader context of the diet as opposed to targeting the treat itself, this may be especially helpful for parents/caregivers taking their children out for a treat to a dessert-only restaurant.