Purpose: The desire to consume food for pleasure in the absence of caloric need is termed hedonic (pleasure-based) hunger. This study aimed to explore whether self-control moderates the associations between hedonic hunger, as measured by the Power of Food Scale (PFS), and overeating frequency, snacking frequency and palatable food intake.  This has rarely been examined in a large randomly selected adult sample.

Methods: Data from the Swiss Food Panel 2.0 study was analyzed (N=5,238 from the German- and French-speaking parts of Switzerland, 51% men).  Measures included the PFS, dispositional self-control, overeating frequency, snacking frequency, intake of high-fat salty snack foods, and intake of high-sugar foods assessed with a semiquantitative food frequency questionnaire. Pearson correlations between variables were calculated. Four moderation analyses were conducted, using the PROCESS macro for SPSS developed by Hayes (2013), with overeating (Model 1), consumption of high-sugar foods (Model 2), consumption of high-fat salty snack foods (Model 3) and overall snacking frequency (Model 4) as dependent variables. Simple slope analyses and graphical displays for PFS scores on eating variables for people low (-1 SD), moderate and high (+1 SD) in self-control were conducted.

Results: Higher scores on the PFS and lower self-control were correlated with higher overeating frequency and higher food consumption.  Four separate moderation analyses revealed that the effect of power of food on overeating frequency, snacking frequency, and palatable food intake was significantly attenuated by self-control.  For example, simple slope analyses revealed that PFS was positively related to overeating frequency when self-control was low (one SD below the mean: B=0.50, t(4747)=19.71,p<.001). This positive association was attenuated when self-control was high (1 SD above the mean: B=.09, t(4747)=2.94,p<.003).

Conclusions: Hedonic hunger was associated with overeating, snacking, and palatable food intake when it occurred together with low self-control. Self-control may lead both directly to less overeating, snacking, and palatable foods intake, in addition to attenuating the effects of hedonic hunger on these behaviours.

Purpose: The reduction of red meat consumption in developed countries is recommended for environmental sustainablity and population health. Female adolescents may be receptive to dietary change messages but may also be at highest risk of inadequate intakes of some nutrients. Our objective was to determine the dietary and motivational correlates of red meat consumption patterns in female adolescents.

Methods: Female adolescents, aged 15 – 18 years, were recruited through participating high schools across New Zealand as part of the SuNDiAL project (Survey of Nutrition, Dietary Assessment and Lifestyles). The dietary habits questionnaire assessed red meat consumption patterns (including processed meat, beef, lamb, pork, and venison) as well as other dietary habits, such as fruit and vegetable consumption. Red meat consumption was categorised into three groups: high consumers (more than 5 times a week), moderate consumers (2-4 times a week), and low consumers (once a week or less). Nutrient intake was assessed using two 24-h diet recalls with adjustment to usual intake. The Food Choice Questionnaire assessed eleven different motivations for food choice. Regression models estimated differences between red meat consumption groups.

Results: Thirteen schools participated with 242 girls completing the dietary habits questionnaire. On average, low red meat consumers (n=48) consumed 0.7 more serves of vegetables (95% CI: 0.3, 1.1), and 2.0 more serves of legumes ( 95% CI:1.2, 2.7) and were 18 times more likely to consume vegetarian meat alternatives (95% CI: 6, 56). They also had lower saturated fat, protein, zinc and B12 intakes and greater polyunsaturated fat and dietary fibre than those who consumed red meat more frequently.  High red meat consumers (n=103) consumed more fast food, and sweet snacks. Low red meat consumers were more motivated in their food choices by environmental concerns and animal welfare, whereas high red meat consumers were more motivated by mood and convenience.

Conclusions: Female adolescents with a low red meat consumption pattern generally consumed a healthier diet, but attention must be given to protein, zinc and B12 intakes. Making red meat alternatives convenient and appealing will be important if we wish to decrease the red meat consumption of female adolescents.

Purpose: Large portions have been regarded as one of the drivers behind the rise in obesity, as they encourage individuals to consume food above the needed energy level. Large portions of energy dense foods are especially problematic, such as large portions of sweets and crisps. The objective was to study how consumer’s portion size norms and price are linked to choices and portion size decisions.

Method: We conducted an online survey experiment (n=1020; age 18-65 years) where consumers chose an appropriate portion to eat, portion they would like to eat and the portion they normally eat of sweets or crisps from eight pictures that varied in size.  The portion size pictures varied from 50 to 400 g for sweets and 25 to 300 g for crisps.  Participants were also asked to make a choice between three packaging sizes at two price points from eight choice sets in both products. Data were analysed using t-tests and multiple regressions.

