Optimal Defaults in Online Grocery Shopping: A Secondary Analysis to Explore Impacts in Multiresident Households and Families.

OBJECTIVE: To examine whether household type (eg, families with children) moderated the effects of an optimal defaults grocery intervention and examine intervention effects on grocery purchases to be consumed by the participant vs others in the household. METHODS: Participants (n = 65) diagnosed with or at risk for type 2 diabetes were recruited and randomized into an optimal default online grocery intervention or an online or in-person control group. Grocery receipt data were coded into Dietary Approaches to Stop Hypertension nutritional quality scores, and energy, carbohydrate, and sugar content were calculated. Repeated measures analysis of variance examined household types (eg, single vs multi-resident) as moderators of intervention effects. Parallel models explored foods purchased for the participant and foods purchased for other household members separately. RESULTS: Household type was not a significant moderator of intervention effects on nutritional quality or other nutrients of interest (P > 0.10). The default intervention significantly increased the nutritional quality of groceries purchased across household types and for other household members besides the participant (P < 0.05). CONCLUSIONS AND IMPLICATIONS: Optimal defaults may improve grocery purchases across different household types and extend to others in the household, supporting use across household types.

HIV Support Source: Development of a Distress Screening Measure for Adults with HIV.

To provide an effective, multidimensional, and psychometrically valid measure to screen for distress among people with HIV, we developed and assessed the psychometric properties of HIV Support Source, a distress screening, referral, and support program designed to identify the unmet needs of adults with HIV and link them to desired resources and support. Development and testing were completed in three phases: (1) item generation and initial item pool testing (N = 375), (2) scale refinement via exploratory factor analysis (N = 220); external/internal item quality, and judging theoretical and practical implications of items, and (3) confirmatory validation (N = 150) including confirmatory factor analysis along with reliability and validity analyses to corroborate dimensionality and psychometric properties of the final measure. Nonparametric receiver operating characteristic (ROC) curve analyses determined scoring thresholds for depression and anxiety risk subscales. The final measure comprises 17-items representing four domains of concern: emotional well-being, financial and practical needs, physical well-being, and HIV treatment and sexual health, plus one screening item assessing tobacco and substance use. Our analyses showed strong internal consistency reliability, a replicable factor structure, and adequate convergent, discriminant, and known groups validity. Sensitivity of 2-item depression and 2-item anxiety risk subscales was 0.90 and 0.79, respectively. HIV Support Source is a reliable and valid multidimensional measure of distress that also screens for risk for clinically significant depression and anxiety. It can be implemented within a distress screening, referral, and follow-up program to rapidly assess and support the unmet needs of adults with HIV.

A pilot randomized controlled trial comparing nutritious meal kits and no-prep meals to improve food security and diet quality among food pantry clients.

BACKGROUND: Food pantry clients have high rates of food insecurity and greater risk for and prevalence of diet-related diseases. Many clients face time, resource, and physical constraints that limit their ability to prepare healthy meals using foods typically provided by pantries. We compared two novel approaches to alleviate those barriers and encourage healthier eating: meal kits, which bundle ingredients with a recipe on how to prepare a healthy meal, and nutritious no-prep meals, which can be eaten after thawing or microwaving. METHODS: Participants were adult pantry clients from a large food pantry in the Southern sector of Dallas, Texas. We conducted a repeated measures between-subjects study with 70 clients randomized to receive 14-days of meal kits (n = 35) or no-prep meals (n = 35). Participants completed questionnaires at baseline and two-week follow-up on demographics, hedonic liking of study meals, perceived dietary quality, and food security. Two-way repeated measures analysis of variance was used to examine group and time effects, and group by time interactions. We also describe feasibility and satisfaction outcomes to inform future implementation. RESULTS: Sixty-six participants completed the study (94%). Participants were predominantly Hispanic or Latino(a) (63%) and African American or Black (31%) women (90%). There was a significant interaction on hedonic liking of study meals (ηp²=0.16, F(1,64) = 11.78, p < .001), such that participants that received meal kits had greater improvements in hedonic liking over time than participants in the no-prep group. We observed significant improvements in perceived dietary quality (ηp²=0.36, F(1,64) = 36.38, p < .001) and food security (ηp²=0.36, F(1,64) = 36.38, p < .001) across both groups over time, but no between group differences or significant interactions indicating one intervention was more effective than the other. Program satisfaction was high across both groups, but higher among the meal kit group (ηp²=0.09, F(1,64) = 6.28, p = .015). CONCLUSIONS: Results suggest nutritious meal kits and no-prep meals may be desirable nutrition intervention strategies for pantry clients and have potential to increase food security and perceived dietary quality in the short-term. Our findings are limited by a small sample and short follow-up. Future studies should continue to test both interventions, and include longer follow-up, objective measures of dietary quality, and relevant clinical outcomes. TRIAL REGISTRATION: This trial was registered on 25/10/2022 on ClinicalTrials.gov, identifier: NCT05593510.

