Enjoyment Of Food Research Articles

Temporomandibular disorders and dietary changes: A cross-sectional survey.

Advice about a 'soft diet' may be useful in the short-term alleviation of temporomandibular disorders (TMD) but may contradict the long-term aims of multi-dimensional approaches if a poor nutritional state is caused or exacerbated. The changes patients with TMD make to their diet, because of their condition or its management, have not previously been explored. To explore the relationship and trends between TMD, TMD interventions and diet using self-report measures. Registrants of the Temporomandibular Joint Association (TMJA) were invited to participate. After completing a screening questionnaire to check for eligibility, participants completed a questionnaire exploring demographics, TMD interventions and dietary habits, as well as jaw functional limitation scale (JFLS) score, graded chronic pain scale score, self-assessed limitation of opening and patient health questionnaire 4 (PHQ-4). This was followed by a validated 3-day electronic diet diary. Descriptive and inferential statistics were used to explore the data for trends and differences in the dietary intake of those participating according to various strata including demographic variables; experience of surgery; other interventions for TMD; duration of TMD; and limitation of mouth opening. Eighty-five registrants of the TMJA completed the questionnaire, of which 42 (49%) completed the 3-day diet diary. Most participants (66/85 [77.6%]) reported modifying their diet due to their TMD. The most common modification was to cut food into smaller pieces (61/85 [71.8%]) followed by boiling until soft (36/85 [42.4%]) and mashing (34/85 [40%]). Higher JFLS scores were associated with participants reduced enjoyment of food (t(83)=2.78, p=.007), limitations in the foods they can eat (t(83)=2.99, p=.004), necessity for modified food preparation (t(83)=3.38, p=.001) and self-reported weight change (F(2, 82)=9.31, p=.0002). This study suggests a significant proportion of patients with TMD make alterations to their diet which may impact the nutritional value of their diet. However, self-reported symptoms and interventions for TMD made little difference to nutritional intake as measured by a 3-day diary. Patients reporting self-assessed limited opening had more pain as measured by validated tools, suggesting patients' self-reporting of opening is a useful proxy for clinical measurement in monitoring TMD.

Associations Between Birthweight and Appetite Traits: Appetite Traits Partially Mediate the Link Between Birthweight and Later Child Weight in Low-Income Hispanic Families

ObjectivesTo examine whether: 1) birthweight was associated with child appetite traits (AT) at age 2 years; and 2) ATs mediated the link between birthweight and weight at age 3 years among Hispanic children. MethodsThis study is a secondary longitudinal analysis of data collected from the “Starting Early Program” randomized controlled obesity prevention trial of low-income, Hispanic mother-child pairs (n = 533). Birthweight-for-gestational-age z-scores (BWGAz) were determined using Fenton growth curves; weight-for-age z-scores (WFAz) were determined using World Health Organization growth charts. Four ATs, including Food Responsiveness (FR), Enjoyment of Food (EF), Satiety Responsiveness (SR), and Slowness in Eating (SE), were assessed using the Child Eating Behavior Questionnaire at age 2 years. Simple linear regression analysis was used to assess direct associations between BWGAz and each AT. Bootstrapping analyses were used to assess whether ATs were significantly associated with BWGAz, and mediated the relationship between BWGAz and later child WFAz. ResultsOf the 401 children with both BWGAz and AT measures, 49% were male with mean birthweight of 3.4 kg. After adjusting for covariates related to child weight, infants with higher BWGAz had lower SR scores at age 2 years (B = –0.11, 95%CI = –0.18 to – 0.04, P < 0.01) and higher WFAz at age 3 years (B = 0.39, 95%CI = 0.26 to 0.53; P < 0.001). Lower SR was also associated with higher WFAz at age 3 years (B = –0.42, 95%CI = –0.62 to –0.22, P < 0.001). A significant indirect effect of BWGAz on WFAz at age 3 years through SR at age 2 years was detected (B = 0.04, 95%CI = 0.01 to 0.08; P < 0.01 [indirect effect]); however, only 10% of the total effect was mediated by this indirect pathway. Therefore, SR partially mediated the positive relationship between BWGAz and child WFAz at age 3 years. BWGAz was not associated with other ATs. ConclusionsHigher BWGAz was associated with lower SR scores at age 2 years and higher WFAz at age 3 years. SR partially mediated the link between BWGAz and child WFAz. Our findings warrant exploring additional pathways through which birthweight effects appetite traits, as well as later child weight. Funding SourcesUSDA AFRI.

