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Showing papers on "Snacking published in 2016"


Journal ArticleDOI
TL;DR: This review aims to assess the definition of extra eating occasions, to understand why eating is initiated at these occasions, and to determine what food choices are common at these eating occasions in order to identify areas for dietary intervention and improvement.

178 citations


Journal ArticleDOI
TL;DR: The observed cross-sectional associations suggest that snack consumption is a risk factor for poor diet, but unless energy-dense foods are consumed, snacking does not consistently contribute to overweight in US adolescents.
Abstract: BACKGROUND Most adolescents consume ≥1 snack/d; exploring the relevance of snacking patterns for overall diet and weight status is important to guide dietary counseling and public health strategies for obesity prevention. OBJECTIVE This study examined intake of common energy-dense snack foods, total number of snacks consumed, frequency of consuming snacks prepared away from home, and frequency of snacking while watching television in adolescents and how these behaviors may be linked to diet and weight status. Relations were examined with attention to potential confounders that may help explain the mixed findings of previous research. METHODS Survey measures of snacking behavior, a food-frequency questionnaire, and anthropometric measurements were completed by 2793 adolescents (53.2% girls, mean age = 14.4 y) in Minneapolis-St. Paul school classrooms in 2009-2010. Linear regression was used to examine associations with adjustment for sociodemographic characteristics and other potential confounding factors, such as meal skipping, underreporting energy intake, dieting to lose weight, and physical activity. RESULTS Adolescents reported consuming a mean of 2.2 energy-dense snack food servings/d and 4.3 snacks/d and purchasing snacks prepared away from home on 3.2 occasions/wk. More than two-thirds of adolescents reported that they sometimes, usually, or always consumed a snack while watching television. The measures of snacking were directly associated (P < 0.01) with higher energy, lower fruit/vegetable, higher sugar-sweetened beverage, and more frequent fast-food intakes in all models except for one: energy-dense snack food servings were not related to sugar-sweetened beverage intake. A direct relation between daily servings of energy-dense snack foods and body mass index (BMI) z score was found; however, the snacking behaviors were inversely related to BMI z score (P < 0.01). CONCLUSIONS The observed cross-sectional associations suggest that snack consumption is a risk factor for poor diet, but unless energy-dense foods are consumed, snacking does not consistently contribute to overweight in US adolescents.

87 citations


Journal ArticleDOI
TL;DR: The evidence concerning the effects of snack foods on obesity has been mixed, with a number of interventional and observational studies not finding a link between snack foods and increased weight status.

86 citations


Journal ArticleDOI
01 May 2016-Appetite
TL;DR: Functional Imagery Training (FIT) as discussed by the authors is a new theory-based, manualized intervention that trains positive goal imagery, to sustain motivation and compete with less functional cravings, and it can support change in eating behaviours, showing its potential as a motivational intervention for weight management.

83 citations


01 Feb 2016
TL;DR: Frequency of motivational thoughts about snack reduction rose following FIT for both groups, and this change correlated with reductions in snacking and weight loss.
Abstract: Functional Imagery Training (FIT) is a new theory-based, manualized intervention that trains positive goal imagery. Multisensory episodic imagery of proximal personal goals is elicited and practised, to sustain motivation and compete with less functional cravings. This study tested the impact of a single session of FIT plus a booster phone call on snacking. In a stepped-wedge design, 45 participants who wanted to lose weight or reduce snacking were randomly assigned to receive a session of FIT immediately or after a 2-week delay. High-sugar and high-fat snacks were recorded using timeline follow back for the previous 3 days, at baseline, 2 and 4 weeks. At 2 weeks, snacking was lower in the immediate group than in the delayed group, and the reduction after FIT was replicated in the delayed group between 2 and 4 weeks. Frequencies of motivational thoughts about snack reduction rose following FIT for both groups, and this change correlated with reductions in snacking and weight loss. By showing that FIT can support change in eating behaviours, these findings show its potential as a motivational intervention for weight management.

