The influence of supraliminal priming on energy density of food selection : a randomised controlled trial

Funding: This research was funded by the University of St Andrews and did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.Background: Many people exercise because they know it is good for their health. Although this is true, it can make us feel deserving of a reward and lead us to eat more indulgent, less healthy food than if we had not done any exercise. Generally, lower energy-dense (LED) foods are recognised as healthier choices than higher energy-dense (HED) options. Despite our intention to make healthy choices, seeing tempting higher-calorie foods on offer often side-tracks us. Priming is a psychological tool that makes specific changes to our environment that remind us of our motivation to be healthy. This makes it easier to choose a healthier option, by nudging us towards it without us even realising. However, it is currently unclear which method of priming achieves the best results. Aims: Our study explores whether priming people to expect they will receive LED food leads them to make this healthier choice after exercise, even when also offered tempting less healthy HED foods at the moment of selection. Methods: Our study observed the foods selected by university athletes after their sports matches. Before the match, half of the participants were primed by asking them to choose a LED snack from the options we offered, which they would receive after the match. The remaining half of participants were not asked this same question. To distract the athletes from our observation of their food choices, participants completed a task prior to choosing their snack, which was disguised as a ‘thank you’ for taking part. Results: Overall, we found the priming group did not choose LED foods significantly more than the control group, hence priming did not increase LED food selection. Conclusion: Importantly, our results indicate that priming must be more noticeable to achieve its goal. Additionally, we demonstrated that priming may be less successful for young athletic individuals, compared to older and more overweight adults recruited in other studies. This highlights the importance of studying a broader demographic range of individuals from the general population. We support future research into this area, which will help us to tweak priming to achieve the best outcomes.Publisher PDFPeer reviewe

A qualitative study of young peoples’ thoughts and attitudes to follow a more plant-based diet

Funding: This work was supported by the University of St Andrews.Plant-based diets (PBDs) refer to dietary habits that reduce the consumption of animal-based products and increase the consumption of nutritionally rich plant foods. PBD’s have been shown to provide significant health benefits, such as reducing obesity and improving psychological wellbeing, and are environmentally friendly. However, few studies have investigated factors that influence young people’s thoughts and attitudes toward following a PBD in western societies, particularly in the United Kingdom. Understanding these factors may benefit public health interventions that encourage the consumption of more fruit and vegetables. The aim of this study was to explore the factors that affect young people’s intentions toward following a PBD. Twenty-one young people (18–24 years) participated in this qualitative study. Participants were asked about their views of PBDs in a semi-structured interview. Thematic analysis was utilized to explore views and the barriers and facilitators to following a PBD. The Theory of Planned Behavior (TPB) was used as a framework to organise the findings. Within attitudes, the sub-themes identified were an awareness of a healthy diet, environmental concerns, health concerns and distrust, perceptions of PBDs and associated stereotypes, perceived restriction and lack of enjoyment, and need for education. Within subjective norms, the sub-themes identified were cultural and familial norms, peer influence, and exposure through social media. Within perceived behavioral control (PBC), the sub-themes identified were a lack of independence and parental control, lack of knowledge and perceived difficulty, lack of inclusiveness and accessibility, and inconvenience. Overall, the findings suggest that increased provision of education and knowledge about PBDs to young people, and widening access to PBDs, could encourage and help improve their understanding and intention to follow this dietary style. Tailored health promotion strategies, which also consider additional barriers and facilitators found within this study, could motivate young people to consume a more PBD.Publisher PDFPeer reviewe

'You just eyeball it’: parent and nursery staff perceptions and influences on child portion size : a reflexive thematic analysis

Funding: This project was supported by the MSc Health Psychology programme at the University of St Andrews.Background Childhood obesity is one of the most serious public health epidemics of the 21st century. Observational studies report that increases in portion size (PS) have occurred in parallel with levels of obesity. Increased PSs of high-energy-dense foods can promote overeating, and without compensatory behaviours, can contribute to childhood obesity. Caregivers make decisions about PSs for children in the home and nursery environment, thus are gatekeepers to child food intake. Understanding caregiver PS decisions can aid in the best practice of PS provision to young children. The aim of this study was to explore parent and nursery staff influences on child PS selection and their suggestions for useful tools/strategies in PS decisions. Methods A qualitative design was employed using focus group discussions (FGDs) with parents and nursery staff of children aged 3–5 years. FGDs were employed given their ability to generate rich data, as well as permit the exploration of collective perceptions, attitudes, behaviours and experiences. Data were analysed using an inductive, semantic approach to reflexive thematic analysis. Results Four FGDs were conducted: two with parents (n = 13), two with nursery staff (n = 17). Four overarching themes were derived: (i) awareness of PS guidelines; (ii) control over PS; (iii) social influences on children's eating behaviours; (iv) child-specific, social and external factors influencing parent and nursery staff PS decisions. Additionally, participants discussed tools/strategies they believe would be useful in PS decisions. Conclusion Data from the themes suggest that caregiver control, social, child-specific and external factors are more influential than PS guidelines in both parent and nursery staff PS decisions for young children aged 3–5 years. These findings can inform future childhood obesity prevention initiatives focussed on improving parent and nursery staff provision/use of age-appropriate PSs.Peer reviewe

Social prescribing and behaviour change : proposal of a new behaviour change technique concerning the ‘connection’ step

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How important are the influencing factors to the decision on whether to provide seafood in infant and young child feeding?