A pilot randomized controlled trial comparing nutritious meal kits and no-prep meals to improve food security and diet quality among food pantry clients.

Background: Food pantry clients have high rates of food insecurity and greater risk for and prevalence of diet-related diseases. Many clients face time, resource, and physical constraints that limit their ability to prepare healthy meals using foods typically provided by pantries. We compared two novel approaches to alleviate those barriers and encourage healthier eating: meal kits, which bundle ingredients with a recipe on how to prepare a healthy meal, and nutritious no-prep meals, which can be eaten after thawing or microwaving. Methods: Participants were adult pantry clients from a large food pantry in the Southern sector of Dallas, Texas. We conducted a repeated measures between-subjects study with 70 clients randomized to receive 14-days of meal kits (n=35) or no-prep meals (n=35). Participants completed questionnaires at baseline and twoweek follow-up on demographics, hedonic liking of study meals, perceived dietary quality, and food security. Two-way repeated measures analysis of variance was used to examine group and time effects, and group by time interactions. We also describe feasibility and satisfaction outcomes to inform future implementation. Results: Sixty-six participants completed the study (94%). Participants were predominantly Hispanic or Latino(a) (63%) and African American or Black (31%) women (90%). There was a significant interaction on hedonic liking of study meals (ηp2=0.16, F(1,64)=11.78, p<.001), such that participants that received meal kits had greater improvements in hedonic liking over time than participants in the no-prep group. We observed significant improvements in perceived dietary quality (ηp2=0.36, F(1,64)=36.38, p<.001) and food security (ηp2=0.36, F(1,64)=36.38, p<.001) across both groups over time, but no between group differences or significant interactions indicating one intervention was more effective than the other. Program satisfaction was high across both groups, but higher among the meal kit group (ηp2=0.09, F(1,64)=6.28, p=.015). Conclusions: Results suggest nutritious meal kits and no-prep meals may be desirable nutrition intervention strategies for pantry clients and have potential to increase food security and perceived dietary quality in the short-term. Our findings are limited by a small sample and short follow-up. Future studies should continue to test both interventions, and include longer follow-up, objective measures of dietary quality, and relevant clinical outcomes. Trial Registration: This trial was registered on 25/10/2022 on Clinicaltrials.gov, identifier: NCT05593510.

Salivary Epigenetic Measures of Body Mass Index and Social Determinants of Health Across Childhood and Adolescence.