78 citations


Journal ArticleDOI
TL;DR: Modifying food form to encourage increased oral processing (albeit to a lesser extent than in experimental manipulations) might represent a viable target for food manufacturers to help to nudge consumers to manage their weight.
Abstract: Laboratory studies have demonstrated that experimental manipulations of oral processing can have a marked effect on energy intake. Here, we explored whether variations in oral processing across a range of unmodified everyday meals could affect post-meal fullness and meal size. In Study 1, female participants (N = 12) attended the laboratory over 20 lunchtime sessions to consume a 400-kcal portion of a different commercially available pre-packaged meal. Prior to consumption, expected satiation was assessed. During each meal, oral processing was characterised using: (i) video-recordings of the mouth and (ii) real-time measures of plate weight. Hunger and fullness ratings were elicited pre- and post-consumption, and for a further three hours. Foods that were eaten slowly had higher expected satiation and delivered more satiation and satiety. Building on these findings, in Study 2 we selected two meals (identical energy density) from Study 1 that were equally liked but maximised differences in oral processing. On separate days, male and female participants (N = 24) consumed a 400-kcal portion of either the "fast" or "slow" meal followed by an ad libitum meal (either the same food or a dessert). When continuing with the same food, participants consumed less of the slow meal. Further, differences in food intake during the ad libitum meal were not compensated at a subsequent snacking opportunity an hour later. Together, these findings suggest that variations in oral processing across a range of unmodified everyday meals can affect fullness after consuming a fixed portion and can also impact meal size. Modifying food form to encourage increased oral processing (albeit to a lesser extent than in experimental manipulations) might represent a viable target for food manufacturers to help to nudge consumers to manage their weight.

72 citations


Journal ArticleDOI
TL;DR: Consistent with theory, the intention-behavior relation for healthy eating is best understood as a within-person process and interventions to reduce unhealthy snacking should target times of day when intentions are weakest.
Abstract: Despite their good intentions, people often do not eat healthily. This is known as the intention-behavior gap. Although the intention-behavior relationship is theorized as a within-person process, most evidence is based on between-person differences. The purpose of the present study is to investigate the within-person intention-behavior association for unhealthy snack consumption. Young adults (N = 45) participated in an intensive longitudinal study. They reported intentions and snack consumption five times daily for 7 days (n = 1068 observations analyzed). A within-person unit difference in intentions was associated with a halving of the number of unhealthy snacks consumed in the following 3 h (CI95 27–70 %). Between-person differences in average intentions did not predict unhealthy snack consumption. Consistent with theory, the intention-behavior relation for healthy eating is best understood as a within-person process. Interventions to reduce unhealthy snacking should target times of day when intentions are weakest.

59 citations


Journal ArticleDOI
01 Jan 2016-Appetite
TL;DR: It is concluded that individuals who show increased food intake when in a negative emotional state also overeat when experiencing other food-signalling cues, indicating that 'em emotional eating' may not fully capture the eating behaviour of individuals currently identified as 'emotional eaters'.

48 citations


Journal ArticleDOI
TL;DR: A higher %EI at lunch was associated with a lower risk of weight gain; this may help weight control through the appropriate distribution of daily EI.
Abstract: Experimental research suggests that food timing is associated with weight regulation. However, the association between the distribution of energy intake (EI) throughout the day and weight gain in the population is uncertain. A cohort of 4243 individuals (49·9 % men, 50·1 % women) aged ≥18 years was selected in 2008-2010 and followed-up through 2012. At baseline, food consumption for a typical week in the previous year was collected with a validated dietary history, and EI was assessed at six eating occasions: breakfast, mid-morning meal, lunch, mid-afternoon meal, dinner and snacking (at any other moment). Individuals were classified into sex-specific quartiles of %EI for each eating occasion. The cut-off points for increasing quartiles of %EI at lunch were 34·4, 40·8 and 47·7 % in men and 33·2, 39·4 and 46·1 % in women. Weight was self-reported at baseline and at the end of follow-up. During a 3·5-year follow-up, 16·3 % of study participants gained >3 kg. Compared with those in the lowest quartile of %EI at lunch, the multivariate OR of gaining >3 kg was 0·79 (95 % CI 0·63, 0·99) in the second quartile, 0·82 (95 % CI 0·64, 1·04) in the third quartile and 0·62 (95 % CI 0·47, 0·80) in the highest quartile (P trend: 0·001). The association was stronger among women and those with overweight or obesity. No association was found between the %EI at the rest of the eating occasions and weight gain. In conclusion, a higher %EI at lunch was associated with a lower risk of weight gain; this may help weight control through the appropriate distribution of daily EI.

