Findings

Shapely

Kevin Lewis

December 09, 2014

How do I look? Focusing attention on the outside body reduces responsiveness to internal signals in food intake

Evelien van de Veer, Erica van Herpen & Hans van Trijp
Journal of Experimental Social Psychology, January 2015, Pages 207–213

Abstract:
The current study investigates the relationship between focusing on body appearance and the ability to adjust food consumption according to feelings of satiety. Based on a resource perspective, we propose that focusing on outward appearance negatively affects people’s ability to respond to satiety signals. Specifically, we argue that focusing on appearance takes up attentional resources required for sensing and relying on physiological satiety cues in food consumption. The findings of two experiments support this and show that focusing on appearance through a short mirror exposure (Experiment 1) or by looking at advertisements of models (Experiment 2) interferes with people’s ability to compensate for previous consumption (Experiment 1) and leads them to rely less on satiety signals in their eating behavior (Experiment 2). These findings suggest that an emphasis on outer body appearance reduces people’s reliance on satiety cues.

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Body Size, Skills, and Income: Evidence From 150,000 Teenage Siblings

Petter Lundborg, Paul Nystedt & Dan-Olof Rooth
Demography, October 2014, Pages 1573-1596

Abstract:
We provide new evidence on the long-run labor market penalty of teenage overweight and obesity using unique and large-scale data on 150,000 male siblings from the Swedish military enlistment. Our empirical analysis provides four important results. First, we provide the first evidence of a large adult male labor market penalty for being overweight or obese as a teenager. Second, we replicate this result using data from the United States and the United Kingdom. Third, we note a strikingly strong within-family relationship between body size and cognitive skills/noncognitive skills. Fourth, a large part of the estimated body-size penalty reflects lower skill acquisition among overweight and obese teenagers. Taken together, these results reinforce the importance of policy combating early-life obesity in order to reduce healthcare expenditures as well as poverty and inequalities later in life.

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Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial

Lydia Bazzano et al.
Annals of Internal Medicine, 2 September 2014, Pages 309-318

Objective: To examine the effects of a low-carbohydrate diet compared with a low-fat diet on body weight and cardiovascular risk factors.

Participants: 148 men and women without clinical cardiovascular disease and diabetes.

Intervention: A low-carbohydrate (<40 g/d) or low-fat (<30% of daily energy intake from total fat [<7% saturated fat]) diet. Both groups received dietary counseling at regular intervals throughout the trial.

Results: Sixty participants (82%) in the low-fat group and 59 (79%) in the low-carbohydrate group completed the intervention. At 12 months, participants on the low-carbohydrate diet had greater decreases in weight (mean difference in change, −3.5 kg [95% CI, −5.6 to −1.4 kg]; P = 0.002), fat mass (mean difference in change, −1.5% [CI, −2.6% to −0.4%]; P = 0.011), ratio of total–high-density lipoprotein (HDL) cholesterol (mean difference in change, −0.44 [CI, −0.71 to −0.16]; P = 0.002), and triglyceride level (mean difference in change, −0.16 mmol/L [−14.1 mg/dL] [CI, −0.31 to −0.01 mmol/L {−27.4 to −0.8 mg/dL}]; P = 0.038) and greater increases in HDL cholesterol level (mean difference in change, 0.18 mmol/L [7.0 mg/dL] [CI, 0.08 to 0.28 mmol/L {3.0 to 11.0 mg/dL}]; P < 0.001) than those on the low-fat diet.

Conclusion: The low-carbohydrate diet was more effective for weight loss and cardiovascular risk factor reduction than the low-fat diet. Restricting carbohydrate may be an option for persons seeking to lose weight and reduce cardiovascular risk factors.

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Soda and Cell Aging: Associations Between Sugar-Sweetened Beverage Consumption and Leukocyte Telomere Length in Healthy Adults From the National Health and Nutrition Examination Surveys

Cindy Leung et al.
American Journal of Public Health, December 2014, Pages 2425-2431

Objectives: We tested whether leukocyte telomere length maintenance, which underlies healthy cellular aging, provides a link between sugar-sweetened beverage (SSB) consumption and the risk of cardiometabolic disease.