Associations Between Parenting Stress, Feeding Practices, and Child Eating Behaviors During the COVID-19 Pandemic

ObjectivesThe pandemic provides an opportunity to explore how parenting stress during times of crisis may predict parent-child interactions, especially during mealtimes. The objective of the present study was to explore whether parents’ perceived increases in and overall levels of parenting stress during the pandemic were associated with feeding practices and perceptions of child eating behaviors. MethodsParents (n = 284) of children 4–6 years completed a cross-sectional online survey between March and April 2020. Perceived changes in parenting stress during the onset of the pandemic, levels of parenting stress during the pandemic, child feeding practices, and children’s eating behaviors were assessed. We used ordinal linear regression to examine whether changes in and levels of parenting stress predicted use of controlling or responsive feeding practices and perceptions of child eating behaviors. ResultsThe majority (63.7%, n = 181) of parents indicated their family was moderately or extremely emotionally affected by the pandemic and 56.7% (n = 161) indicated pandemic-related precautions had been moderately or extremely challenging. Perceived increases in parenting stress during the onset of the pandemic were associated with more frequent use of food as a reward (OR = 1.15, 95% CI = 1.04–1.26) and for emotional regulation (OR = 1.13, 95% CI = 1.04–1.23), as well as greater child food responsiveness (OR = 0.91, 95% CI = 0.84–0.99) and slow eating (OR = 0.92, 95% CI = 0.84–1.00). Higher overall levels of parenting stress were associated with more frequent use of food as a reward (OR = 1.05, 95% CI = 1.02–1.08) and for emotional regulation (OR = 1.05, 95% CI = 1.03–1.08) but also with use of pressuring feeding practices (OR = 1.03, 95% CI = 1.01–1.06) and encouraging a balanced diet (OR = 1.03, 95% CI = 1.01–1.06). Higher overall levels of parenting stress were associated with greater child food fussiness (OR = 1.05, 95% CI = 1.02–1.08), enjoyment of food (OR = 1.05, 95% CI = 1.02–1.07), and satiety responsiveness (OR = 0.95, 95% CI = 0.93–0.98). ConclusionsDuring the pandemic, parenting stress predicted parents’ use of food for emotional and behavioral regulation and various domains of children’s eating behaviors. Results highlight the need for targeted efforts to support families during times of crisis. Funding SourcesNone.

Food, Eating, and Quality of Life in Community-Dwelling Older Adults

Abstract Objectives Research that explores older adults’ perspectives on how food and eating impact their quality of life (QOL) is limited. The objectives of this study were to 1) understand the factors that impact QOL, both positively and negatively, and 2) understand the effect of food and eating on QOL, from the perspective of older adults living in the community. Methods Twenty five community-dwelling older adults completed in-person, semi-structured interviews. A grounded theory approach was used to assign codes to the participant's responses and organize them into categories representing similar concepts. Relationships between the categories were used to form a framework based on the data. Results Five main themes emerged from the data, representing categories of factors that influence QOL (health and vitality; independence; mental and emotional well-being; socialization and support; activities, both inside and outside the home). Four themes were identified in respondents’ answers explaining how food and eating affect QOL (food access and choice; food preparation; health and vitality; food enjoyment). Due to the interaction between the themes and the other factors in the framework, the results show that food and eating have a broad effect on QOL. Conclusions Many factors that affect QOL are modifiable, and the results of this study can be used as a basis for the development and tailoring of community interventions to improve older adults’ QOL. Additionally, to measure the effects of such interventions, measurement tools that include both physiological and non-physiological effects of food and eating on QOL are necessary. Funding Sources Healthy Food Systems Emerging Innovators Grant Program, Department of Nutrition and Food Science, University of Maryland, College Park

Are food parenting practices gendered? Impact of mothers' and fathers' practices on their child's eating behaviors

Past research has mainly focused on the links between child eating behaviors and maternal food practices. The impact of fathers and of concordant/discordant food parenting practices within families has received much less attention. To fill this gap, both parents of 105 French children aged 2.01–6.51 years (54 boys, Mage = 3.88 years, SD = 1.40) filled in a survey with items from validated questionnaires. Results showed that fathers and mothers perceived their child's eating behaviors in similar ways (Pearson correlations between 0.34 and 0.78; M = 0.60), despite mothers taking significantly more meals with their child than fathers. Fathers reported using significantly more pressure to eat and food as reward, but reported lower levels of “family meal setting” than mothers. Moderate to high correlations were observed between mothers' and fathers' feeding practices and styles. Regression analyses showed that both maternal and paternal practices and styles were predictors for child eating behaviors. One interaction effect was observed: in households where both parents used higher levels of pressure to eat, the child showed a significantly lower food enjoyment than expected if the effects were additive. Our findings underline the importance of studying the individual role of each parent in child feeding research and that both parents within families should avoid using coercive practices. This could finally stimulate new interventions and recommendations addressed to both parents.

