Offering within-category food swaps to reduce energy density of food purchases: a study using an experimental online supermarket.

BACKGROUND: Swaps are often used to encourage healthier food choices, but there is little evidence of their effectiveness. The current study assessed the impact of offering swaps on groceries purchased within a bespoke online supermarket; specifically the objective was to measure the impact on energy density (ED) of food purchases following the offer of lower ED alternatives (a) at point of selection or at checkout, and (b) with or without explicit consent to receive swap prompts. METHOD: Participants were asked to complete a 12-item shopping task within an online shopping platform, developed for studying food purchasing. 1610 adults were randomly assigned to a no swap control condition or to one of four interventions: consented swaps at selection; consented swaps at checkout; imposed swaps at selection; or imposed swaps at checkout. Each swap presented two lower ED options from the same category as the participant's chosen food. Swap acceptance rate and purchased food ED were the primary outcomes. RESULTS: Of the mean 12.36 (SD 1.26) foods purchased, intervention participants were offered a mean of 4.1 (SD 1.68) swaps, with the potential to reduce the ED of purchased food (effect (95% CI): -83 kJ/100 g (-110 - -56), p = <0.0001). A median of one swap (IQR 0 to 2) was accepted, not significantly reducing the purchased food ED (effect (95% CI): -24 kJ/100 g (4 - -52), p = 0.094). More swaps were accepted when offered at selection than at checkout (OR (95% CI) = 1.224 (1.11 - 1.35), p < 0.0001), but no differences were seen with consent. Purchased food ED was unaffected by point of swap or consent, but reduced with number of swaps accepted (effect per swap (95% CI) = -24 kJ/100 g (-35 - -14), p < 0.0001). CONCLUSION: Within category swaps did not reduce the ED of food purchases reflecting the observation that the use of swaps within an on-line shopping platform offered small potential gains in ED and a minority was accepted.This work was funded by the Department of Health (England) Policy Research Program (Policy Research Unit in Behaviour and Health [PR-UN-0409-10109]).This is the final version. It was first published by BioMed Central at http://dx.doi.org/10.1186/s12966-015-0241-

Choosing between an apple and a chocolate bar: the impact of health and taste labels.

Increasing the consumption of fruit and vegetables is a central component of improving population health. Reasons people give for choosing one food over another suggest health is of lower importance than taste. This study assesses the impact of using a simple descriptive label to highlight the taste as opposed to the health value of fruit on the likelihood of its selection. Participants (N=439) were randomly allocated to one of five groups that varied in the label added to an apple: apple; healthy apple; succulent apple; healthy and succulent apple; succulent and healthy apple. The primary outcome measure was selection of either an apple or a chocolate bar as a dessert. Measures of the perceived qualities of the apple (taste, health, value, quality, satiety) and of participant characteristics (restraint, belief that tasty foods are unhealthy, BMI) were also taken. When compared with apple selection without any descriptor (50%), the labels combining both health and taste descriptors significantly increased selection of the apple ('healthy & succulent' 65.9% and 'succulent & healthy' 62.4%), while the use of a single descriptor had no impact on the rate of apple selection ('healthy' 50.5% and 'succulent' 52%). The strongest predictors of individual dessert choice were the taste score given to the apple, and the lack of belief that healthy foods are not tasty. Interventions that emphasize the taste attributes of healthier foods are likely to be more effective at achieving healthier diets than those emphasizing health alone

Underestimating calorie content when healthy foods are present: an averaging effect or a reference-dependent anchoring effect?

OBJECTIVE: Previous studies have shown that estimations of the calorie content of an unhealthy main meal food tend to be lower when the food is shown alongside a healthy item (e.g. fruit or vegetables) than when shown alone. This effect has been called the negative calorie illusion and has been attributed to averaging the unhealthy (vice) and healthy (virtue) foods leading to increased perceived healthiness and reduced calorie estimates. The current study aimed to replicate and extend these findings to test the hypothesized mediating effect of ratings of healthiness of foods on calorie estimates. METHODS: In three online studies, participants were invited to make calorie estimates of combinations of foods. Healthiness ratings of the food were also assessed. RESULTS: The first two studies failed to replicate the negative calorie illusion. In a final study, the use of a reference food, closely following a procedure from a previously published study, did elicit a negative calorie illusion. No evidence was found for a mediating role of healthiness estimates. CONCLUSION: The negative calorie illusion appears to be a function of the contrast between a food being judged and a reference, supporting the hypothesis that the negative calorie illusion arises from the use of a reference-dependent anchoring and adjustment heuristic and not from an 'averaging' effect, as initially proposed. This finding is consistent with existing data on sequential calorie estimates, and highlights a significant impact of the order in which foods are viewed on how foods are evaluated

Priming healthy eating. You can't prime all the people all of the time.