Methods: We examined cross-sectional associations between the consumption of SSBs, diet soda, and fruit juice and telomere length in a nationally representative sample of healthy adults. The study population included 5309 US adults, aged 20 to 65 years, with no history of diabetes or cardiovascular disease, from the 1999 to 2002 National Health and Nutrition Examination Surveys. Leukocyte telomere length was assayed from DNA specimens. Diet was assessed using 24-hour dietary recalls. Associations were examined using multivariate linear regression for the outcome of log-transformed telomere length.

Results: After adjustment for sociodemographic and health-related characteristics, sugar-sweetened soda consumption was associated with shorter telomeres (b = –0.010; 95% confidence interval [CI] = −0.020, −0.001; P = .04). Consumption of 100% fruit juice was marginally associated with longer telomeres (b = 0.016; 95% CI = −0.000, 0.033; P = .05). No significant associations were observed between consumption of diet sodas or noncarbonated SSBs and telomere length.

Conclusions: Regular consumption of sugar-sweetened sodas might influence metabolic disease development through accelerated cell aging.

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The Impact of Obesity on Consumer Bankruptcy

Mouhcine Guettabi & Abdul Munasib
Economics & Human Biology, forthcoming

Abstract:
Over the last two decades, both bankruptcy and obesity rates in the U.S. have seen a steady rise. As obesity is one of the leading causes of medical and morbidity related economic costs, its influence on personal bankruptcy is analyzed in this study. Using the National Longitudinal Survey of Youth 1979, we employ a duration model to investigate the relative importance of obesity on the timing of bankruptcy. Even after accounting for possible endogeneity of BMI and controlling for a wide variety of individual and aggregate-level confounding factors, being obese puts one at a greater risk of filing for bankruptcy.

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Snack Purchasing Is Healthier When the Cognitive Demands of Choice Are Reduced: A Randomized Controlled Trial

Julia Allan, Marie Johnston & Neil Campbell
Health Psychology, forthcoming

Objective: Individuals with inefficient executive (higher level cognitive) function have a reduced ability to resist dietary temptation. The present study aimed to design and test a theory-based point-of-purchase intervention for coffee shops that reduced the calorie content of customers’ purchases by reducing the need for executive function (EF) at the moment of choice.

Methods: Key facets of EF were identified by a multidisciplinary group and used to develop a point-of-purchase intervention (signage). This intervention was evaluated in a randomized controlled trial (RCT) in a public coffee shop on consumer purchases of >20,000 snacks and drinks over 12 weeks. A sample of customers (n = 128) was recruited to complete an embedded cross-sectional study measuring EF strength, dietary intentions, typical purchases, and purchases made after exposure to the intervention.

Results: The proportion of snack purchases that were high in calorie reduced significantly (t(10) = 2.34, p = .04) in intervention weeks relative to control. High calorie drink purchases were also lower in intervention than control weeks, however, this difference was not significant (t(10) = 1.56, p = .15). On average, customers purchased items containing 66 calories < usual after exposure to the intervention. The magnitude of the intervention’s positive effect on customer behavior increased as EF strength decreased (β = .24, p = .03).

Conclusions: The calorie content of cafe purchases can be lowered by reducing the cognitive demands of healthy food choice at the moment of purchase, especially in those with poor EF. Environmental changes like these have the potential to help achieve population weight control.