45 citations


Journal ArticleDOI
TL;DR: Food selection and the motivations of those selections are dependent on liking, but other motivators differed across eating occasions, suggesting that the intended meal time is a key factor that should be considered when testing food and beverage products.
Abstract: This pilot study applied an eating motivation survey to explore motivations behind eating occasions by looking at specific choices of foods and beverages people consumed at various meal times. This study was conducted online with 198 people. The survey included questions about demographics, the most recent meal including specific food choices and an eating motivation questionnaire which contained 50 subscales to measure 17 motivations using Check-All-That-Apply procedures. Data were analyzed by Correspondence Analysis. Liking was the strongest motivation that drove people to select certain foods, regardless of eating occasions. Need and Hunger, Habits, Price and Convenience were the main motivations for breakfast, lunch and dinner while Health and Weight Control were found to be the main driving factors for daytime snacking. Late-night snacks were linked to Pleasure and Visual appeal. For dinner, people were additionally motivated by Variety Seeking and Traditional Eating. Practical Applications Daily food choice is a complex decision influenced by various factors and eating context is one of those. Food selection and the motivations of those selections are dependent on liking, but other motivators differed across eating occasions. This suggests that the intended meal time is a key factor that should be considered when testing food and beverage products.

43 citations


Journal ArticleDOI
TL;DR: It is suggested that unhealthy dietary and lifestyle practices could increase the risk of adherence to unhealthy Western-based food pattern that is high in fat, sugar and salt contents, and, consequently, increase therisk of developing obesity and metabolic-related disorders during these critical years of growth.
Abstract: Objective: The aim of the study was to identify the ethnic differences in dietary patterns and its association with socio-economic, dietary and lifestyle practices among adolescents in Kelantan, Malaysia. Methods: A population-based study of 454 adolescents aged 12 to 19 years was included. A validated food frequency questionnaire was used to assess dietary patterns and three dietary patterns were identified based on the principal component analysis method. Results: Malay adolescents had significantly higher scores for the Western-based food pattern and local-based food pattern, whereas Chinese adolescents showed higher scores for the healthy-based food pattern. Multivariate analyses show that age and physical activity (PA) levels were positively associated with healthy-based food pattern in Malay (All, p < 0.001), whereas higher consumption of eating-out from home (EatOut) (p = 0.014) and fast food (p = 0.041) were negatively associated. High weekly breakfast skipping (p < 0.001) and EatOut (p = 0.003) were positively associated with a Western-based pattern, whereas age (p < 0.001) and household income (p = 0.005) were negatively associated. Higher frequency of daily snacking (p = 0.013) was positively associated with local-based food pattern. For Chinese adolescents, age (p < 0.001), PA levels (p < 0.001) and maternal education level (p = 0.035) showed positive associations with the healthy-based pattern, whereas high EatOut (p = 0.001) and fast food intakes (p = 0.001) were negatively associated. Higher weekly consumption of EatOut (p = 0.007), fast food (p = 0.023) and carbonated beverages (p = 0.023), and daily snacking practice (p = 0.004) were positively associated with higher Western-based food pattern, whereas age (p = 0.004) was inversely associated. Conclusion: This study showed that there were significant differences in dietary patterns and its association factors between Malay and Chinese adolescents. More importantly, these findings suggest that unhealthy dietary and lifestyle practices could increase the risk of adherence to unhealthy Western-based food pattern that is high in fat, sugar and salt contents, and, consequently, increase the risk of developing obesity and metabolic-related disorders during these critical years of growth.