OBJECTIVE: In the context of a food purchasing environment filled with advertising and promotions, and an increased desire from policy makers to guide individuals toward choosing healthier foods, this study tests whether priming methods that use healthy food adverts to increase preference for healthier food generalize to a representative population. METHODS: In two studies (Study 1 n = 143; Study 2 n = 764), participants were randomly allocated to a prime condition, where they viewed fruit and vegetable advertisements, or a control condition, with no advertisements. A subsequent forced choice task assessed preference between fruits and other sweet snacks. Additional measures included current hunger and thirst, dietary restraint, age, gender, education and self-reported weight and height. RESULTS: In Study 1, hunger reduced preferences for fruits (OR (95% CI) = 0.38 (0.26-0.56), p <0.0001), an effect countered by the prime (OR (95% CI) = 2.29 (1.33-3.96), p = 0.003). In Study 2, the effect of the prime did not generalize to a representative population. More educated participants, as used in Study 1, chose more fruit when hungry and primed (OR (95% CI) = 1.42 (1.13-1.79), p = 0.003), while less educated participants' fruit choice was unaffected by hunger or the prime. CONCLUSION: This study provides preliminary evidence that the effects of adverts on healthy eating choices depend on key individual traits (education level) and states (hunger), do not generalize to a broader population and have the potential to increase health inequalities arising from food choice.We gratefully acknowledge the participation of all NIHR Cambridge BioResource (CBR) volunteers. We thank the Cambridge BioResource staff for their help with volunteer recruitment, members of the Cambridge BioResource SAB and Management Committee for their support of our study and the National Institute for Health Research Cambridge Biomedical Research Centre for funding. Access to CBR volunteers and their data and samples is governed by the CBR SAB. Documents describing access arrangements and contact details are available at http://www.cambridgebioresource.org.uk/. We are grateful to Chris Holmes and Sarah Walker for advice, comment and discussion on this work from a marketing perspective and to Graham Finlayson for use of the food images. The study was funded by the Department of Health Policy Research Program (Policy Research Unit in Behavior and Health [PR-UN-0409-10109]). The Department of Health had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.This is the final published version. It first appeared at http://dx.doi.org/10.1016/j.appet.2015.01.01

Double dissociation between the effects of peri-postrhinal cortex and hippocampal lesions on tests of object recognition and spatial memory: heterogeneity of function within the temporal lobe.

It is widely believed that declarative memory is mediated by a medial temporal lobe memory system consisting of several distinct structures, including the hippocampus and perirhinal cortex. The strong version of this view assumes a high degree of functional homogeneity and serial organization within the medial temporal lobe, such that double dissociations between individual structures should not be possible. In the present study, we tested for a functional double dissociation between the hippocampus and peri-postrhinal cortex in a single experiment. Rats with bilateral excitotoxic lesions of either the hippocampus or peri-postrhinal cortex were assessed in tests of spatial memory (radial maze) and object recognition memory. For the latter, the spontaneous object recognition task was conducted in a modified apparatus designed to minimize the potentially confounding influence of spatial and contextual factors. A clear functional double dissociation was observed: rats with hippocampal lesions were impaired relative to controls and those with peripostrhinal cortex lesions on the spatial memory task, whereas rats with peri-postrhinal lesions were impaired relative to the hippocampal and control groups in object recognition. These results provide strong evidence in favor of heterogeneity and independence of function within the temporal lobe

What Are the Structural Barriers to Planning for Later Life? A Scoping Review of the Literature

The rollback of the welfare state in countries such as the UK, coupled with population ageing, have contributed to a situation in which responsibility for older people’s wellbeing is placed more heavily on the individual. This is exemplified in the notion in popular and policy circles that individuals should plan for later life, particularly financially, and a corresponding concern that they are not doing so sufficiently. This scoping review aimed to identify the structural factors which inhibit people from engaging in planning for later life. For the purposes of this review, we characterised planning as the range of activities people deliberately pursue with the aim of achieving desired outcomes in later life. This entails a future, as opposed to shorter-term goal orientation. In study selection, we focused on planning at mid-life (age 40-60). Systematic and snowball searching identified 2,317 studies, of which 36 were included in the final qualitative synthesis. The review found that limited financial resources were a key barrier to planning. Related factors included: living in rented accommodation, informal caring, and working part-time. A lack of support from employers, industry, regulators and landlords was also found to inhibit planning. The findings suggest that certain sections of society are effectively excluded from planning. This is particularly problematic if popular and policy discourse comes to blame individuals for failing to plan. The review also provides a critical perspective on planning, highlighting a tendency in the literature towards individualistic and productivist interpretations of the concept

The relationship between chronic diseases and number of sexual partners: an exploratory analysis