The relation between stimulated salivary flow and the temporal consumption experience of a liquid oral nutritional supplement

Use of oral nutritional supplements (ONS) in undernourished patients has proven clinical benefits, but this can be hampered by low adherence due to poor experience of palatability. Many patients, particularly older patients, experience hyposalivation which can cause taste changes and reduce the enjoyment of foods. The aim of this study was to investigate differences in the temporal consumption experience (comprising sensory perception, in-mouth aroma release and subjective appetite) of a clinically relevant portion of ONS, for groups differing in saliva flow rates (SFR). The SFR (mL/min) of thirty healthy individuals was measured on three occasions. This data was used to categorise individuals into three groups using quartile analysis: low flow (LF) (0.3–0.6 mL/min, n = 5), medium flow (MF) (0.7–1.2 mL/min, n = 16) and high flow (HF) (1.3–1.8 mL/min, n = 9). Over the consumption of eight 15 mL sips of ONS, individuals rated their sensory perception and subjective appetite perception using line scales. Additionally, in-mouth aroma release was measured for each sip, using atmospheric pressure chemical ionisation (APCI). Compared with the MF and HF group, the LF group reported a significantly greater increase of mouth-drying over increased sips (p = 0.02). The LF group also experienced significantly higher aftertaste perception (p < 0.001), and more intense in-mouth aroma release (p = 0.015), compared with the HF group. These findings occurred concurrently with relatively lower hunger sensations in the LF and MF group. Many patients who are prescribed ONS likely experience reduced salivary flow rates. The unique sensory experiences of these individuals should be considered in order to optimise palatability and nutritional intake.

How Can Speech-Language Pathologists Think About Sensation During Swallowing Evaluation and Intervention?

Purpose Both the enjoyment of foods and safe swallowing revolve around incorporating multiple streams of sensory feedback to form a positive sensory experience; these include information about the taste, smell, texture, temperature, and even the sight of food. Traditional swallowing assessment and treatment paradigms have primarily focused on the motor aspects of swallowing. However, sensory information is vital for not only enjoying foods while eating but also coordinating safe and efficient swallow behaviors. The purpose of this clinical focus article is to discuss the clinical importance of sensation in swallowing evaluation and intervention. Conclusions During their clinical assessments of swallowing, speech-language pathologists are already documenting the functional results of oropharyngeal sensorimotor impairments (e.g., residue). A combination of sensory and motor aspects is already integrated within current behavioral treatment strategies for dysphagia. Focused attention to the salient sensory features of swallowing has the potential to improve swallowing evaluation and intervention efforts. A discussion of potential future research in improved measurement and documentation of altered sensation is provided.

Anxiety is associated with appetitive traits in university students during the COVID-19 pandemic

BackgroundCOVID-19 has impacted mental health globally, however, associations between anxiety and appetitive traits during the pandemic are unreported. This study evaluated anxiety symptom severity and associations with appetitive traits in students at a large public University in the U.S. during the pandemic.MethodsCurrent undergraduate and graduate/professional students completed a cross-sectional survey in fall 2020. Demographic information, anxiety symptoms in the past 2 weeks assessed by the Generalized Anxiety Disorder Scale (GAD-7), and appetitive traits assessed by the Adult Eating Behavior Questionnaire (AEBQ) were evaluated. Mean scores for eight AEBQ scales (four food approach and four food avoidance traits) were calculated. Differences in mean scores were examined between participants with moderate to severe anxiety symptoms (GAD-7 score ≥ 10) and those with mild to no anxiety symptoms (GAD-7 score < 10) via independent samples t-tests and effect sizes. Associations between GAD-7 score and individual appetitive traits were also examined, adjusting for age and gender.ResultsOf the 1243 students who completed the survey (57% undergraduates; mean age = 26.5 years), 51.9% reported moderate to severe anxiety symptoms. Groups experiencing the highest degree of moderate to severe anxiety symptoms included transgender, gender fluid, and other-gendered participants (73.6%); the youngest age group [18–20 years (62%)]; undergraduate students (60.7%); and Hispanic/Latinx participants (57.7%). Participants with moderate to severe anxiety symptoms had higher scores for most food approach and avoidance traits but lower scores for enjoyment of food than those with mild to no anxiety symptoms. Effect sizes were largest for hunger and emotional over-eating (Cohen’s d = 0.31 and 0.30, respectively). Adjusting for age and gender, GAD-7 score was significantly and positively associated with hunger, emotional over-eating, food and satiety responsiveness, and food fussiness and negatively associated with enjoyment of food.ConclusionsOver half of students at a U.S. University reported moderate to severe anxiety symptoms during COVID-19. More severe anxiety symptoms were associated with increased hunger, emotional over-eating, and food and satiety responsiveness and decreased enjoyment of food. Universities must consider strategies to address anxiety, particularly in younger students; transgender, gender fluid, and students of other genders; and across race/ethnicities keeping in mind associations with appetitive traits.