Journal ArticleDOI
01 Jun 2016-Emotion
TL;DR: On stressful days, increasing physical activity or ensuring high sleep quality may buffer adverse effects of stress on affect in young adults, and suggest potential targets for health-promotion and stress-prevention programs, which could help reduce the negative impact of stress.
Abstract: We investigated the potential stress-buffering effect of 3 health behaviors-physical activity, sleep quality, and snacking-on affect in the context of everyday life in young adults. In 2 intensive longitudinal studies with up to 65 assessment days over an entire academic year, students (Study 1, N = 292; Study 2, N = 304) reported stress intensity, sleep quality, physical activity, snacking, and positive and negative affect. Data were analyzed using multilevel regression analyses. Stress and positive affect were negatively associated; stress and negative affect were positively associated. The more physically active than usual a person was on a given day, the weaker the association between stress and positive affect (Study 1) and negative affect (Studies 1 and 2). The better than usual a person's sleep quality had been during the previous night, the weaker the association between stress and positive affect (Studies 1 and 2) and negative affect (Study 2). The association between daily stress and positive or negative affect did not differ as a function of daily snacking (Studies 1 and 2). On stressful days, increasing physical activity or ensuring high sleep quality may buffer adverse effects of stress on affect in young adults. These findings suggest potential targets for health-promotion and stress-prevention programs, which could help reduce the negative impact of stress in young adults. (PsycINFO Database Record

Journal ArticleDOI
01 Aug 2016-Appetite
TL;DR: It is found that employees who used the beverage station closer to the snack station were more likely to take a snack, and employers and even families could reduce snack consumption easily, cheaply, and without backlash by increasing the relative distance between beverages and snacks.

Journal ArticleDOI
TL;DR: The aim was to investigate how adolescents evaluate the healthiness of snacks currently available for consumption in school environments, and the findings are important for tailoring future interventions to promote healthy eating and setting priorities for nutrition education.

Journal ArticleDOI
22 Jul 2016-PLOS ONE
TL;DR: It is demonstrated that key components of adolescents’ dietary behaviors are influenced by a complex interplay of individual and environmental factors that varied by type of dietary behavior.
Abstract: OBJECTIVE: Given the public health importance of improving dietary behavior in chronic disease prevention in low- and middle-income countries it is crucial to understand the factors influencing dietary behavior in these settings. This study tested the validity of a conceptual framework linking individual and environmental factors to dietary behavior among Ecuadorian adolescents aged 10-16 years. METHODS: A cross-sectional survey was conducted in 784 school-going Ecuadorian adolescents in urban and rural Southern Ecuador. Participants provided data on socio-economic status, anthropometry, dietary behavior and its determining factors. The relationships between individual (perceived benefits and barriers, self-efficacy, habit strength, and a better understanding of healthy food) and environmental factors (physical environment: accessibility to healthy food; social environment: parental permissiveness and school support), and their association with key components of dietary behavior (fruit and vegetables, sugary drinks, breakfast, and unhealthy snack intake) were assessed using structural equation modeling. RESULTS: The conceptual model performed well for each component of eating behavior, indicating acceptable goodness-of-fit for both the measurement and structural models. Models for vegetable intake and unhealthy snacking showed significant and direct effects of individual factors (perceived benefits). For breakfast and sugary drink consumption, there was a direct and positive association with socio-environmental factors (school support and parental permissiveness). Access to healthy food was associated indirectly with all eating behaviors (except for sugary drink intake) and this effect operated through socio-environmental (parental permissiveness and school support) and individual factors (perceived benefits). CONCLUSION: Our study demonstrated that key components of adolescents' dietary behaviors are influenced by a complex interplay of individual and environmental factors. The findings indicate that the influence of these factors varied by type of dietary behavior.