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'Globesity'? The Effects of Globalization on Obesity and Caloric Intake

Joan Costa-Font & Núria Mas
London School of Economics Working Paper, September 2014

Abstract:
This study considers the effects of globalization, in its economic and social dimensions, on obesity and caloric intake. In assessing these effects using longitudinal analysis, this study adopts an extensive list of controls to account for compositional changes and effects, as well as different specifications. The results suggest a robust association between globalization and both obesity and caloric intake. A one standard deviation increase in globalization is associated with a 20 percent increase in obese population and a 4 percent rise in calorie intake. The effect remains statistically significant even with an instrument variable strategy, a lagged structure, and corrections for panel standard errors. The primary driver is social globalization, and specifically the effects of changes in information flows and social proximity. A one standard deviation increase in social globalization increased the percentage of obese population by 14.5 percent and the consumption of calories by 2.8 percent, respectively.

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Community socio economic deprivation and obesity trajectories in children using electronic health records

Claudia Nau et al.
Obesity, forthcoming

Objectives: Longitudinal studies of the role of community context in childhood obesity are lacking. The objective of this study was to examine associations of community socio economic deprivation (CSD) with trajectories of change in body mass index (BMI) in childhood and adolescence.

Methods: Data came from electronic health records on 163,473 children aged 3-18 residing in 1,288 communities in Pennsylvania whose weight and height were measured longitudinally. CSD at the year of birth was measured using six US Census variables and modeled in quartiles. Trajectories of BMI within CSD quartiles were estimated using random effects growth-curve models accounting for differences by age, sex, and race/ethnicity as well as correcting for non-constant residual variance across age groups.

Results: CSD was associated with higher BMI at average age (10.7 years) and with more rapid growth of BMI over time. Children born in communities with greater CSD had steeper increases of BMI at younger ages. Those born into the poorest communities displayed sustained accelerated BMI growth. CSD remained associated with BMI trajectories after adjustment for a measure of household socio economic deprivation.

Conclusions: Higher CSD may be associated with more obesogenic growth trajectories in early life. Findings suggest that individual-level interventions that ignore the effect of community context on obesity-related behaviors may be less efficient.

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When zero is greater than one: Consumer misinterpretations of nutrition labels

Dan Graham & Gina Mohr
Health Psychology, December 2014, Pages 1579-1587

Objective: Front-of-package (FOP) nutrition labels are increasingly used by food manufacturers. A call to regulate the content and format of these labels resulted in recommendations by the Institute of Medicine (IOM) for standardized FOP labels that clearly communicate packaged foods’ healthfulness. It is currently unclear how consumers would interpret and use these proposed labels. This research addresses psychological factors affecting the efficacy of FOP label use. It was hypothesized that IOM’s proposed 0- to 3-point rating scale would produce the zero-comparison effect, leading to more favorable evaluations than are warranted for the least healthful products (i.e., those earning zero nutritional points).

Methods: In two studies (Study 1, n = 68; Study 2, n = 101), participants evaluated products containing FOP labels on the basis of IOM recommendations. Primary outcomes were perceived product healthfulness and purchase intentions.

Results: Study 1 demonstrated that less-healthful products were rated by study participants to be equally healthful as more-healthful products. The relationship between FOP rating and purchase intentions was mediated by perceived healthfulness. Biases in product healthfulness ratings were exacerbated for consumers with higher (vs. lower) health concern. Study 2 demonstrated that by changing the rating scale from 0–3 to 1–4, consumers avoid the zero-comparison effect and accurately evaluate products’ healthfulness.

Conclusions: This research has implications for theory and policy in the domains of nutrition labeling and consumer health. Specifically, FOP labels can help consumers identify healthful options, but products receiving zero nutritional points may be misidentified as healthful; a simple label modification can prevent this confusion.

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An Apple a Day Brings More Apples Your Way: Healthy Samples Prime Healthier Choices

Aner Tal & Brian Wansink
Psychology & Marketing, forthcoming

Abstract:
Samples may guide consumer choice towards consistent products, resulting in a shopping basket that has a greater proportion of products similar to the sample. Specifically, healthy (unhealthy) samples in a grocery setting may lead to healthier (less healthy) shopping baskets. We demonstrate this in lab (study 1) and field (studies 2) settings. The effect of sample occurs for both related healthy products (study 1) and healthy/unhealthy choices that are less closely related (study 2). These findings suggest consumers may display consistent shopping behavior even with product choices that are situationally determined rather than being their own, such that even externally imposed product “choices,” rather than just observation of one’s own choice, can lead to consistent subsequent choices. 