Eating in the absence of hunger in 18-month-old children in a home setting.

SummaryBackgroundEating in the absence of hunger (EAH), the susceptibility to eat despite satiety, may increase overweight. While EAH has been established in school‐aged children, less is known about it during toddlerhood.ObjectivesThis study assessed to what extent 18‐month‐old children eat in the absence of hunger, the stability of this behaviour at 24 months and the association of child eating behaviours with EAH.MethodsChildren were presented with four palatable finger foods (total 275 kcal) after dinner. Univariate GLM's assessed the association between EAH, child satiety and eating behaviours and energy intake of dinner at 18 and 24 months (n = 206 and 103, respectively). Another GLM was run to assess the association between EAH at both time points.ResultsMean (±SD) energy intakes from dinner and finger foods were 240 kcal (±117) and 40 kcal (±37), respectively. No association was found between energy intake of dinner and finger foods. Enjoyment of food was significantly related to intake of finger foods (P = .005). EAH at 18 months predicted EAH at 24 months.ConclusionEighteen‐month‐old children ate in the absence of hunger, irrespective of satiety. Thus, preceding energy intake was not compensated for. Other factors, for example, enjoyment of food seem to determine finger food intake.

Infant and Early Child Appetite Traits and Child Weight and Obesity Risk in Low-Income Hispanic Families

BackgroundChild appetite traits (ATs) are associated with later child weight and obesity risk. Less research has focused on ATs in low-income Hispanic children or included longitudinal associations with infant weight. ObjectiveTo determine stability of ATs during infancy and childhood and their relationship with subsequent weight and obesity risk at age 3 years among low-income Hispanic children. DesignA secondary longitudinal analysis of data from the Starting Early Program randomized controlled obesity prevention trial. Participants/settingThree hundred twenty-two low-income, Hispanic mother–child pairs enrolled between 2012 and 2014 in a public hospital in New York City. Main outcome measuresATs, including Slowness in Eating, Satiety Responsiveness, Food Responsiveness, and Enjoyment of Food were assessed using the Baby and Child Eating Behavior Questionnaires at ages 3 months, 2 years, and 3 years. Main outcome measures were child standardized weight-for-age z score (WFAz) and obesity risk (WFA≥95th percentile) at age 3 years. Statistical analyses performedAT stability was assessed using correlations and multilevel modeling. Linear and logistic regression analyses examined associations between ATs and child WFAz and obesity risk at age 3 years. ResultsThere was limited stability for all ATs measured over time. During infancy, Slowness in Eating was associated with lower 3-year WFAz (B = –0.18, 95% CI –0.33 to –0.04; P = 0.01). At age 2 years, Slowness in Eating and Satiety Responsiveness were associated with lower WFAz (B = –0.29, 95% CI –0.47 to –0.12; P < 0.01; B = –0.36, 95% CI –0.55 to –0.17; P < 0.01) and obesity risk (adjusted odds ratio 0.49, 95% CI 0.28 to 0.85; adjusted odds ratio 0.61, 95% CI 0.38 to 0.99) at 3 years. Increased Slowness in Eating and Satiety Responsiveness over time were associated with lower 3-year WFAz (B = –0.74, 95% CI –1.18 to –0.2 [Slowness in Eating]; B = –1.19, 95% CI –1.87 to –0.52 [Satiety Responsiveness], both P values = 0.001). Higher Enjoyment of Food over time was associated with higher 3-year WFAz (B = 0.62, 95% CI 0.24 to 1.01; P = 0.002). ConclusionsInfants with lower Slowness in Eating and Satiety Responsiveness may have higher levels of obesity risk and need more tailored approaches to nutrition counseling and obesity prevention.

Meal-time Smartphone Use in an Obesogenic Environment: Two Longitudinal Observational Studies.