Importance: Children who are socioeconomically disadvantaged are at increased risk for high body mass index (BMI) and multiple diseases in adulthood. The developmental origins of health and disease hypothesis proposes that early life conditions affect later-life health in a manner that is only partially modifiable by later-life experiences. Objective: To examine whether epigenetic measures of BMI developed in adults are valid biomarkers of childhood BMI and if they are sensitive to early life social determinants of health. Design, Setting, and Participants: This population-based study of over 3200 children and adolescents aged 8 to 18 years included data from 2 demographically diverse US pediatric cohort studies that combine longitudinal and twin study designs. Analyses were conducted from 2021 to 2022. Exposures: Socioeconomic status, marginalized groups. Main Outcome and Measure: Salivary epigenetic BMI, BMI. Analyses were conducted to validate the use of saliva epigenetic BMI as a potential biomarker of child BMI and to examine associations between epigenetic BMI and social determinants of health. Results: Salivary epigenetic BMI was calculated from 2 cohorts: (1) 1183 individuals aged 8 to 18 years (609 female [51%]; mean age, 13.4 years) from the Texas Twin Project and (2) 2020 children (1011 female [50%]) measured at 9 years of age and 15 years of age from the Future of Families and Child Well-Being Study. Salivary epigenetic BMI was associated with children's BMI (r = 0.36; 95% CI, 0.31-0.40 to r = 0.50; 95% CI, 0.42-0.59). Longitudinal analysis found that epigenetic BMI was highly stable across adolescence but remained both a leading and lagging indicator of BMI change. Twin analyses showed that epigenetic BMI captured differences in BMI between monozygotic twins. Moreover, children from more disadvantaged socioeconomic status (b = -0.13 to -0.15 across samples) and marginalized racial and ethnic groups (b = 0.08-0.34 across samples) had higher epigenetic BMI, even when controlling for concurrent BMI, pubertal development, and tobacco exposure. Socioeconomic status at birth relative to concurrent socioeconomic status best predicted epigenetic BMI in childhood and adolescence (b = -0.15; 95% CI, -0.20 to -0.09). Conclusion and Relevance: This study demonstrated that epigenetic measures of BMI calculated from pediatric saliva samples were valid biomarkers of childhood BMI and may be associated with early-life social inequalities. The findings are in line with the hypothesis that early-life conditions are especially important factors in epigenetic regulation of later-life health. Research showing that health later in life is linked to early-life conditions has important implications for the development of early-life interventions that could significantly extend healthy life span.

Feasibility and implementation of a grocery shopping intervention for adults diagnosed with or at-risk for type 2 diabetes.

OBJECTIVE: To examine the feasibility and implementation of an optimal defaults intervention designed to align grocery purchases with a diet recommended for people with or at-risk for type 2 diabetes. DESIGN: This was a 5-week pilot randomised trial with three groups: in-person grocery shopping, shopping online and shopping online with 'default' carts. Participants were asked to shop normally in Week One, according to group assignment in Weeks Two-Four (intervention period), and as preferred in Week Five. All groups received diabetes-friendly recipes via email each intervention week. SETTING: Participants grocery shopped in person or online. Grocery receipt forms, enrolment information and exit surveys were collected remotely and used to assess feasibility and implementation. PARTICIPANTS: Sixty-five adults with or at-risk for type 2 diabetes. RESULTS: Sixty-two participants completed the exit survey and fifty-five submitted receipts all 5 weeks. Forty utilised recipes, 95 % of whom indicated recipes were somewhat or very useful. Orange chicken, quesadillas and pork with potato and apples were the most liked recipes. Most Defaults group participants accepted at least some default cart items. Recipes with the highest default acceptance were whole grain pasta and chicken, quesadillas with black beans and chicken with olives. Participants' primary concerns about the intervention were costs associated with online shopping, inability to select preferred foods and some recipes including ingredients household members would not eat. CONCLUSIONS: The study had high retention, data were successfully collected remotely and the intervention was acceptable to most participants. Tailoring recipes to household preferences may be beneficial in future studies.

Measuring the long arm of childhood in real-time: Epigenetic predictors of BMI and social determinants of health across childhood and adolescence.