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Benefits of adding small financial incentives or optional group meetings to a web-based statewide obesity initiative

Tricia Leahey et al.
Obesity, forthcoming

Objective: To examine whether adding either small, variable financial incentives or optional group sessions improves weight losses in a community-based, Internet behavioral program.

Methods: Participants (N = 268) from Shape Up Rhode Island 2012, a 3-month Web-based community wellness initiative, were randomized to: Shape Up+Internet behavioral program (SI), Shape Up+Internet program+incentives (SII), or Shape Up+Internet program+group sessions (SIG).

Results: At the end of the 3-month program, SII achieved significantly greater weight losses than SI (SII: 6.4% [5.1-7.7]; SI: 4.2% [3.0-5.6]; P = 0.03); weight losses in SIG were not significantly different from the other two conditions (SIG: 5.8% [4.5-7.1], P's ≥ 0.10). However, at the 12-month no-treatment follow-up visit, both SII and SIG had greater weight losses than SI (SII: 3.1% [1.8-4.4]; SIG: 4.5% [3.2-5.8]; SI: 1.2% [−0.1-2.6]; P's ≤ 0.05). SII was the most cost-effective approach at both 3 (SII: $34/kg; SI: $34/kg; SIG: $87/kg) and 12 months (SII: $64/kg; SI: $140/kg; SIG: $113/kg).

Conclusions: Modest financial incentives enhance weight losses during a community campaign, and both incentives and optional group meetings improved overall weight loss outcomes during the follow-up period. However, the use of the financial incentives is the most cost-effective approach.

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Persistence in Body Mass Index in a Recent Cohort of US Children

Daniel Millimet & Rusty Tchernis
Economics & Human Biology, forthcoming

Abstract:
While childhood obesity has become a significant public health concern over the last few decades, and underweight children continue to be a concern, knowledge pertaining to the origins of or persistence in childhood anthropometric measures is incomplete. Here, we utilize several nonparametric metrics to assess the evolution of weight and body mass index (BMI) across the entire distribution during early childhood. We find that movements within the distribution of weight – both upward and downward – are quite high prior to primary school and then decline noticeably. For BMI, we find that movements within the distribution – both upward and downward – are highest at the start of kindergarten and at the start of middle school. However, there are important sources of heterogeneity, including race, gender, and age that should prove insightful to researchers and policymakers. For instance, comparing males versus females who are initially in the bottom quartile of the distribution of BMI, we find that males have a higher probability of moving up at least ten percentile points between kindergarten and eighth grade (53% versus 50%). Comparisons among racial groups indicate that whites who are initially in the top quartile of the distribution of BMI have a higher probability of moving down at least ten percentile points between kindergarten and eighth grade than blacks and Hispanics (46% versus 37% and 40%, respectively).

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Ecological Momentary Assessment of Urban Adolescents’ Technology Use and Cravings for Unhealthy Snacks and Drinks: Differences by Ethnicity and Sex

Nicholas Borgogna et al.
Journal of the Academy of Nutrition and Dietetics, forthcoming

Objective: We examined whether momentary associations between four technology types (ie, television, video games, computer messaging, and phone messaging) and cravings for unhealthy snack foods and sweetened drinks were moderated by youths’ sex, ethnicity, body mass index, and age.

Methods: Urban adolescents (N=158) aged 14 to 17 years provided momentary information about their technology use and food cravings during the course of 1 week and completed survey reports of their personal characteristics. We used multilevel modeling to determine momentary associations and interactions.

Results: Non-Hispanic adolescents showed stronger associations between television exposure and cravings for sweet snacks, salty snacks, and sweetened drinks. Being Hispanic was associated with stronger associations between phone messaging and cravings for sweet snacks, salty snacks, and sweetened drinks. Males showed stronger associations between video game use and salty snack cravings.