BackgroundDespite a large volume of research on the impact of other digital screens (eg, televisions) on eating behavior, little is known about the nature and impact of mealtime smartphone use.ObjectiveWe investigated how smartphones are used in everyday meals, whether phone users differ according to mealtime phone use patterns, and whether specific phone functions (particularly food photography) would affect the amount and enjoyment of food eaten.MethodsAcross 2 studies, we used the experience sampling method to track 1780 meals in situ. In study 1, a total 137 young adults reported on their mealtime smartphone use 3 times per day over 7 consecutive days. This corresponded to each main meal, with participants recording whether they used their phones and what phone functions they engaged in while eating. In study 2, a total of 71 young adults were similarly tracked for 3 meals per day over 7 days. Across the week, participants’ meals were randomized to 1 of 3 smartphone conditions: food photography while eating, nonfood photography while eating, or no phone use. As the outcome measures, participants reported on the amount and enjoyment of food they ate.ResultsDuring the week-long tracking, most participants (110/129, 85.3%) recorded at least one instance of mealtime smartphone use, with an average frequency of 1 in 3 meals where phones were used (27.1%; 95% CI 23.6-30.6). Unlike traditional digital screens, mealtime phone use encompassed a wide range of social and nonsocial activities. Further, specific forms of phone use behaviors influenced food intake in different ways. Specifically, in study 2, participants showed the typical pattern of increased food intake across the day when they engaged in nonfood photography during a meal (P<.001); however, this pattern was disrupted when they engaged in food photography (P=.73).ConclusionsOur findings underscore the prevalence and multifaceted nature of mealtime phone use, distinguishing mobile phones from traditional forms of digital screens.Trial RegistrationClinicalTrials.gov NCT03299075; https://www.clinicaltrials.gov/ct2/show/NCT03299075 and ClinicalTrials.gov NCT03346785; https://clinicaltrials.gov/ct2/show/NCT03346785

Preliminary evaluation of the Chinese version of the Baby Eating Behaviour Questionnaire.

BackgroundThis study was conducted to develop a Chinese version of the Baby Eating Behaviour Questionnaire (BEBQ) and to evaluate its reliability and validity.MethodsThe Chinese version of the BEBQ was developed by translation and back‐translation of the original BEBQ, followed by revision according to experts on the most appropriate item content. Mothers of 300 infants aged <12 months were recruited for survey participation from the paediatric outpatient departments of two large general hospitals in Xi'an, China. Fifty of the mothers were selected randomly for retesting after 2 weeks. Face‐to‐face surveys included explanation of the process, administration of the Chinese version of the BEBQ with regard to the exclusive breast‐feeding period, and demographic data collection. The reliability, validity and discrimination of the questionnaire were evaluated through correlation coefficient calculation, factor analysis, parallel analysis and other methods.ResultsThe Chinese version of the BEBQ consists of 15 items in four dimensions (food responsiveness, enjoyment of food, slowness in eating and satiety responsiveness). The cumulative variance contribution rate was 58.4%, the Cronbach's α coefficient was 0.93, the Guttman split‐half reliability coefficient was 0.87 and the test–retest reliability coefficient was 0.75. The satiety responsiveness and food responsiveness scores differed significantly according to gestational age at birth, infant sex and average monthly weight gain (all P < 0.05). The enjoyment of food score differed significantly according to average monthly weight gain (P < 0.05).ConclusionsThe Chinese version of the BEBQ showed good reliability and validity and can be used to evaluate infants' appetite through the assessment of eating behaviour.

Psychometric properties of the Child Eating Behavior Questionnaire (CEBQ) in school age children with overweight and obesity: A proposed three-factor structure.

Obesity in youth is a significant public health concern, with eating behaviors being a major contributor. The Child Eating Behavior Questionnaire (CEBQ) was developed to evaluate the appetitive characteristics of young children, across a myriad of eating domains. Despite the breadth of its use, the psychometric properties of the measure in children with overweight/obesity (OW/OB), particularly treatment seeking youth, remains largely unexplored. The psychometric properties of the CEBQ were examined in a sample of school age children (8-12) with OW/OB. Parent-child dyads (N=148) completed assessments prior to beginning a family weight management program. Exploratory factor analysis (EFA) was performed utilizing polychoric correlations, and emerging subscales were assessed to ensure that the range of response scores demonstrated adequate variability. Indices of the number of factors to be retained included acceleration factor (2), optimal coordinates (4), Velicer's MAP (5) and parallel analysis (11). These indices were used in combination with clinical utility to determine the final factor structure. A three-factor structure emerged. The first factor combined many food responsiveness, enjoyment of food, satiety responsiveness and slowness in eating items, with the latter two domains loading negatively. The second factor retained the food fussiness subscale, and the third factor included items from the emotional over- and under-eating subscales. These results suggest that in children with OW/OB, eating behaviors may be optimally assessed using three domains: reward-based eating, emotional eating and picky eating. Future research should explore how this structure holds in non-treatment-seeking samples and across wider socio-demographic profiles.