Children who are socioeconomically disadvantaged are at increased risk for high body mass index (BMI) and multiple diseases in adulthood. The developmental origins of health and disease hypothesis proposes that early life conditions affect later-life health in a manner that is only partially modifiable by later-life experiences. Epigenetic mechanisms may regulate the influence of early life conditions on later life health. Recent epigenetic studies of adult blood samples have identified DNA-methylation sites associated with higher BMI and worse health (epigenetic-BMI). Here, we used longitudinal and twin study designs to examine whether epigenetic predictors of BMI developed in adults are valid biomarkers of child BMI and are sensitive to early life social determinants of health. Salivary epigenetic-BMI was calculated from two samples: (1) N=1,183 8-to-19-year-olds (609 female, mean age=13.4) from the Texas Twin Project (TTP), and (2) N=2,020 children (1,011 female) measured at 9 and 15 years from the Future of Families and Child Well-Being Study (FFCWS). We found that salivary epigenetic-BMI is robustly associated with children's BMI (r=0.36 to r=0.50). Longitudinal analysis suggested that epigenetic-BMI is highly stable across adolescence, but remains both a leading and lagging indicator of BMI change. Twin analyses showed that epigenetic-BMI captures differences in BMI between monozygotic twins. Moreover, children from more disadvantaged socioeconomic status (SES) and marginalized race/ethnic groups had higher epigenetic-BMI, even when controlling for concurrent BMI, pubertal development, and tobacco exposure. SES at birth relative to concurrent SES best predicted epigenetic-BMI in childhood and adolescence. We show for the first time that epigenetic predictors of BMI calculated from pediatric saliva samples are valid biomarkers of childhood BMI that are sensitive to social inequalities. Our findings are in line with the hypothesis that early life conditions are especially important factors in epigenetic regulation of later life health. Research showing that health later in life is linked to early life conditions have important implications for the development of early-life interventions that could significantly extend healthy life span.

Effects of a grocery shopping intervention designed to improve diet adherence in diabetes: a randomized trial.

OBJECTIVE: The goal of this study was to examine the potential of an optimal-defaults intervention to promote grocery purchases corresponding to a diet for diabetes. METHODS: In total, 65 adults diagnosed with or at increased risk for type 2 diabetes who grocery shopped at one of two study stores were randomized to one of three groups: Defaults, Online, or Control. All groups received diabetes-friendly recipes. In addition, the Online group was asked to grocery shop online during a 3-week intervention, and the Defaults group was asked to shop online, with their online grocery carts prefilled with food items needed to prepare provided recipes. Participants provided weekly grocery receipt data at baseline, at each week of the 3-week intervention, and at post-intervention. RESULTS: Overall, the Defaults group had grocery purchases of a significantly greater nutritional quality versus other groups (F = 16.3, p < 0.001). Between-group comparisons of least-squares means showed consistent effects of the Defaults intervention while intervention components were in place, with a similar pattern for energy and carbohydrate content of grocery purchases. CONCLUSIONS: These results build upon emerging evidence that optimal defaults can promote healthier grocery purchases. Continued examination of this approach could promote healthy food acquisition in accordance with individual dietary preferences and needs.

Objective and perceived barriers and facilitators of daily fruit and vegetable consumption among under-resourced communities in Central Texas.

INTRODUCTION: Fruit and vegetable consumption (FVC) continues to be low, particularly among people living in under-resourced communities. Identifying barriers and facilitators of FVC and whether those barriers and facilitators differ for racially and ethnically minoritized people is imperative for developing effective and equitable public health policies and interventions. METHODS: A baseline cohort of 390 participants from Central Texas communities historically lacking healthy food retailers completed a survey including FVC, 7 psychosocial barriers and facilitators of FVC, distance to a grocery retailer, participation in government assistance programs, and race/ethnicity. RESULTS: Not having time to prepare fruits and vegetables was the only significant psychosocial barrier identified (B = -.11, t(390) = 2.04, P = .04), but was not significant after accounting for sociodemographic variables. Significant facilitators of daily FVC were liking F&V (B=.31, t(390) = 6.40, P<.001), participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) (B=.14, t(390) = 2.81, P = .005), and Hispanic/Latino(a) ethnicity (B = -.21, t(390) = 4.30, P<.001). The final model accounted for 17% of the variance in daily FVC (R2=.17, F(4, 375) = 7.69, P < .001). Black, white and Other race participants were more likely to report having difficulty using F&V before spoiling than Hispanic/Latino(a) participants (P = .003). White and Other race participants were more likely to report that F&V were hard to prepare (P = .006) and that they didn't have time to prepare F&V (P = .005). DISCUSSION: When designing public health policy and interventions to increase FVC, researchers could prioritize identifying ways to alleviate time constraints, increase F&V liking, and help eligible participants to enroll in WIC. Strategies that reduce the risk of F&V spoiling and make F&V easier to prepare may also benefit some groups.