Journal ArticleDOI
TL;DR: Findings underscore the effect of unhealthy eating practices among adolescents on mental health and targeted education should be implemented to improve psychological well-being.

Journal ArticleDOI
TL;DR: Eating more frequently improves dietary quality especially if some eating occasions are low in energy, and a focus on replacing high-energy snacks with low-energy alternatives rather than reducing the number of eating occasions may result in improved dietary quality in adolescents.
Abstract: To describe the effects of number of eating occasions and snacks on dietary quality (DQ), defined as adherence to dietary recommendations. A sample of 884 adolescents (11–18 years) in the UK National Diet and Nutrition Survey (NDNS) were included. The Diet Quality Index for Adolescents (DQI-A) was implemented. The total number of eating occasions and snacks was frequency of food or beverages consumed over 24 h and frequency of foods or beverages consumed outside of the three mealtimes, respectively. Results were generated with and without low-energy food under 210 kJ (50 kcal). Regression models were generated with DQ score as the outcome variable and number of eating occasions and snacks as predictors. The mean (95 % CI) DQ score was 31.1 % (30.2, 32.0). The mean number of eating occasions and snacks was 7.5 (7.3, 7.7) and 2.6 (2.6, 2.7) times/day, respectively. When low-energy events were excluded, the mean number of eating occasions and snacks reduced to 6.2 (6.1, 6.4) and 2.0 (2.0, 2.1) times/day, respectively. DQ score increased by 0.74 points (0.42, 1.05; p < 0.01) and 0.55 points (−0.08, 0.69; p = 0.17) for total eating occasions and snacks, respectively. When low-energy events were excluded, DQ score increased by 0.30 points (−0.84, 0.69; p = 0.13) for each eating occasion and decreased by 1.20 points (−2.1, −0.3; p < 0.01) for each snack. Eating more frequently improves dietary quality especially if some eating occasions are low in energy. A focus on replacing high-energy snacks with low-energy alternatives rather than reducing the number of eating occasions may result in improved dietary quality in adolescents.

Journal ArticleDOI
TL;DR: Modifying snacking choices, especially in the afternoon, could improve the nutritional quality of children's diets.

Journal ArticleDOI
TL;DR: More research looking at screen exposure before bedtime and its effects on sleep is needed given the pervasiveness of electronic media devices in today’s environment.
Abstract: Chronic lack of sleep (called "sleep deprivation") is common in modern societies with 24/7 availability of commodities. Accumulating evidence supports the role of reduced sleep as contributing to the current obesity epidemic in children and youth. Longitudinal studies have consistently shown that short sleep duration is associated with weight gain and the development of obesity. Recent experimental studies have reported that sleep restriction leads to weight gain in humans. Increased food intake appears to be the main mechanism by which insufficient sleep results in weight gain. Voluntary sleep restriction has been shown to increase snacking, the number of meals eaten per day, and the preference for energy-dense foods. Although the causes of sleep loss in the pediatric population are numerous, more research looking at screen exposure before bedtime and its effects on sleep is needed given the pervasiveness of electronic media devices in today's environment. Health professionals should routinely ask questions about sleep and promote a good night's sleep because insufficient sleep impacts activity and eating behaviors. Future research should examine the clinical benefits of increasing sleep duration on eating behaviors and body weight control and determine the importance of adequate sleep to improve the treatment of obesity.