202 COVID-19 Pandemic Sleep Disturbances Related To Dietary Behavior at the US-Mexico Border

IntroductionThe COVID-19 pandemic has disrupted life at the US-Mexico border in many ways, including sleep and dietary behavior. Given the potential long-term impact of worsening sleep and metabolic health due to the pandemic, the present study examines whether changes to dietary behavior were associated with changes to sleep.MethodsParticipants were 155 individuals who completed the Nogales Cardiometabolic Health and Sleep (NOCHES) Study and were contacted about completing a COVID-19 sub-study (95% Hispanic/Latino). Participants reported the degree to which they experienced pandemic-related changes to sleep, including a more regular schedule, overall improvement, overall worsening, more initial insomnia, more middle-of-the-night insomnia, more daytime sleepiness, and more napping. They were also asked whether as a result of the pandemic they consumed an overall healthier diet, more homecooked meals, more processed meals, more regular meals, whether they enjoyed food more, and degree of overeating. Ordinal regressions with diet change as outcome and sleep change as predictor were adjusted for age, sex, education, and socioeconomics.ResultsThose who reported more regular sleep were more likely to report a healthier overall diet (oOR=3.12,p<0.0005), more homecooked meals (oOR=2.18,p=0.001), more enjoyment of food (oOR=1.71,p=0.028), and less likelihood of overeating (oOR=0.59,p=0.033). Similarly, those who reported more “improved” sleep reported healthier overall diet (oOR=7.42,p<0.0005), more homecooked meals (oOR=2.59,p=0.001), more regular diet (oOR=2.15,p=0.006), more enjoyment of food (oOR=2.92,p<0.0005), less consumption of processed foods (oOR=0.54,p=0.039), and less overeating (0.33,p<0.0005). Those whose sleep worsened reported eating more processed foods (oOR=1.78,p=0.030) and overeating (oOR=3.90,p<0.0005). Those who reported more initial insomnia reported eating more processed foods (oOR=1.93,p=0.016), more regular diet (oOR=1.65,p=0.042), and overeating more often (oOR=4.11,p<0.0005). More middle-of-the-night insomnia was associated with eating more processed foods (oOR=2.45,p=0.001), more regular diet (oOR=1.66,p=0.031), and overeating more often (oOR=3.68, <0.0005). Those with more daytime sleepiness also reported eating more processed foods (oOR=2.36,p=0.003), more regular diet (oOR=1.79, =0.019), and overeating more often (oOR=3.28,p<0.0005). More napping was associated with a more regular diet (oOR=1.90,p=0.011) and more overeating (oOR=3.53,p<0.0005).ConclusionOverall, worse sleep led to worse dietary behavior, especially eating more processed food and overeating.Support (if any)Supported by T32HL007249, R01MD011600, R01DA051321

Acquired Brain Injury-Induced Hyperphagia and Obesity, Successfully Treated With a GLP-1 Agonist

Background: Several Glucagon-like peptides 1 (GLP-1s) were approved since 2005 for the treatment of DM & obesity. Their usefulness in other conditions is not well studied. We present two cases of hyperphagia after TBI successfully treated with GLP-1 agonists. Clinical cases: Case 1: A 54-year-old female with a history of multiple traumatic brain injuries (multiple falls and a ski accident) complained of years of insatiable hunger leading to hyperphagia and over 20 pounds weight gain. With tremendous will-power, she avoided additional weight gain by adopting a strict meal-plan and increasing her water intake (10–12 liters a day) to relieve her hunger. She sipped so much water, that her sodium remained 123 - 133 mmol/L (ref: 135–146) with dilute urine. Initial tests revealed: IGF-1 315 ng/ml (52–328), FSH 77.5 mIU/ml (23–116.3), LH 24.3 mIU/ml (14.2–52.3), prolactin 17.1 ng.ml (10–54.7), estradiol 17 (<31), TSH 1.09mIU/ml (0.45–4.5), FT4 1.0 ng/dl(0.8–1.8), all within the normal limit for her age. Semaglutide 0.25mg/week was started and increased to 0.5mg/week. Within the first six months of treatment, she experienced 22 pounds of weight loss, hunger relief, less water sipping behavior, and more enjoyment of food. Her sodium rose to 137 mmol/L. Case 2: A 40-year-old female, s/p craniectomy and aneurysm clipping due to intracranial hemorrhage complicated by an ischemic stroke developed sudden, documented, 45-pound weight gain over thirteen months despite aggressive lifestyle modification attempts. Initial labs revealed: TSH 1.33 mIU/ml (0.45–4.5), FT4 1.22 ng/dl (0.8–1.8), midnight salivary cortisol 0.03 mcg/dl (<0.09), ruling out hypothyroidism and Cushing syndrome. Liraglutide 1.8mg/day was started and has resulted to date in 26 pounds (11.8% of maximum weight) by 9 months with an associated decrease in subjective hunger. Conclusion: Hyperphagia can be seen in brain injury, in response to some medications, and some genetic conditions, like Prader-Willi. The exact mechanisms are not clear am may be multifactorial. In the case of brain injury, proposed mechanisms include insatiable hunger due to ventromedial hypothalamic or brain stem dysfunction, or disinhibition and poor impulse control due to frontal lobe injury. GLP-1’s may act on the causal mechanism for increased hunger, or it may result in clinical improvement through a parallel pathway. More studies are warranted to investigate the application of GLP-1’s to hyperphagia.

