“It’s Just Addictive People That Make Addictive Videos”: Children’s Understanding of and Attitudes towards Influencer Marketing of Food and Beverages by YouTube Video Bloggers

Exposure to influencer marketing of foods and beverages high in fat, sugar, and/or salt (HFSS) increases children’s immediate intake. This study qualitatively explored children’s understanding of, and attitudes towards, this marketing, to elucidate potential mechanisms through which exposure affects behavior. In six focus groups (n = 4) children (10–11 years) were shown a YouTube video featuring influencer marketing of an HFSS product. Inductive thematic analysis identified six themes from children’s discussions of this marketing: (1) YouTubers fill a gap in children’s lives, (2) the accessibility of YouTubers increases children’s understanding of their actions, (3) influencer marketing impacts all—the influencer, the brand, and the viewer, (4) attitudes towards influencer marketing are most affected by a YouTuber’s familiarity, (5) YouTuber influencer marketing is effective because they are not ‘strangers’, (6) children feel able to resist influencer marketing of HFSS products. Children had an understanding of the persuasive intent of this marketing, and although most were sceptical, familiar YouTubers elicited particularly sympathetic attitudes. Children felt affected by influencer marketing of HFSS products, but believed they were able to resist it. Beyond theoretical insight, this study adds to the growing body of evidence to suggest children’s exposure to HFSS influencer marketing should be reduced

A Qualitative Analysis of Problematic and Non-problematic Alcohol Use After Bariatric Surgery

Objectives Bariatric surgery is an effective weight loss tool, but an under-communicated side effect may include the increased risk for alcohol problems. Few studies have examined contributors towards alcohol problems following surgery using a qualitative approach. Therefore, the current study aimed to generate insight informed by participants with problematic alcohol use following bariatric surgery, in comparison with participants without. Methods Participants (14; females, n = 9; males, n = 5) completed semi-structured interviews using questions relating to alcohol use, relationship to food, support and surgical experiences. Thematic analysis was conducted to provide insight into the factors which influenced drinking behaviours that participants engaged in following bariatric surgery, and motivations for drinking or limiting alcohol. Results Five core themes were identified between both participants with and without problematic alcohol use: (1) drinking motivations, (2) self-image, (3) impact of restriction on eating behaviour, (4) support needs and (5) surgical preparedness. A sixth core theme (“resilience”) was identified specifically amongst participants without problematic alcohol use. Divergent experiences, cognitions and behaviours formed sub-themes within the five core themes and highlighted the differences between participants with and without problematic alcohol use within the core themes. Conclusion This study is the first to qualitatively assess themes relating to the development of problematic alcohol use after bariatric surgery while additionally using a comparison group without problematic alcohol use. The findings highlight key features which contribute to problematic alcohol use, as well as experiences and cognitions that may be helpful in preventing this phenomenon in bariatric populations

Reductions to main meal portion sizes reduce daily energy intake regardless of perceived normality of portion size: a 5 day cross-over laboratory experiment

Background Smaller portions may help to reduce energy intake. However, there may be a limit to the magnitude of the portion size reduction that can be made before consumers respond by increasing intake of other food immediately or at later meals. We tested the theoretical prediction that reductions to portion size would result in a significant reduction to daily energy intake when the resulting portion was visually perceived as ‘normal’ in size, but that a reduction resulting in a ‘smaller than normal’ portion size would cause immediate or later additional eating. Methods Over three 5-day periods, daily energy intake was measured in a controlled laboratory study using a randomized crossover design (N = 30). The served portion size of the main meal component of lunch and dinner was manipulated in three conditions: ‘large-normal’ (747 kcal), ‘small-normal’ (543 kcal), and ‘smaller than normal’ (339 kcal). Perceived ‘normality’ of portion sizes was determined by two pilot studies. Ad libitum daily energy intake from all meals and snacks was measured. Results Daily energy intake in the ‘large-normal’ condition was 2543 kcals. Daily energy intake was significantly lower in the ‘small-normal’ portion size condition (mean difference − 95 kcal/d, 95% CI [− 184, − 6], p = .04); and was also significantly lower in the ‘smaller than normal’ than the ‘small-normal’ condition (mean difference − 210 kcal/d, 95% CI [− 309, − 111], p < .001). Contrary to predictions, there was no evidence that the degree of additional food consumption observed was greater when portions were reduced past the point of appearing normal in size. Conclusions Reductions to the portion size of main-meal foods resulted in significant decreases in daily energy intake. Additional food consumption did not offset this effect, even when portions were reduced to the point that they were no longer perceived as being normal in size. Trial registration Prospectively registered protocol and analysis plan: https://osf.io/natws/; retrospectively registered: https://clinicaltrials.gov/ct2/show/NCT03811210