Results: The survey on sweets received 528 valid responses, and the survey on crisps received 492 valid responses. Respondents eat significantly larger portions of sweets and crisps  than what they feel is appropriate ((t-test, p<0.001; M_sweets= 95 g vs 72 g; M_crisps= 108 g vs 87 g), but less than what they would have liked to eat or what they thought other people like them ate. Respondents tended to choose small or medium sized packages of both sweets and crisps, but price did have an impact. When participants had to choose between packages with a high price per kilo, only 2,3 and 2,6% choose the largest package. However, when the large package had a relatively low price per kilo, compared to the two smaller packages, the large package was chosen significantly more (t-test, p<0.005).

Conclusion: Consumers are aware that they should eat smaller portions of energy dense foods, than they do. Rather than telling them to eat less, we should focus on ensuring that larger packages are not priced relatively lower than smaller packages, through pricing strategies.

Purpose: Associations between nutrition and health related outcomes such as obesity, diabetes, and cancer are well established. However, individuals continue to make poor dietary decisions. Using the Health Belief Model (HBM) as a theoretical framework, the current study aimed to explore the acceptability of different nutrition-related behaviours to reduce the risk of cancer due to  consumption of arsenic in rice. At present, research results in this area are limited and use specific samples. Using a diverse sample across multiple countries this study aimed to identify whether a) adopting a specific cooking method, b) using a newly developed rice cooker, or c) buying reformulated rice might be most acceptable to consumers. The suitability of the HBM to predict these behaviours was also examined.

Methods: A total of 3,081 individuals across six European countries completed a cross-sectional online survey (nationally representative to +/- 5%). Alongside relevant sociodemographic questions, participants answered questions measuring the constructs of the HBM: perceived severity, susceptibility, benefits, barriers, and self-efficacy. IBM SPSS and AMOS were used to analyse the data, with structural equation modelling used to explore the application of the HBM to the data.

Results: Participants were most willing to use reformulated food as a method of reducing risk (70%), compared with the specific cooking method (61%) and the new cooker (52%). Frequency of rice consumption and knowledge were consistent significant predictors of all three behaviours. In addition, gender was a significant predictor of using the specific cooking method and reformulated rice, and age was a significant predictor of using the new cooker and the cooking method. Country was a significant predictor of using the cooker. SEM indicated that the HBM could be applied to willingness to use each of the behaviours.  

Conclusions: The majority of participants would prefer to reduce their risk of disease using the most convenient method rather than changing their cooking behaviour. Thus future efforts to change nutrition-related behaviour or consumption might be most effective at the environmental or industry level.

Purpose: Understanding how to sustain long-term exercise practice is a contemporary preoccupation. For that matter, several theoretical approaches focused in motivational process have emerged in order to support a better understanding of exercise continuous adherence. The present preliminary work addresses the motivational sequence proposed by Self-Determination Theory (SDT) and aims to test the effect of past behavior on intention and future exercise behavior (i.e., supportive behaviors > basic psychological needs > behavioral regulation (autonomous motivation) > enjoyment > intention > future behavior).

Methods: In present study, 293 (of a total of 567) health club exercisers aged between 18-65 (M=36.57 ± SD=11.25) years completed a survey of motivational, emotional and cognitive-related variables. Exercise frequency was measured using computer records. Past and future behavior scores were obtain through the sum of previous 6 months exercise frequency, and the sum of the future 6 months of practice, respectively. Structural equation modeling (SEM) procedures were developed with IBM SPSS AMOS v. 23.0 in order to test the proposed model adjustment and variables interactions.

Results: Descriptive analysis were made for each motivational variable, enjoyment, intention, past and future behavior. Psychological variables presented mean scores slightly higher that the middle point of their Likert response scales. Both models (with and without past behavior) presented a good model fit (CFI/TLI > .90; RMSEA/SRMR < .08). Results present support for the SDT expanded motivational sequence, where positive and significant direct effects appeared in all tested relations. When past behavior was added to this sequence, a strong and significant direct effect appeared with future behavior (β = .93; and independently of intention) and a 87% of explained variance of the model was reported.

Conclusions: Considering the study purpose, it was possible to observe that the motivational sequence tested presented a good model fit, as expected in SDT framework. Moreover, past behavior was found to offset the direct effect of intention on future behavior and the indirect effect of all other variables under analysis on intention. This may suggest that past behavior may act as an important determinant of future exercise behavior, and warrants further research in this particular context.