Journal ArticleDOI
TL;DR: Focusing on children with low educated parents and on snacking at home after school after school offers the greatest potential to reduce snack food and drink intakes.
Abstract: OBJECTIVE: To describe the energy-dense snack food (EDSF) and energy-dense drink (EDD) consumption of children in the Netherlands and investigate subgroup differences. The amounts consumed, eating occasions, places of consumption and consumed types are reported. DESIGN: Twenty-four hour dietary recall data were used to describe the EDSF and EDD consumption. Subgroup differences concerning these intakes were identified with ANCOVA. SETTING: Dutch National Food Consumption Survey 2007-2010. SUBJECTS: Children (n 860) aged 7-12 years. RESULTS: The mean number of EDSF events was 3.3 (sd 1.6) per day, yielding 1569.7 (sd 928.7) kJ. Average EDD consumption was 594.2 (sd 342.3) ml/d, yielding 737.2 (sd 495.9) kJ. Over 90 % of the children consumed more energy from non-core foods per day than recommended. Differences in EDSF and EDD consumption were found between several subgroups. Most importantly, we found higher intakes among older children and children with low educated mothers. Almost half of the EDSF events took place in the afternoon and at home. Cookies and sweets were consumed during half of the EDSF events. Almost one-third of the EDD were consumed in the afternoon. The majority of these drinks were consumed at home and most were soft drinks. CONCLUSIONS: The results demonstrate that snack food and drink consumption is highly prevalent among Dutch children. Health promotion efforts addressing these behaviours are warranted and the present study could accelerate these initiatives. Focusing on children with low educated parents and on snacking at home after school offers the greatest potential to reduce snack food and drink intakes.

Journal ArticleDOI
TL;DR: The effect of a novel behaviour change intervention, Gerakan Rumpi Sehat (the Healthy Gossip Movement), on infant and young child feeding practices in peri‐urban Indonesia is studied.
Abstract: OBJECTIVE: It is unclear how best to go about improving child feeding practices. We studied the effect of a novel behaviour change intervention, Gerakan Rumpi Sehat (the Healthy Gossip Movement), on infant and young child feeding practices in peri-urban Indonesia. METHODS: The pilot intervention was designed based on the principles of a new behaviour change theory, Behaviour Centred Design (BCD). It avoided educational messaging in favour of employing emotional drivers of behaviour change, such as affiliation, nurture and disgust and used television commercials, community activations and house-to-house visits as delivery channels. The evaluation took the form of a 2-arm cluster randomised trial with a non-randomised control arm. One intervention arm received TV only, while the other received TV plus community activations. The intervention components were delivered over a 3-month period in 12 villages in each arm, each containing an average of 1300 households. There were two primary outcomes: dietary diversity of complementary food and the provision of unhealthy snacks to children aged 6-24 months. RESULTS: Dietary diversity scores increased by 0.8 points in the arm exposed to TV adverts only (95% CI: 0.4-1.2) and a further 0.2 points in the arm that received both intervention components (95% CI: 0.6-1.4). In both intervention arms, there were increases in the frequency of vegetable and fruit intake. We found inconsistent evidence of an effect on unhealthy snacking. CONCLUSION: The study suggests that novel theory-driven approaches which employ emotional motivators are capable of having an effect on improving dietary diversity and the regularity of vegetable and fruit intake among children aged 6-24 months. Mass media can have a measurable effect on nutrition-related behaviour, but these effects are likely to be enhanced through complementary community activations. Changing several behaviours at once remains a challenge.