Family Food Insecurity, Food Acquisition, and Eating Behavior Over 6 Months Into the COVID-19 Pandemic.

OBJECTIVES: Describe coronavirus disease 2019 (COVID-19)-related employment and food acquisition changes for food-secure and food-insecure households. Examine associations between food insecurity, parent food acquisition, and child eating. METHODS: A nationally representative cross-sectional survey with parents (N = 1,000) in Fall 2020. Measures included sociodemographics, food retail regulations, food insecurity, frequency of meals, changes in parent employment, food preparation, and food acquisition because of COVID-19. RESULTS: Parents that reported recent food insecurity were more likely to report COVID-19-related employment changes (eg, job loss, reduced hours) and food acquisition changes. Food insecurity was modestly associated with more frequent in-person restaurant dining (B = 0.12, t(999) = 4.02, P < 0.001), more frequent restaurant delivery (B = 0.13, t(999) = 4.30, P < 0.001), less frequent homecooked meals (B = -0.14, t(999) = 4.56, P < 0.001) but was not associated with take-out (B = 0.02, t(999) = 0.62, P = 0.54). CONCLUSIONS AND IMPLICATIONS: Food insecurity was associated with employment changes, parent food acquisition, and children's consumption of homecooked and restaurant meals during COVID-19. Future work could explore resources that help parents acquire affordable, nutritious food.

Written or drawn episodic future thinking cues improves delay discounting in adults.

Delay discounting (DD) describes choices between small, immediate rewards and larger, delayed rewards. Individuals who are high in DD favor small, immediate rewards, and this preference is related to health behaviors including higher energy intake, smoking and less physical activity. Episodic future thinking (EFT) is an intervention in which one thinks about personal positive future events and this decreases DD in adults and children. In previous studies episodic events have been presented as written or auditory cues. Episodic future images are also imagined visually, but the impact of personal visual cues has not been tested. Research examining sensory modality and semantic memory has shown drawn items are associated with better recall than writing or viewing provided images. This study compared drawn versus written episodic future or recent cues on DD. Sixty-nine adults were randomized to one of three groups; EFT-written, EFT-drawn or Episodic recent thinking (ERT)-written cues, and completed a computerized adjusting amount DD task cued with episodic events. Results showed both written and drawn EFT cues had a larger effect on DD than ERT-written cues and individual differences in immediate time perspective moderated this effect. This suggests that drawn and written cues can have similar effects on DD, providing future clinical work flexibility in how to present cues in the field. In addition, presenting drawn cues may improve DD for individuals who have an immediate time perspective.

Mothers' DASH diet adherence and food purchases after week-long episodic future thinking intervention.

Prospection has helped participants forego the temptation to buy and eat higher calorie nutrient poor foods in favor of buying and eating fewer calories and healthier macronutrient profiles in laboratory tasks and brief field studies. This pilot study examines whether episodic future thinking (EFT) improves mothers' dietary behavior and food purchasing over a longer 7-10-day period. The study utilized a 2 × 2 factorial design with mothers (N = 60) randomized to EFT or standardized episodic thinking (SET) crossed with dietary approaches to stop hypertension (DASH) diet education or a food safety education control. Participants listened to their cues (e.g., recordings of themselves imagining a future event or recalling a past episode) using a mobile ecological momentary intervention (EMI) tool and returned to complete a follow-up dietary recall and submit food receipts. Results showed diets of mothers in the EFT groups became more concordant with the DASH diet (ηp2 = 0.08, p < .05) than mothers in the SET group. When considering food purchases for the family, there was an EFT effect on milligrams of sodium purchased (ηp2 = 0.07, p < .05) and a trend towards a decrease in grams of fat purchased (ηp2 = 0.06, p = .06), however, these findings were no longer significant after correcting for multiple comparisons. There were no DASH education effects and no DASH by EFT interactions observed. The dietary intake and food purchasing results should be replicated in larger more representative samples.