Purpose:  In the UK, 28% of adults currently cycle less than once a month but would like to cycle more regularly. Designed in partnership with a major bank and UK cycling organisation, the Cycle Nation Project (CNP) is a workplace-based initiative to encourage staff who cycle infrequently to cycle more. At the heart of CNP is a practical cycling programme, where bank staff are offered a loaned bike to attend a nine-week foundation (or six-week intermediate) group training course delivered by self-identified cycling enthusiast colleagues trained for two days as CNP Cycle Champions. This study aimed to explore the feasibility and acceptability of the practical cycling programme to inform its optimisation for a future full-scale randomised controlled trial.

Methods: The CNP programme was delivered in 90-minute sessions at four bank offices across the UK between August 2019 and April 2020. Observation of weekly sessions, and end-of-programme participant focus groups and Cycle Champion interviews were analysed thematically.

Results: Sessions were feasible to deliver. Appropriate locations were found near each office for off- and on-road cycle training. Accessing additional storage for participants’ loaned bikes proved difficult. Fidelity was high: Cycle Champions found the delivery protocol easy to follow and felt the programme’s ‘hands-on’ approach was appropriate for the participant group: “[the] practical nature of building up week by week people’s confidence… was very good” (CC101, male). The goal setting component was least well delivered: few participants used the goal-setting tool in their CNP handbooks, and in-session goal review was often rushed. Participants were extremely positive about the programme content.  Attendance was good initially, but dropped as the weeks progressed, with work commitments and winter weather cited as contributing factors. Despite the bank’s Cycle to Work Scheme being promoted throughout, few participants utilised it to replace their loaned bike by the end of the programme, raising questions about sustainability.

Conclusions: The CNP practical training programme was well received, but adaptations are needed to improve delivery of goal setting and attendance at later sessions, and to promote maintenance of cycling post-programme.

Purposes: Workplace sitting is a major cause of sedentary behaviour. Aim 1 was to assess occupational sitting time in Malaysian office employees in the government sector. Aim 2 was to investigate the multilevel determinants of occupational sitting time and enquire the potential strategies to interrupt and reduce occupational sitting time.

Methods: To achieve Aim 1, we invited employees from all federal ministries in Malaysia (N = 24) via email to complete an online questionnaire containing socio-demographic questions and the Occupational Sitting and Physical Activity Questionnaire which is used to enquire about time spent sitting, standing, walking, and heavy labour during work hours. Descriptive statistics were used to assess sitting time. To achieve Aim 2, we conducted five Focus Groups (with between 5 to 8 employees in each group) who spent at least seven hours sitting at work daily. We enquired about knowledge, awareness and perceptions related to prolonged sitting time, and used the socio-ecological framework to enquire about barriers and facilitators to occupational sitting time. We also enquired about potential intervention strategies. Thematic analysis was used to analyze qualitative data.

Results: Of 26,647 employees invited, 1,338 completed the questionnaire. Mean daily occupational sitting time was 5.96 hours (SD = 1.37 hours). None of the socio-demographic factors were associated with sitting time. Focus Groups revealed employees were generally aware of prolonged sitting time but could not elaborate the definition. Prolonged sitting time was mainly influenced by organizational factors (job nature and load of work). In addition, the social (behaviour of employees), physical environment (layout and office design), and policy (no plan for employees to be active) in the organization also affected sitting time. Participants expressed a preference to break sitting time if prompted by a message or instruction. In terms of potential strategies, a smartphone intervention with educational and motivational messages was preferred.

Conclusions: Office-based Malaysian government employees spent a significant amount of sitting time at work. There are multiple factors operating at different levels of the Socio-Ecological Model for health behaviour that influence office-sitting time. A smartphone-based intervention to interrupt sitting could be considered and is currently being tested.

Purpose: Research shows that inactivity increases risk of cardiovascular diseases (CVD), diabetes, obesity, some cancers, osteoporosis, and psychological disorders. Individuals residing in rural Appalachian areas in the eastern U.S. are some of the least likely to meet physical activity (PA) recommendations compared to urban and suburban counterparts. This qualitative research aims to understand perceived barriers and limitations of the built environmental that influence PA engagement in a geographically isolated rural Appalachian community.

Methods: Lead by grounded theory, this qualitative study included five focus groups in one highly obese (>40%) rural Appalachian county. Participants included community leaders and residents (n=34), ages ranged from 32- 72, and 24% (n=8) reporting an annual household income <$20,000. Focus groups lasted 53-76 minutes with an average of 7 participants per session. A semi-structured facilitator guide was developed to reveal community barriers and environmental factors influencing PA participation of individuals in the county. Each focus group was digitally recorded and transcribed verbatim prior to thematic content analysis.