Acknowledgements The authors would like to thank the mothers who volunteered to take part in the Q sort interviews. Sources of funding This study was funded by the Seafish Authority and Interface Food and Drink Scotland as part of a PhD scholarship for SC.Peer reviewedPostprin

The feasibility and acceptability of two methods ofsnack portion control in United Kingdom (UK) preschool children: reduction and replacement.

Large portions of high energy dense (HED) snacks are offered to children from a young age and are pervasive in our food environment. This study aimed to explore the feasibility, acceptability, and preliminary efficacy of two strategies of snack portion control: reduction and replacement. Forty-six mother-child dyads aged 22⁻56 months (36.6 ± 9.5 m, 48% female) completed a three-week intervention. In week 1 (baseline) no changes were made to the child's diet; week 2 (acclimation) children received a standardised selection of HED snacks, and in week 3 (intervention) participants were randomly assigned to snack replacement (n = 24) or snack reduction (n = 22). Snack replacement involved swapping HED snacks for fruits and vegetables, whilst snack reduction involved reducing the size of HED snacks by 50%. Food and energy intake were measured using a weighed food diary for four consecutive days. Snack replacement resulted in more positive changes to children's diets; vegetable intake increased (p < 0.01), and total daily energy intake decreased when compared to snack reduction (p < 0.05). Mothers expressed a more favourable attitude to snack replacement, although snack reduction was also well received by mothers. Despite increased preliminary efficacy of snack replacement on dietary intake, both strategies were feasible and acceptable. The current pilot study provides the necessary information to inform the design of future interventions

Increasing physical activity levels : designing a referral pathway to a community- and volunteer-based physical activity programme

Funding: Funded by NHS Fife Endowment Fund.Background/Aim: The NICE guideline on exercise referral schemes to promote physical activity suggests that referral to activities based outside of the gym may be linked to improved adherence. We aim to design and pilot a process of referring patients attending primary care to community-based jogscotland groups and to examine the barriers and facilitators of such a process for health professionals and patients. Methods: GPs and nurses from over 20 practices across Fife have expressed interest in the study. Exploratory interviews with health professionals and patients of primary care practices in Fife will be conducted (N=15-25 primary care registered patients with no physical health barriers to engage in physical activity and N=15-25 GPs/Nurses). These interviews will be guided by Theoretical Domains Framework and analysed using thematic analysis. Informed by findings from the interviews, a process of referral to jogscotland will be designed around how community-based programmes can acceptably be introduced through GP/nurse consultations. Lastly, a feasibility study testing this method of offering referral to jogscotland will be conducted. Results: The findings will enable the design of a full trial to test a community-based approach to physical activity participation that would be scalable cross Scotland. Conclusion: This project will link primary care patients to a structured and volunteer-led physical activity programme in their community that is not gym-based. Given these factors, it has the strong potential of being successful in maintaining behaviour change and achieving positive health outcomes for patients. This project additionally provides a unique opportunity to develop a partnership between primary care and community-based physical activity groups.OtherNon peer reviewe

Colour as a cue to eat : effects of plate colour on snack intake in pre-school children

Environmental cues, such as the colour of food and dishware, have been shown to influence food and drink consumption in adult populations. This proof of concept study investigated whether plate colour could be utilised as a strategy to reduce intake of high energy density (HED) snacks and increase intake of low energy density (LED) snacks in pre-school children. In a between and within-subjects design, children were randomly assigned to either a control group (no colour message) or intervention group (received a colour message: red = stop, green = go) and were provided a snack at nursery on three occasions on differently coloured plates (red, green and white), for each snack type (HED, LED). Snack intake, colour preference, colour association, and anthropometrics were recorded for each child. The results showed that there was no effect of group (control vs intervention) on HED (p=0.540) and LED intake (p=0.575). No effect of plate colour on HED (p=0.147) or LED snack intake (p=0.505) was evident. Combining red and green plates for a chromatic versus achromatic comparison showed that there was no significant effect of chromatic plate on HED (p=0.0503) and LED (p=0.347) intakes. Despite receiving a brief learning intervention, the use of plate colour was found in the present study to be an ineffective strategy to control snack food intake in pre-school aged children. Rather, we suggest that food intake in young children may best be predicted by portion size, energy density and eating behaviour traits

Factors influencing mothers' decisions on whether to provide seafood during early years' feeding : A qualitative study

Sources of funding This study was funded by the Seafish Authority and Interface Food and Drink Scotland (HS053 RGD1371) as part of a PhD scholarship for SC.Peer reviewedPostprin