An ecological momentary episodic future thinking intervention on mother's weekly food purchases.

BACKGROUND: Imagining one's own future (episodic future thinking, EFT) has helped mothers with overweight purchase healthier groceries during an online shopping task in the laboratory. The present study explored whether delivering an EFT intervention to participants' devices via an ecological momentary intervention (EMI) tool would help mothers purchase healthier food at brick-and-mortar stores. METHOD: Participants (N = 43, mothers 31-52 years of age, BMI ≥ 24.9 kg/m2) were randomized to EFT or standardized episodic thinking (SET). EFT cues include a positive and vivid description of future events while SET cues focus on the recent experience of playing games in the laboratory. Cues were uploaded to participant profiles on an EMI site. Participants were trained on how to read and listen to cues as well as how to detail purchases. Participants received text reminders to listen to cues before shopping and returned with receipts the following day. Receipt data was analyzed to derive dependent variables, calories, and nutrients purchased per person. Correlations were used to analyze associations between study variables of interest, and ANOVAs were conducted to compare dietary variables by group. RESULTS: Participants in the EFT group purchased fewer calories, fewer grams of fat, fewer grams of saturated fat, and fewer miligrams of sodium than participants in the SET control group. CONCLUSION: Delivering EFT cues to participant devices may be a promising way to improve the calorie and nutrient content of food purchases. Future research should include a longer follow-up and analyze calorie changes over time. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

The introduction of new food retail opportunities in lower-income communities and the impact on fruit and vegetable intake: a systematic review.

A lack of access to fresh fruits and vegetables (F&Vs) is associated with consumption of fewer F&Vs and higher risk of obesity, especially for lower-income individuals. It is widely believed that the addition of new food retail opportunities could improve F&V consumption and subsequently reduce the chronic disease burden. Observational studies provide some support for these hypotheses, but contradictions exist. In this study we sought to examine if the introduction of a food retailer affects F&V consumption in lower-income communities. We used a systematic PRISMA approach to conduct this study. We searched PubMed, EMBASE, and ProQuest Dissertations & Theses for academic journal references and gray literature published before August 2018. Included studies were those looking at the effect of the introduction of a new food retailer on F&V consumption. Studies were also categorized based on which dimensions of food access were targeted by the food retailer. We identified 15 studies meeting inclusion criteria: 11 studies reported a positive increase in F&V consumption attributable to the introduction of a new food retailer, of which 6 were statistically significant. The remaining 4 studies, all of which examined the impact of introducing a new retail supermarket, showed no change or a decrease in F&V intake. Results from studies which change the food environment generally support the idea that increased access to healthy food improves diet, but more studies are needed in order to assess the differences between the various types of retailers, and to identify strategies for improving impact. Understanding which types of new food retail programs are most likely to impact diet has implications for policies which incentivize new food retail.

Improvements in episodic future thinking methodology: Establishing a standardized episodic thinking control.

OBJECTIVE: Delay discounting (DD) is the choice of a smaller immediate reward over a larger delayed reward, which has been associated with a number of maladaptive behaviors. Episodic future thinking (EFT), the ability to project oneself into the future, is an intervention designed to reduce DD. EFT has reliable effects on DD, but the size of the effect varies, which could be due in part to the use of different control groups. Episodic recent thinking (ERT) serves as a common control for many EFT studies, but the temporal window of "recent" cues ranges from 24 hours ago to 12 days past. Since prior research has shown that retrospection can lead to prospection, it may be important to ensure that EFT controls do not inadvertently lead to prospection for some participants thereby increasing the variability of the control condition. The present study sought to develop a comparison group that standardizes the time frame and experiences that are the basis for the recent thinking control. METHODS: Participants (n = 53, 18-45) were randomized to one of three conditions: EFT, ERT, or standardized episodic thinking (SET). Participants attended a laboratory appointment where they played mobile application games, created cues, and completed a DD task. RESULTS: There was a significant difference between groups (p<0.05), with EFT reducing discounting more than either control (p<0.05), and no differences between ERT and SET (p>0.05). CONCLUSION: This study established that SET provides an alternative control in EFT studies and provides the advantage of standardizing the participant's recent experience without changing the relationship between EFT and recent thinking controls.