Lowering barriers to plant-based diets: The effect of human and non-human animal self-similarity on meat avoidance intent and sensory food satisfaction

The connection between plant-based diets and compassion is intuitive. Prior research has demonstrated that food of ethical origin subjectively tastes better to consumers who embrace ethical values. Since meat avoiders generally internalize the values associated with the avoidance of animal-derived products, higher levels of compassion are expected to enhance the subjective taste of meatless food choices, which has implications for lowering barriers to the adoption of vegetarian diets.Three experimental laboratory studies demonstrate that compassion improves the subjective taste of meatless foodstuffs and increases meat avoidance intent, which translates into a higher probability to choose a vegetarian wrap rather than a meat-containing wrap. Two online studies illuminate the underlying psychological process, which is mediated by perceived self-similarity to human and non-human animals.Identifying individual traits that are associated with heightened enjoyment of meatless foods facilitates marketing segmentation for meatless foodstuffs. Furthermore, the tested compassion-inducing visual stimuli can be adapted for product packaging or employed in restaurant décor to elevate consumers’ subjective taste of meatless foods, potentially counteracting the negative individual and societal health effects of excessive meat intake.The moderating effect of meat avoidance intent on subjective taste suggests that, for people who consider reducing their meat intake, transitory zones exist where the perceived enhancement in taste of vegetarian food is not sufficiently motivating to change dietary practices permanently and it may appear more rewarding to simply revert to meat consumption. Social marketers can focus on these zones where moral conflict about meat consumption is salient by providing support to make dietary transitions less frustrating.This set of studies is the first to articulate the connection between compassion and ethical food choices in a consumer-relevant context. The findings point towards avenues to promote meat reduction, improve individual physical and mental health, and reduce the environmental impact of meat production.

Visible sugar : Salient sugar information impacts health perception of fruit juices but only when motivated to be responsible and not when motivated to enjoy

The present study explores when consumers recognize the high sugar content of fruit juice and refrain from choosing it for themselves or their families. Fruit juice may be typically perceived as a healthy drink, despite its often high sugar content. We investigate the role of salience of sugar information and enjoyment and responsibility goals in perception and choice of fruit juices. We argue that sugar information needs to be salient to prevent this health halo effect, but that consumers also need to be in a motivational state that promotes processing of this information. In three experiments (N = 801), we manipulate the salience of the sugar content using a salient sugar label (or no explicit sugar label) as well as the activation of different goals (to enjoy versus to be responsible, in the context of choices for self versus significant others). Utilising a newly designed fictitious juice brand, salient sugar labels are effective in significantly raising awareness of sugar content in study 1. Consumers primed for responsibility consider fruit juice with salient sugar information unhealthier as compared to those primed for enjoyment in study 2. Further, in study 3, parents primed for responsibility perceive fruit juice with salient sugar information as unhealthier and less appealing in comparison to parents primed for enjoyment. The effects of responsibility and enjoyment primes on health perceptions are stronger when people think of responsibility or enjoyment of food in the context of their families rather than themselves. We discuss implications for theorizing, beverage marketing, and public policy.