Results/Findings: Participants indicated disinterest and a lack of motivation as major barriers to PA participation, specifically walking. Participants conveyed safety as a major concern for engaging in PA. Several reported it being unpleasant and dangerous to walk throughout the community, and described street design, lack of sidewalks, and no crosswalks as hindrances. Thus, individuals are forced to rely on vehicles for routine daily travel within the county. Conversely, residents who reported activity engagement recognized social support as a key facilitator for PA behavior.

Conclusions: These findings reveal that PA participation and engagement is scarce within this distinctive population. Pedestrian-oriented design and infrastructure enhancement can alleviate multiple barriers, like safety, to support PA engagement. Community-based efforts focused on modifying aspects of the built environment are needed to advance sustainable solutions to reduce obesity by encouraging daily PA. Continued investigation of active living in rural Appalachian communities should consider autonomous motivation and self-efficacy to specifically address individual PA behavior.

Purpose: To describe this systematic and phased process used to develop and evaluate the evidence-based collaborative Exercise and Depression Toolkit for health care providers (HCP) working with adults with depression.

Methods: The four phases of development included a review of relevant literature, formative interviews, an expert panel meeting, and toolkit development. The Theoretical Domains Framework (TDF) and the Behaviour Change Wheel were used to guide analysis and to determine behaviour change techniques (BCTs) to be included in the toolkit. Various stakeholders were involved throughout the process including health care providers, adults who have lived experience with depression, researchers, and exercise professionals who have experience working with adults with depression. The Appraisal of Guidelines, Research and Evaluation (AGREE) II tool was consulted throughout the developmental phased process, and used to guide toolkit content and dissemination strategies. Dissemination of the toolkit (www.exerciseanddepression.ca) was tracked to understand reach and implementation of the toolkit in practice using google analytics and case study evaluation through interviews and daily logs.

Findings: Recommendations from the consultation process resulted in the toolkit being depression tailored including common barriers that individuals with depression face to engaging in physical activity and practical strategies they can use. The toolkit promotes collaboration and a person-centered approach, with different sections for the intended audience of HCP and/or adults with depression. BCTs were included to target the Emotion and Social Influences domains of the TDF. In the first three months 1201 people have downloaded the toolkit from over 20 different countries. Half (n=608) identify as healthcare providers and 370 are individuals seeking help for their depression. In case studies, HCP reported having used the toolkit at least once in practice over a one month period, and perceived the toolkit to be acceptable, easy to use, and adaptable to their practice context.

Conclusions: The development of the collaborative evidence-based Exercise and Depression Toolkit is the first step in bridging the gap and implementing treatment guidelines for depression and the consideration of exercise as a treatment option in practice.

Purpose: Postpartum weight retention is a significant contributor to obesity in women. Identification of the effective core components, such as behaviour change techniques (BCTs), within the successful implementation of postpartum lifestyle interventions has not been investigated in postpartum women. This systematic review and meta-analysis aimed to describe the associations between BCTs and changes in weight, diet and physical activity in postpartum women.

Methods: Databases including MEDLINE, CINAHL, EMBASE, and PsycINFO were searched to identify randomised controlled trials of lifestyle intervention in postpartum women (within 2 years post-delivery) published up to 3^rd May 2019. BCTs were extracted according to the Behaviour Change Technique Taxonomy (v1). Univariate regression analyses were conducted to determine the effect of individual BCTs on body weight, physical activity and energy intake.

Results: From 5000 articles, 46 articles were included (n=3,905 women, age 23-36 years). Meta-analysis showed that postpartum lifestyle interventions resulted in significant improvement in weight (MD -2.46 kg, 95% CI -3.65 to -1.27), and physical activity (SMD 0.61, 95% CI 0.20 to 1.02) but not in energy intake. The average number of BCTs per study was 7.0+3.0. No individual BCT was significantly associated with weight or physical activity outcomes. On meta-regression, the total number of BCTs (β=-0.36, P=0.019), specifically BCTs on problem solving (β=-1.74, P=0.045), goal setting of outcome (β=-1.91, P=0.046), review outcome goal (β=-3.94, P=0.007), feedback on behaviour (β=-2.81, P=0.002), self-monitoring of behaviour (β=-3.20, P=0.003), behavioural substitution (β=-3.20, P=0.003) and credible source (β=-1.72, P=0.033) were associated with lower energy intake.

Conclusions: The total number of BCTs and the provision of certain BCTs including problem-solving, goal-setting of outcome, review outcome goal, feedback on behaviour, self-monitoring of behaviour, behavioural substitution and credible source were associated with greater decreases in energy intake. All lifestyle intervention studies for postpartum women should include these strategies as part of the core components. Further research is required to identify effective BCTs for increasing physical activity and promoting weight loss in postpartum women.