Cue-Reminders to Prevent Health-Risk Behaviors: A Systematic Review

Introduction: It has been proposed that the use of cue-reminders may increase the effectiveness of interventions that aim to prevent health-risk behaviors (i.e., having unsafe sex, unhealthy dietary intake, lack of physical activity, and substance use). The aim of this systematic review was to explore whether there is evidence supporting this proposition, and to explore how cue-reminders are applied in health-risk behavior interventions to date.Method: We systemically reviewed (non-) randomized trials that examine differences in health-risk behaviors between an experimental group receiving an intervention with exposure to a cue-reminder and a control group receiving the intervention without such cue.Results: Six studies were eligible for inclusion. The studies differed in sample and research design, and how the cue-reminder was applied. One study demonstrated a positive and small effect, and one study found a negative medium effect of the cue-reminder. In the remaining studies, the effect sizes were positive but non-significant.Discussion: It is unclear whether complementing health-risk behavior interventions with cue-reminders increases the effectiveness of these interventions. Further investigation and experimentation into the efficiency and effectiveness of cue-reminders is needed before health-risk behavior interventions are complemented with cue-reminders

Mimicry of Food Intake: The Dynamic Interplay between Eating Companions

Numerous studies have shown that people adjust their intake directly to that of their eating companions; they eat more when others eat more, and less when others inhibit intake. A potential explanation for this modeling effect is that both eating companions' food intake becomes synchronized through processes of behavioral mimicry. No study, however, has tested whether behavioral mimicry can partially account for this modeling effect. To capture behavioral mimicry, real-time observations of dyads of young females having an evening meal were conducted. It was assessed whether mimicry depended on the time of the interaction and on the person who took the bite. A total of 70 young female dyads took part in the study, from which the total number of bites (N = 3,888) was used as unit of analyses. For each dyad, the total number of bites and the exact time at which each person took a bite were coded. Behavioral mimicry was operationalized as a bite taken within a fixed 5-second interval after the other person had taken a bite, whereas non-mimicked bites were defined as bites taken outside the 5-second interval. It was found that both women mimicked each other's eating behavior. They were more likely to take a bite of their meal in congruence with their eating companion rather than eating at their own pace. This behavioral mimicry was found to be more prominent at the beginning than at the end of the interaction. This study suggests that behavioral mimicry may partially account for social modeling of food intake

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

A system dynamics and participatory action research approach to promote healthy living and a healthy weight among 10–14-year-old adolescents in Amsterdam: The LIKE programme

This paper describes the design of the LIKE programme, which aims to tackle the complex problem of childhood overweight and obesity in 10–14-year-old adolescents using a systems dynamics and participatory approach. The LIKE programme focuses on the transition period from 10-years-old to teenager and was implemented in collaboration with the Amsterdam Healthy Weight Programme (AHWP) in Amsterdam-East, the Netherlands. The aim is to develop, implement and evaluate an integrated action programme at the levels of family, school, neighbourhood, health care and city. Following the principles of Participatory Action Research (PAR), we worked with our population and societal stakeholders as co-creators. Applying a system lens, we first obtained a dynamic picture of the pre-existing systems that shape adolescents’ behaviour relating to diet, physical activity, sleep an

Adolescents' responses to a school-based prevention program promoting healthy eating at school

Contains fulltext : 178856.pdf (publisher's version ) (Open Access)Background: To improve the effectiveness of school-based obesity prevention programs, it is essential to understand the views and behaviors of the target group. The present study aimed to get a better understanding of adolescents' food and health perceptions and their willingness to be involved in a specific school-based prevention program, i.e., the Dutch 'Healthy School Canteen Program'. Methods: The present study used a mixed methods research design. First, seven semi-structured focus groups were conducted using a selective sample of 42 Dutch adolescents (24 girls, 18 boys, aged 13-16 years). Second, an online survey among 133 adolescent respondents (72 girls, 61 boys, aged 12-19 years) using snowball sampling was conducted. Content analysis was performed to make inferences about the focus group discussions, whereas statistical analyses were conducted to analyze the survey data. Results: Findings from the group discussions indicated that healthy eating was only an issue of importance when adolescents perceived negative physical changes (e.g., with regards to looks or physical performance). Adolescents also indicated that they clearly wanted to make their own food and drink choices at school. The quantitative data indicated that taste, price and variety were seen as the most important aspects of a healthy food assortment (mean scores 8.1, 7.8 and 7.7 on a 10-point scale respectively). In general, most adolescents (64%) expressed that students should be involved in the organization of a healthy food environment in schools. At the same time, however, adolescents were not willing to participate themselves. This was mostly because they were skeptical about their ideas being heard and put into action by their schools. Conclusions: School-based prevention programs, such as the Healthy School Canteen, should take into account that adolescents have a low risk perception of unhealthy eating and are seeking food choice autonomy. In addition, schools should not lose sight of product price, taste, and variety to make their food assortment attractive to students. If schools aim to involve adolescents in universal prevention programs that promote healthy eating, it is essential that they have a formal student involvement process that ensures that adolescents' suggestions are valued.11 p