Conclusions: As the public health field continues to monitor the effects of technology use on adolescents’ eating and overall health, it will be important to determine the extent to which these groups are differentially affected by different forms of technology.

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Awareness of social influence on food intake. An analysis of two experimental studies

Eric Robinson & Matt Field
Appetite, forthcoming

Abstract:
There is consistent evidence that the amount of food we consume can be influenced by the eating behaviour of other people. Some previous experimental studies reported that consumers are unaware of this influence on their behaviour. The present research tested whether people may be more aware of social influence on their eating than previously assumed. In two studies, participants (total n = 160) were exposed to information about the amount of snack food other people had been eating shortly before being served the same snack food and eating as much as they liked. After this, participants responded to questions regarding whether they thought their food intake had been socially influenced, and reported the reasons why they believed they had or had not been influenced. Of the 160 participants, 34% reported that they had been influenced, 10% were unsure and 56% reported they had not been influenced. Crucially, participants' reports of social influence appeared to be accurate; the food intake of participants reporting social influence was significantly affected by the amount of food other people had been eating, whereas the food intake of participants denying social influence was unaffected. Individuals may be more aware of the effect that social influence has on their eating behaviour than previously assumed. Further work is needed to identify the factors which determine whether people are susceptible to social influence on eating behaviour.

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Quality and Cost of Student Lunches Brought From Home

Michelle Caruso & Karen Cullen
JAMA Pediatrics, forthcoming

Objectives: To examine the quality and cost of lunches brought from home by elementary and intermediate school students.

Design, Setting, and Participants: An observational study was conducted in 12 schools (8 elementary and 4 intermediate) in one Houston, Texas, area school district from October 6, 2011, to December 5, 2011. Participants included 242 elementary and 95 intermediate school students who brought lunches from home.

Main Outcomes and Measures: Foods brought and amounts eaten were recorded along with student grade level and sex. Nutrient and food group content were calculated and compared with current National School Lunch Program (NSLP) guidelines. Per-serving prices for each item were collected from 3 grocery stores in the study area and averaged.

Results: Compared with the NSLP guidelines, lunches brought from home contained more sodium (1110 vs ≤640 mg for elementary and 1003 vs ≤710 mg for intermediate students) and fewer servings of fruits (0.33 cup for elementary and 0.29 cup for intermediate students vs 0.50 cup per the NSLP guidelines), vegetables (0.07 cup for elementary and 0.11 cup for intermediate students vs 0.75 cup per the NSLP guidelines), whole grains (0.22-oz equivalent for elementary and 0.31-oz equivalent for intermediate students vs 0.50-oz minimum per the NLSP guidelines), and fluid milk (0.08 cup for elementary and 0.02 cup for intermediate students vs 1 cup per the NSLP guidelines). About 90% of lunches from home contained desserts, snack chips, and sweetened beverages, which are not permitted in reimbursable school meals. The cost of lunches from home averaged $1.93 for elementary and $1.76 for intermediate students. Students from lower-income intermediate schools brought significantly higher-priced ($1.94) lunches than did students from middle-income schools ($1.63).

Conclusions and Relevance: Lunches brought from home compared unfavorably with current NSLP guidelines. Strategies are needed to improve the nutritional quality of lunches brought from home.

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An Evaluation of Government and Industry Proposed Restrictions on Television Advertising of Breakfast Cereals to Children

Joshua Berning, Rui Huang & Adam Rabinowitz
Journal of Consumer Policy, December 2014, Pages 507-525

Abstract:
In the United States, both industry and the federal government have worked to establish voluntary guidelines for how firms market food to children and to establish a threshold for the nutritional quality of foods marketed to children. The authors evaluate three US guidelines that deal with television advertising of breakfast cereals, which is both heavily advertised and a common meal item for children. They find that the majority of cereals advertised primarily to children from 2006 to 2008 do not meet any of the current and proposed self-regulatory nutrition guidelines, and that this is generally due to excessive sugar content. Further, children and adolescents are exposed to more advertising for products that do not meet the nutritional guidelines. We evaluate the extent to which each of the guidelines impacts advertising of cereals that are most viewed by children and purchased by households with children. The results provide insight for policy makers concerned with limiting the extent to which children see television advertising and ultimately consume unhealthy breakfast cereals.