Background: We investigated sex-specific associations between lifetime number of sexual partners and several health outcomes in a large sample of older adults in England. Methods: We used cross-sectional data from 2,537 men and 3,185 women aged ≥50 years participating in the English Longitudinal Study of Ageing. Participants reported the number of sexual partners they had had in their lifetime. Outcomes were self-rated health and self-reported limiting long-standing illness, cancer, coronary heart disease (CHD), and stroke. We used logistic regression to analyse associations between lifetime number of sexual partners and health outcomes, adjusted for relevant sociodemographic and health-related covariates. Results: Having had 10 or more lifetime sexual partners was associated with higher odds of reporting a diagnosis of cancer than having had 0-1 sexual partners in men (OR=1.69, 95% CI 1.01-2.83) and women (OR=1.91, 95% CI 1.04-3.51), respectively. Women who had 10 or more lifetime sexual partners also had higher odds of reporting a limiting long-standing illness (OR=1.64, 95% CI 1.15 2.35). No other statistically significant associations were observed. Conclusions: A higher lifetime number of sexual partners is associated with increased odds of reported cancer. Longitudinal research is required to establish causality. Understanding the predictive value of lifetime number of sexual partner as a behavioural risk factor may improve clinical assessment of cancer risk in older adults

Multiple Cognitive Abilities from a Single Cortical Algorithm

Abstract ■ One strong claim made by the representational-hierarchical account of cortical function in the ventral visual stream ( VVS) is that the VVS is a functional continuum: The basic computations carried out in service of a given cognitive function, such as recognition memory or visual discrimination, might be the same at all points along the VVS. Here, we use a single-layer computational model with a fixed learning mechanism and set of parameters to simulate a variety of cognitive phenomena from different parts of the functional continuum of the VVS: recognition memory, categorization of perceptually related stimuli, perceptual learning of highly similar stimuli, and development of retinotopy and orientation selectivity. The simulation results indicate-consistent with the representational-hierarchical view-that the simple existence of different levels of representational complexity in different parts of the VVS is sufficient to drive the emergence of distinct regions that appear to be specialized for solving a particular task, when a common neurocomputational learning algorithm is assumed across all regions. Thus, our data suggest that it is not necessary to invoke computational differences to understand how different cortical regions can appear to be specialized for what are considered to be very different psychological functions.

Planning and Preparing for Later Life

There is a widespread and common-sense-based perception, backed to some extent by evidence, that planning and preparing for later life is associated with increased wellbeing in older age. Despite this, many people at mid-life have not thought much about their later life nor taken fundamental future-oriented actions, such as engaging in financial planning or writing a will. This mismatch between the perceived benefits of planning and the prevalence of planning is the impetus for this scoping review of the evidence. It involved the synthesis of evidence from 116 papers and is structured around three overarching research questions: 1. Who does, or does not, plan and prepare for later life during mid-life? 2. What are the barriers and enablers to planning and preparing for later life? 3. What does or might work to enable people to overcome barriers, or to better facilitate enablers? This review focuses on planning for later life (age 60 and over) from mid-life (age 40-60) onwards. It characterises planning for later life as the range of activities people deliberately pursue with the aim of achieving desired outcomes in later life. Such planning can consist of a variety of strategies in different domains, from the often researched activity of contributing to a pension, or deciding when to retire, to less studied forms of planning, such as deciding not to downsize, or to nurture existing friendships. Planning is often conceived as an individual pursuit, yet it is undertaken in relation to others, such as family and social networks, and it is shaped by social, economic and political contexts. These factors, as well as individual level ones, create differences between people’s propensity to plan

The Presence of Real Food Usurps Hypothetical Health Value Judgment in Overweight People.

To develop more ecologically valid models of the neurobiology of obesity, it is critical to determine how the neural processes involved in food-related decision-making translate into real-world eating behaviors. We examined the relationship between goal-directed valuations of food images in the MRI scanner and food consumption at a subsequent ad libitum buffet meal. We observed that 23 lean and 40 overweight human participants showed similar patterns of value-based neural responses to health and taste attributes of foods. In both groups, these value-based responses in the ventromedial PFC were predictive of subsequent consumption at the buffet. However, overweight participants consumed a greater proportion of unhealthy foods. This was not predicted by in-scanner choices or neural response. Moreover, in overweight participants alone, impulsivity scores predicted greater consumption of unhealthy foods. Overall, our findings suggest that, while the hypothetical valuation of the health of foods is predictive of eating behavior in both lean and overweight people, it is only the real-world food choices that clearly distinguish them.This study was supported by the Bernard Wolfe Health Neuroscience Fund (HZ, PCF), the Wellcome Trust (NM, HZ, PCF), the Medical Research Council grant U105960389 (ALA, KMD, SAJ) and the Department of Health Policy Research Program (Policy Research Unit in Behaviour and Health [PR-UN-0409-10109]) (TMM, SEF).This is the final version of the article. It first appeared from the Society for Neuroscience via https://doi.org/10.1523/ENEURO.0025-16.201