Social modeling of eating: A review of when and why social influence affects food intake and choice

A major determinant of human eating behavior is social modeling, whereby people use others' eating as a guide for what and how much to eat. We review the experimental studies that have independently manipulated the eating behavior of a social referent (either through a live confederate or remotely) and measured either food choice or intake. Sixty-nine eligible experiments (with over 5800 participants) were identified that were published between 1974 and 2014. Speaking to the robustness of the modeling phenomenon, 64 of these studies have found a statistically significant modeling effect, despite substantial diversity in methodology, food type, social context and participant demographics. In reviewing the key findings from these studies, we conclude that there is limited evidence for a moderating effect of hunger, personality, age, weight or the presence of others (i.e., where the confederate is live vs. remote). There is inconclusive evidence for whether sex, attention, impulsivity and eating goals moderate modeling, and for whether modeling of food choice is as strong as modeling of food intake. Effects with substantial evidence were: modeling is increased when individuals desire to affiliate with the model, or perceive themselves to be similar to the model; modeling is attenuated (but still significant) for healthy-snack foods and meals such as breakfast and lunch, and modeling is at least partially mediated through behavioral mimicry, which occurs without conscious awareness. We discuss evidence suggesting that modeling is motivated by goals of both affiliation and uncertainty-reduction, and outline how these might be theoretically integrated. Finally, we argue for the importance of taking modeling beyond the laboratory and bringing it to bear on the important societal challenges of obesity and disordered eating

Descriptive peer norms, self-control and dietary behaviour in young adults Descriptive peer norms, self-control and dietary behaviour in young adults

There is evidence that perceived peer eating norms can influence dietary behaviour. This cross-sectional study examined whether certain personality traits increase the likelihood that personal eating habits are similar to perceived peer eating habits. We assessed frequency of consumption of sugarsweetened soda (SSS) and sweet pastries (SP), as well as perceived peer descriptive eating norms for SSS and SP in a group of 1056 young adults. We examined whether individual differences in the need for social acceptance and self-control moderated whether participants were likely to display similar dietary habits to their peers. Perceived peer eating norms for SSS and SP predicted frequency of consumption; believing that one's peers frequently consumed SSS and SP was associated with increased personal consumption for both. Individuals with low self-control, as opposed to high self-control, were more likely to adhere to peer norms for SP, but not for SSS. Trait social acceptance needs did not significantly moderate similarity between peer norms and personal consumption for either SSS or SP. The extent to which young adults adhere to descriptive peer dietary norms may depend upon self-control, whereby individuals with low self-control are less able to inhibit social influence of descriptive peer norms on dietary behaviour

Effects of eating with an augmented fork with vibrotactile feedback on eating rate and body weight: a randomized controlled trial

Background Eating rate is a basic determinant of appetite regulation: people who eat more slowly feel sated earlier and eat less. A high eating rate contributes to overeating and potentially to weight gain. Previous studies showed that an augmented fork that delivers real-time feedback on eating rate is a potentially effective intervention to decrease eating rate in naturalistic settings. This study assessed the impact of using the augmented fork during a 15-week period on eating rate and body weight. Methods In a parallel randomized controlled trial, 141 participants with overweight (age: 49.2 +/- 12.3 y; BMI: 31.5 +/- 4.48 kg/m2) were randomized to intervention groups (VFC, n = 51 or VFC+, n = 44) or control group (NFC, n = 46). First, we measured bite rate and success ratio on five consecutive days with the augmented fork without feedback (T1). The intervention groups (VFC, VFC+) then used the same fork, but now received vibrotactile feedback when they ate more than one bite per 10 s. Participants in VFC+ had additional access to a web portal with visual feedback. In the control group (NFC), participants ate with the fork without either feedback. The intervention period lasted four weeks, followed by a week of measurements only (T2) and another measurement week after eight weeks (T3). Body weight was assessed at T1, T2, and T3. Results Participants in VFC and VFC+ had a lower bite rate (p <.01) and higher success ratio (p <.0001) than those in NFC at T2. This effect persisted at T3. In both intervention groups participants lost more weight than those in the control group at T2 (p <.02), with no rebound at T3. Conclusions The findings of this study indicate that an augmented fork with vibrotactile feedback is a viable tool to reduce eating rate in naturalistic settings. Further investigation may confirm that the augmented fork could support long-term weight loss strategies