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Blue lighting decreases the amount of food consumed in men, but not in women

Sungeun Cho et al.
Appetite, February 2015, Pages 111–117

Abstract:
Previous research has demonstrated that colors of lighting can modulate participants' motivation to consume the food placed under the lighting. This study was designed to determine whether the colors of lighting can affect the amount of food consumed, in addition to sensory perception of the food. The influence of lighting color was also compared between men and women. One-hundred twelve participants (62 men and 50 women) were asked to consume a breakfast meal (omelets and mini-pancakes) under one of three different lighting colors: white, yellow, and blue. During the test, hedonic impression of the food's appearance, willingness to eat, overall flavor intensity and overall impression of the food, and meal size (i.e., the amount of food consumed) were measured. Blue lighting decreased the hedonic impression of the food's appearance, but not the willingness to eat, compared to yellow and white lighting conditions. The blue lighting significantly decreased the amount consumed in men, but not in women, compared to yellow and white lighting conditions. Overall flavor intensity and overall impression of the food were not significantly different among the three lighting colors. In conclusion, this study provides empirical evidence that the color of lighting can modulate the meal size. In particular, blue lighting can decrease the amount of food eaten in men without reducing their acceptability of the food.

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Experiencing Weight Bias in an Unjust World: Impact on Exercise and Internalization

Rebecca Pearl & John Dovidio
Health Psychology, forthcoming

Objective: This research explores the effects of belief in a just world on exercise and psychological well-being among individuals who have experienced weight bias.

Methods: In Study 1, 804 participants in an online study reported belief in a just world; exercise intentions, motivation, self-efficacy, and behavior; experiences with weight bias; and height/weight and self-perceived weight status. In Study 2, 237 participants with overweight and obesity were randomly assigned to read 1 of 2 passages (online) describing weight bias and discrimination as rare versus pervasive, and rated their perceptions of pervasiveness. Participants then read 1 of 3 randomly assigned vignettes that confirmed, challenged, or did not attempt to influence belief in a just world, and completed measures of exercise intentions and motivation, body dissatisfaction, weight bias internalization, and experiences with weight bias.

Results: Study 1 revealed that weaker belief in a just world was associated with lower ratings on all exercise variables among participants who reported experiencing weight bias. In Study 2, regression analyses revealed an interaction between ratings of perceived pervasiveness of weight discrimination and the Challenge condition for all outcome measures. The Challenge condition led to lower ratings of exercise intentions and motivation, and higher reports of body dissatisfaction and weight bias internalization, when weight bias was perceived to be more pervasive.

Conclusion: Threats to belief in a just world may lead to negative outcomes for health behaviors and psychological well-being among individuals who have experienced weight bias and perceive it to be pervasive.

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Toward a quantitative theory of food consumption choices and body weight

Sebastien Buttet & Veronika Dolar
Economics & Human Biology, forthcoming

Abstract:
We propose a calibrated dynamic model of food consumption choices and body weight to study changes in daily caloric intake, weight, and the away-from-home share of calories consumed by adult men and women in the U.S. during the period between 1971 and 2006. Calibration reveals substantial preference heterogeneity between men and women. For example, utility losses stemming from weight gains are ten times greater for women compared to men. Counterfactual experiments show that changes in food prices and household income account for half of the increase in weight of adult men, but only a small fraction of women's weight. We argue that quantitative models of food consumption choices and body weight have a unique role to play in future research in the economics of obesity.


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