Visual perceptions of portion size normality and intended food consumption: A norm range model

Smaller portion sizes are associated with lower energy intake. We test a norm range model of the portion size effect on intended intake. A wide range of portion sizes were perceived as normal. Portions perceived as normal did not prompt intended compensatory eating. Portions perceived as smaller than normal prompted intended compensation

Awareness and portion size : individuals appear to be more aware of the influence of larger portions than previously thought

There is reliable evidence that larger portions lead to increased energy intake. It has been suggested that individuals are unaware of the influence that large portion sizes have on the amount of food they consume. The current study sought to determine whether individuals are able to identify the influence that larger portions have on their food intake. Participants (n ¼ 40) were provided with a fixed-sized lunch and then a large portion of ice-cream. They rated how much they intended to consume of the ice-cream before eating as much of the portion as desired. After the meal, participants reported to what extent they believed they had been influenced by the size of the portion and reasons why they felt they had or had not been influenced. The majority of participants (65.7%) believed that they had been influenced by the size of the portion they received. Critically, these beliefs also appeared to reflect behaviour, as participants who believed they had been influenced by portion size tended to have eaten more ice cream. These findings suggest that consumers may be more aware of external influences on their food intake than previously assumed

Reactivity to television food commercials in overweight and lean adults: Physiological, cognitive and behavioral responses

Recent evidence indicates that acute exposure to food advertising increases food intake. However, little research to date has explored the potential mechanisms underpinning this, such as the extent to which food commercials elicit conditioned physiological responses (e.g. increased salivation). The aim of the current study was to examine salivary, cognitive and consumptive responses to televised food commercials in overweight (N = 26) and lean (N = 29) adult females. Participants attended two laboratory sessions in a counterbalanced order; in one session they viewed a television show with embedded commercials for unhealthy foods, and in the other session they viewed the same show with non-food commercials. In both conditions, following viewing participants were exposed to an in vivo food cue (freshly cooked pizza) which they were then invited to eat ad libitum. Salivation was measured at baseline, during commercial exposure, and during in vivo exposure. Participants also self-reported components of appetite on visual analogue scales and completed a word stem task. Results indicated little evidence of increased salivary reactivity to the food commercials. In both conditions, lean participants showed reliable salivary responses to the in vivo food cue. In contrast, overweight participants only showed increased salivation to the in vivo cue in the food commercials condition. Food commercial exposure did not increase the number of food-related cognitions or amount of food consumed, but did drive a greater increase in desire to eat prior to pizza consumption than exposure to the control commercials. Exposure to food advertising primes eating-related motivations, and while it may not be associated with increased intake or salivation per se, non-food commercials may attenuate subsequent physiological responses to actual food cues in overweight individuals

EffectS of non-nutritive sWeetened beverages on appetITe during aCtive weigHt loss (SWITCH): Protocol for a randomized, controlled trial assessing the effects of non-nutritive sweetened beverages compared to water during a 12-week weight loss period and a follow up weight maintenance period

Background Acute and medium-term intervention studies suggest that non-nutritive sweeteners (NNS) are beneficial for weight loss, however there is limited human data on the long-term effects of consuming NNS on weight loss, maintenance, and appetite. Further research is therefore required to elucidate the prolonged impact of NNS consumption on these outcome measures. Methods/design A randomized parallel groups design will be used to assess whether regular NNS beverage intake is equivalent to a water control in promoting weight loss over 12-weeks (weekly weight loss sessions; Phase I), then supporting weight maintenance over 40-weeks (monthly sessions; Phase II) and subsequently independent weight maintenance over 52-weeks (Phase III) in 432 participants. A subset of these participants (n = 116) will complete laboratory-based appetite probe days (15 sessions; 3 sessions each at baseline, at the start of phase I and the end of each phase). A separate subset (n = 50) will complete body composition scans (DXA) at baseline and at the end of each phase. All participants will regularly be weighed and will complete questionnaires and cognitive tasks to assess changes in body weight and appetitive behaviours. Measures of physical activity and biochemical markers will also be taken. Discussion The trial will assess the efficacy of NNS beverages compared to water during a behavioural weight loss and maintenance programme. We aim to understand whether the impact of NNS on weight, dietary adherence and well-being are beneficial or transient and effects on prolonged successful weight loss and weight maintenance through sustained changes in appetite and eating behaviour. Trial registration: Clinical Trials: NCT02591134; registered: 23.10.201