Journal ArticleDOI
TL;DR: Obesity severity and obesogenic behaviors increased with age and varied by gender and race/ethnicity, and several key prevalent modifiable behaviors can be targeted by healthcare professionals to reduce obesity when counseling children with obesity and their parents are identified.
Abstract: Identification of modifiable behaviors is important for pediatric weight management and obesity prevention programs. This study examined obesogenic behaviors in children with obesity in a Northern California obesity intervention program using data from a parent/teen-completed intake questionnaire covering dietary and lifestyle behaviors (frequency of breakfast, family meals, unhealthy snacking and beverages, fruit/vegetable intake, sleep, screen time, and exercise). Among 7956 children with BMI ≥ 95th percentile, 45.5% were females and 14.2% were 3–5, 44.2% were 6–11, and 41.6% were 12–17 years old. One-quarter (24.9%) were non-Hispanic white, 11.3% were black, 43.5% were Hispanic, and 12.0% were Asian/Pacific Islander. Severe obesity was prevalent (37.4%), especially among blacks, Hispanics, and older children, and was associated with less frequent breakfast and exercise and excess screen time, and in young children it was associated with consumption of sweetened beverages or juice. Unhealthy dietary behaviors, screen time, limited exercise, and sleep were more prevalent in older children and in selected black, Hispanic, and Asian subgroups, where consumption of sweetened beverages or juice was especially high. Overall, obesity severity and obesogenic behaviors increased with age and varied by gender and race/ethnicity. We identified several key prevalent modifiable behaviors that can be targeted by healthcare professionals to reduce obesity when counseling children with obesity and their parents.

Journal ArticleDOI
TL;DR: It is suggested that an accumulation of unhealthy lifestyle behaviors, especially those related to lack of habitual moderate exercise and presence of late-night dinner and bedtime snacking may be associated with the prevalence of CKD.

Journal ArticleDOI
01 Jan 2016-Appetite
TL;DR: The finding that temptation can be effectively controlled by blocking people's cognitive resources, even for people highly sensitive to hedonic food cues, suggests that tempted people can be regulated by blocking cognitive resources.

Journal ArticleDOI
TL;DR: A new social-business eating pattern, characterized by high consumption of red and processed meat, alcohol, and sugar-sweetened beverages, and by frequent snacking and eating out as part of an overall unhealthy life-style, is associated with an increased prevalence, burden, and multisite presence of subclinical atherosclerosis.

Journal ArticleDOI
TL;DR: The findings indicate that the association between SR and the consumption of unhealthy snacks is partially explained by external and emotional eating in a population-based sample of adolescents irrespective of the home or school availability of these foods.
Abstract: Although previous research found a positive association between sensitivity to reward (SR) and adolescents’ unhealthy snacking and drinking behavior, mechanisms explaining these associations remain to be explored. The present study will therefore examine whether the associations between SR and unhealthy snack and/or sugar-sweetened beverage (SSB) intake are mediated by external and/or emotional eating and if this mediation is moderated by availability at home or at school. Cross-sectional data on snacking, availability of snacks at home and at school, SR (BAS drive scale) and external and emotional eating (Dutch eating behavior questionnaire) of Flemish adolescents (n = 1104, mean age = 14.7 ± 0.8 years; 51 % boys; 18.0 % overweight) in 20 schools spread across Flanders were collected. Moderated mediation analyses were conducted using generalized structural equation modeling in three steps: (1) direct association between SR and unhealthy snack or SSB intake, (2) mediation of either external or emotional eating and (3) interaction of home or school availability and emotional or external eating. Partial mediation of external eating (a*b = 0.69, p < 0.05) and of emotional eating (a*b = 0.92, p < 0.01) in the relation between SR and intake of unhealthy snacks was found (step 2). The relation between SR and SSB intake was not mediated by external or emotional eating (step 2). No moderation effects of home or school availability were found (step 3). Our findings indicate that the association between SR and the consumption of unhealthy snacks is partially explained by external and emotional eating in a population-based sample of adolescents irrespective of the home or school availability of these foods.