Eating behaviour, physical activity, TV exposure and sleeping habits in five year olds: a latent class analysis

BackgroundDiet, physical activity, sedentary behaviours, and sleep time are considered major contributory factors of the increased prevalence of childhood overweight and obesity. The aims of this study were to (1) identify behavioural clusters of 5 year old children based on lifestyle behaviours, (2) explore potential determinants of class membership, and (3) to determine if class membership was associated with body measure outcomes at 5 years of age.MethodsData on eating behaviour, engagement in active play, TV watching, and sleep duration in 1229 5 year old children from the Cork BASELINE birth cohort study was obtained through in-person interviews with parent. Latent class analysis was used to identify behavioural clusters. Potential determinants of cluster membership were investigated using multinomial logistic regression. Associations between the identified classes and cardio metabolic body measures were examined using multivariate logistic and linear regression, with cluster membership used as the independent variable.Results51% of children belonged to a normative class, while 28% of children were in a class characterised by high scores on food avoidance scales in combination with low enjoyment of food, and 20% experienced high scores on the food approach scales. Children in both these classes had lower conditional probabilities of engaging in active play for at least 1 hour per day and sleeping for a minimum of 10 h, and higher probability of watching TV for 2 hours or more, compared to the normative class. Low socioeconomic index (SEI) and no breastfeeding at 2 months were found to be associated with membership of the class associated with high scores on the food avoidance scale, while lower maternal education was associated with the class defined by high food approach scores. Children in the class with high scores on the food approach scales had higher fat mass index (FMI), lean mass index (LMI), and waist-to-height ratio (WtHR) compared to the normative class, and were at greater risk of overweight and obesity.ConclusionFindings suggest that eating behaviour appeared to influence overweight and obesity risk to a greater degree than activity levels at 5 years old. Further research of how potentially obesogenic behaviours in early life track over time and influence adiposity and other cardio metabolic outcomes is crucial to inform the timing of interventions.

Gender effect on eating habits of Nigerian school children.

It is important to investigate children's eating habits based on different eating behaviors such as satiety responsiveness (SR), slowness in eating (SE), food fussiness (FF), food responsiveness (FR), enjoyment of food (EF), desire to drink (DD), emotional under-eating (EUE), and emotional over-eating (EOE). The main objective of this research was to investigate whether gender affects the eating habits of Nigerian school children.A cross-sectional survey was conducted between March and June 2019. A total of 120 parents of school children participated in the study. The Child Eating Behavior Questionnaire (CEBQ) was used to collect data. The CEBQ is composed of 35 items and eight subscales.Based on the analysis of parents’ reports, DD was higher in boys than girls, t (118) = 7.086, P < .001; EOE was higher in boys than girls, t (118) = 5.184, P < .001; EF was higher in boys than girls, t (118) = 2.183, P < .001; FF was higher in boys than girls, t (118) = 9.441, P < .001; and SR was higher in boys than girls, t (118) = 7.323, P < .001. However, EUE was lower in boys than girls, t (118) = −4.339, P < .001; FR was lower in boys than girls, t(118) = −3.112, P < .001; SE was lower in boys than girls, t(118) = −3.832, P < .001; thus, gender had a significant influence on eating habits of the school children.Gender significantly affects the eating habits of Nigerian school children. Thus, gender is an important factor to be considered when aiming to improve the eating habits of Nigerian school children.

Quality of life and safety impact of COVID-19 associated smell and taste disturbances

ObjectiveThe association between COVID-19 and chemosensory loss has garnered substantial attention, however to date little is known about the real-life consequences of impairment in this unique patient population. The aim of this study is to evaluate the quality of life (QOL) and personal safety deficits experienced by patients with COVID-19 infection. Study designProspective, longitudinal questionnaires. SettingNational survey. MethodsA longitudinal web-based nationwide survey of adults with COVID-19 and/or a sudden change in smell and taste was launched April 10, 2020. Previously published questions on chemosensory-related QOL and safety events were asked at the 6-month follow-up survey. ResultsAs of February 10, 2021, 480 eligible respondents took the 6-month questionnaire, of whom 322 were COVID-19 positive. Impact on QOL was substantial with 96% of subjects reporting at least one of the defined deficits, and over 75% reporting at least 3 of these. “Reduced enjoyment of food” was the most common complaint (87%), while 43% of subjects self-reported depression. The prevalence of safety-related issues was common in this population, with over 57% reporting at least one, and 36% reporting 2 or more events. Of the events asked, the inability to smell smoke that others could perceive was the most common at 45%. ConclusionsCOVID-19 associated chemosensory losses have a real and substantial impact on both quality of life and safety, beyond mere inconvenience. The high prevalence of these issues despite a relatively short period of olfactory deficit should alert clinicians to the serious risks to an already vulnerable patient population.