Episodic future thinking and grocery shopping online.

Grocery shopping shapes the home food environment, which can contribute to the development of obesity. Episodic future thinking (EFT) helps adults make healthier decisions by initiating prospective thinking, which guides one to forego smaller immediate rewards in favor of larger delayed rewards. EFT could help parents improve grocery purchases thereby improving the home food environment and family eating behaviors. The effect of EFT on food shopping was evaluated in two studies with mothers who were overweight/obese and primary household shoppers. In Study 1, 24 mothers were randomized to goal-directed process EFT versus a money saving control. In Study 2, 33 mothers were randomized to goal-directed process EFT, general EFT, or an episodic recent thinking (ERT) control. Following cue generation, participants completed a task where they purchased one week of groceries from an online store. Food purchases were analyzed for calories purchased per family member. In Study 1 the goal-directed process EFT group purchased fewer calories per person (F(1, 23) = 25.16, p < .001; ηp2 = 0.522). In Study 2 the goal-directed process EFT purchased fewer calories (F(1, 30) = 5.98, p = .02; ηp2 = 0.166) than the ERT control as did the EFT general group (F(1, 30) = 4.61, p = .04; ηp2 = 0.133). The two EFT groups did not differ from each other (F(1, 30) = 0.16, p = .69; ηp2 = 0.005). EFT may be an effective intervention for reducing the energy intake of foods purchased while grocery shopping.

Mix and Match: An Investigation into Whether Episodic Future Thinking Cues Need to Match Discounting Delays in Order to Be Effective.

Episodic future thinking (EFT), or prospectively imagining yourself in the future, has been developed into an intervention tool to reduce delay discounting (DD), or the preference for smaller immediate over larger future rewards, and to make healthier choices that promote long-term health rather than short-term enjoyment. Most EFT interventions use EFT cues whose future events match the time delays of the DD task, which may limit the utility of EFT. The current study (N = 160, Mage = 35.25, 47.5% female) used a 2 × 2 factorial design with type of episodic thinking (matched, unmatched) and temporal perspective (EFT, episodic recent thinking (ERT)) as between-subject factors to investigate whether there were differences in DD for groups that had EFT cues matched to the time delays of the DD task in comparison to cues with unmatched temporal delays. The results showed EFT reduced DD compared to ERT controls, and no differences emerged between matched and unmatched EFT groups. Our findings suggest that either the process of generating EFT cues or the use of any positive and vivid future event, regardless of whether it is matched to the DD task, can reduce DD.

Epidemiological Trends in Colorectal Cancer in China: An Ecological Study.

BACKGROUND: Due to the changes in lifestyle and dietary behaviors, the incidence of colorectal cancer (CRC) has been rapidly increasing in China. AIMS: This study is to present the trends of CRC in China over the past decade. METHODS: It used a series of nationally representative data, including the National Central Cancer Registry of China, the GLOBOCAN project and the Global Burden of Disease. RESULTS: The age-standardized rate of CRC incidence increased from 12.8 in 2003 to 16.8 per 100,000 in 2011, while the mortality rose from 5.9 to 7.8 per 100,000. The age group most affected by incident CRC cases were those aged 60-74 years old, whereas CRC death was most associated with those >74 years. Furthermore, the east coast of China presented a higher mortality rate (>15 and 10-14.9 per 100,000 in men and women) than central and west China (5-14.9 and 5-9.9 per 100,000). Compared with other countries worldwide, China indicated lower rates of incidence (14.2 per 100,000), mortality (7.4 per 100,000), and 5-year prevalence (52.7 per 100,000) than most developed countries. However, China had a higher case-fatality ratio (14.0 %) and mortality/incidence ratio (52.1 %). Lastly, disability-adjusted life years attributed to CRC in China was 224.2 per 100,000. CONCLUSIONS: It presents a steady increase in CRC in China over the past decade. It also reveals the domestic diversity of age, gender, and geography and finds the differences between China and developed countries, which may yield insights for national programs and policies.