Journal ArticleDOI
22 Sep 2016-PLOS ONE
TL;DR: It was found that children with ADHD symptoms were likely to spend more time using a computer during school days; they were also more likely to eat while using aComputer and an increased risk of obesity in children withADHD was associated with the overuse of electronic devices.
Abstract: Attention-deficit/hyperactivity disorder (ADHD) has been associated with obesity in children. Lifestyle-related behaviors (external eating, screen time and physical inactivity) are well known to be associated with increased risk of obesity, but their associations with ADHD are unclear. The objectives of this study were to clarify the associations between ADHD symptoms in children and their associated lifestyle. A cross sectional study was carried out with a total of 785 primary students aged 9 to 13 years old and their parents were recruited by stratified random sampling from primary schools of China. The Cochran-Mantel-Haenszel (CMH) test was used to examine the relationships between ADHD symptoms and health related behaviors. We found that children with ADHD symptoms were likely to spend more time using a computer during school days; they were also more likely to eat while using a computer. These children were also more likely to eat while seated in a car, using a smart phone, using a computer at bedtime, and snacking before going to sleep than children without ADHD symptoms. An increased risk of obesity in children with ADHD symptoms was associated with the overuse of electronic devices, eating while using electronic devices, and delaying bedtimes to snack and use electronic devices.

Journal ArticleDOI
TL;DR: The rationale, the development, and evaluation design of the ‘Snack Track School’ app are described, which will offer a new scientifically-based vision, guidelines and practical tools for public health and health promotion.
Abstract: As the snacking pattern of European adolescents is of great concern, effective interventions are necessary. Till now health promotion efforts in children and adolescents have had only limited success in changing adolescents’ eating patterns and anthropometrics. Therefore, the present study proposes an innovative approach to influence dietary behaviors in youth based on new insights on effective behavior change strategies and attractive intervention channels to engage adolescents. This article describes the rationale, the development, and evaluation design of the ‘Snack Track School’ app. The aim of the app is to improve the snacking patterns of Flemish 14- to 16-year olds. The development of the app was informed by the systematic, stepwise, iterative, and collaborative principles of the Intervention Mapping protocol. A four week mHealth intervention was developed based on the dual-system model with behavioral change strategies targeting both the reflective (i.e., active learning, advance organizers, mere exposure, goal-setting, monitoring, and feedback) and automatic processes (i.e., rewards and positive reinforcement). This intervention will be evaluated via a controlled pre-post design in Flemish schools among 1400 adolescents. When this intervention including strategies focused on both the reflective and automatic pathway proves to be effective, it will offer a new scientifically-based vision, guidelines and practical tools for public health and health promotion (i.e., incorporation of learning theories in intervention programs). NCT02622165 registrated November 15, 2015 on clinicaltrials.gov.

Journal ArticleDOI
TL;DR: Initial evidence is provided suggesting unpleasant acute stressors contribute to reduced inhibitory region responsiveness in relation to external food cues and later food consumption among BED-symptomatic women.
Abstract: Stressors can trigger binge-eating but researchers have yet to consider their effects on both neural responses to food cues and food consumption among those at risk. In this experiment, we examined the impact of acute stressors on neural activation to food images and subsequent food consumption within binge-eating disorder (BED) and non-eating disordered control groups. Eighteen women meeting DSM-IV BED criteria and 26 women serving as non-eating disordered controls were randomly assigned to unpleasant stressor (painful cold pressor test (CPT) followed by negative performance feedback) or less unpleasant stressor (non-painful sensory discrimination task followed by positive performance feedback) conditions. Subsequently, they were scanned with functional magnetic resonance imaging (fMRI) while viewing food and neutral images. After the scans, participants completed a self-report battery in an environment conducive to snacking. During exposure to food images, BED-symptomatic women in the unpleasant stressor condition reported more liking of high calorie food images and showed less activation in one inhibitory area, the hippocampus, compared to controls in this condition. BED-symptomatic women exposed to unpleasant stressors also consumed more chocolate than any other group during the post-scan questionnaire completion. Crucially, reduced hippocampal activation to high calorie food images predicted more chocolate consumption following fMRI scans within the entire sample. This experiment provides initial evidence suggesting unpleasant acute stressors contribute to reduced inhibitory region responsiveness in relation to external food cues and later food consumption among BED-symptomatic women.

Journal ArticleDOI
TL;DR: Emerging evidence suggests that eating irregularity and eating later in the day may be detrimental for weight control, but more studies are needed.