The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app: a randomized controlled trial.
The international journal of behavioral nutrition and physical activity. 2018;15(1):22
Plain language summary
Acceptance and commitment therapy is one promising method in changing behaviour towards a person’s own value and goals. It aims to strengthen positive psychological processes related to commitment, behaviour change, mindfulness, and acceptance, which can be applied to promote healthy behaviour pattern. The aim of this study was to investigate the effects of acceptance and commitment therapy intervention delivered in two different ways i.e., via face-to-face group sessions and via mobile app, on reported eating behaviour and diet quality among adults with psychological distress and overweight or obesity. The study is a secondary analysis of the parallel-arm randomised controlled trial in which 3 different psychological interventions were studied. 219 individuals participated in the study with a mean body mass index of 31.3kg/m2, and a mean age of 49.5 years. Results indicate that acceptance and commitment therapy-based were able to change the reasons for eating from emotional or environmental triggers towards hunger and satiety cues, increase the acceptance of a variety of foods, and help the individual to perceive healthy eating more consistently. Authors conclude that acceptance and commitment therapy-based interventions delivered in the face-to-face group sessions or by the Mobile app showed beneficial effects on several aspects of eating behaviour.
BACKGROUND Internal motivation and good psychological capabilities are important factors in successful eating-related behavior change. Thus, we investigated whether general acceptance and commitment therapy (ACT) affects reported eating behavior and diet quality and whether baseline perceived stress moderates the intervention effects. METHODS Secondary analysis of unblinded randomized controlled trial in three Finnish cities. Working-aged adults with psychological distress and overweight or obesity in three parallel groups: (1) ACT-based Face-to-face (n = 70; six group sessions led by a psychologist), (2) ACT-based Mobile (n = 78; one group session and mobile app), and (3) Control (n = 71; only the measurements). At baseline, the participants' (n = 219, 85% females) mean body mass index was 31.3 kg/m (SD = 2.9), and mean age was 49.5 years (SD = 7.4). The measurements conducted before the 8-week intervention period (baseline), 10 weeks after the baseline (post-intervention), and 36 weeks after the baseline (follow-up) included clinical measurements, questionnaires of eating behavior (IES-1, TFEQ-R18, HTAS, ecSI 2.0, REBS), diet quality (IDQ), alcohol consumption (AUDIT-C), perceived stress (PSS), and 48-h dietary recall. Hierarchical linear modeling (Wald test) was used to analyze the differences in changes between groups. RESULTS Group x time interactions showed that the subcomponent of intuitive eating (IES-1), i.e., Eating for physical rather than emotional reasons, increased in both ACT-based groups (p = .019); the subcomponent of TFEQ-R18, i.e., Uncontrolled eating, decreased in the Face-to-face group (p = .020); the subcomponent of health and taste attitudes (HTAS), i.e., Using food as a reward, decreased in the Mobile group (p = .048); and both subcomponent of eating competence (ecSI 2.0), i.e., Food acceptance (p = .048), and two subcomponents of regulation of eating behavior (REBS), i.e., Integrated and Identified regulation (p = .003, p = .023, respectively), increased in the Face-to-face group. Baseline perceived stress did not moderate effects on these particular features of eating behavior from baseline to follow-up. No statistically significant effects were found for dietary measures. CONCLUSIONS ACT-based interventions, delivered in group sessions or by mobile app, showed beneficial effects on reported eating behavior. Beneficial effects on eating behavior were, however, not accompanied by parallel changes in diet, which suggests that ACT-based interventions should include nutritional counseling if changes in diet are targeted. TRIAL REGISTRATION ClinicalTrials.gov ( NCT01738256 ), registered 17 August, 2012.
Association between eating behaviour and diet quality: eating alone vs. eating with others.
Nutrition journal. 2018;17(1):117
Plain language summary
Selecting foods for a day is easily influenced by the social environment and eating together or alone plays a big role in that decision. The study aims to evaluate the association between diet quality of the modern Korean adult population based on the eating behaviour and the socioeconomic factors that influence their diet quality. The study is a cross-sectional study which included 3365 men and 5258 women aged between 19 and 64 years. The study included demographic, socioeconomics, and health behaviour factors as covariates. Results indicate that diet quality is influence by eating behaviour. Authors observed that when Korean adults ate without a companion, their diet quality was significantly lower than those who consistently ate with others. Furthermore, from the higher education to lower education level, the diet quality declined when they eat alone. Authors conclude that many Korean adults are experiencing low diet quality when they eat alone. The study provides evidence to promote interventions to improve diet quality among the public.
BACKGROUND To discover the association between eating alone and diet quality among Korean adults who eat alone measured by the mean adequacy ratio (MAR), METHODS The cross-sectional study in diet quality which was measured by nutrient intakes, indicated as MAR and nutrient adequacy ratio (NAR) with the Korean National Health and Nutrition Examination Survey (KNHANES) VI 2013-2015 data. Study population was 8523 Korean adults. Multiple linear regression was performed to identify the association between eating behaviour and MAR and further study analysed how socioeconomic factors influence the diet quality of those who eat alone. RESULTS We found that the diet quality of people who eat alone was lower than that of people who eat together in both male (β: - 0.110, p = 0.002) and female participants (β: - 0.069, p = 0.005). Among who eats alone, the socioeconomic factors that negatively influenced MAR with the living arrangement, education level, income levels, and various occupation classifications. CONCLUSIONS People who eat alone have nutrition intake below the recommended amount. This could lead to serious health problems not only to those who are socially disadvantaged but also those who are in a higher social stratum. Policy-makers should develop strategies to enhance diet quality to prevent potential risk factors.
Do implementation intentions help to eat a healthy diet? A systematic review and meta-analysis of the empirical evidence.
Plain language summary
Eating a healthy diet reduces the likelihood of becoming overweight or chronically ill. Many people are aware of the health benefits of eating a healthy diet, and are hence motivated to eat healthily. This study is a review and meta-analysis with the aim to evaluate the effectiveness of setting implementation intentions (the where, when and how planning in goal setting) in promoting healthy eating behaviour. Results indicate that implementation intentions can be effective in increasing healthy eating behaviours with 12 studies showing an overall medium size effect on increasing fruit and vegetable consumption. Authors conclude that implementation intentions to promote healthy eating have more promising effects that those aiming to diminish unhealthy eating patterns.
OBJECTIVE This systematic review and meta-analysis examined whether implementation intentions are an effective tool to help people put their intentions to eat a healthy diet into practice. Additionally, it was investigated whether the quality of the outcome measures and the quality of the control conditions that are used in these studies influence implementation intentions' effectiveness. METHODS Twenty three empirical studies investigating the effect of implementation intentions on eating behavior were included. In assessing the empirical evidence, a distinction was made between studies that aim to increase healthy eating (i.e., eating more fruits) and studies that aim to diminish unhealthy eating (i.e., eating fewer unhealthy snacks). RESULTS Implementation intentions are an effective tool for promoting the inclusion of healthy food items in one's diet (Cohen's d=.51), but results for diminishing unhealthy eating patterns are less strong (Cohen's d=.29). For studies aiming to increase healthy eating, it was found that higher quality outcome measures and lower quality control conditions tended to yield stronger effects. CONCLUSION Implementation intentions are somewhat more effective in promoting healthy eating than in diminishing unhealthy eating, although for some studies promoting healthy eating effect sizes may have been inflated due to less than optimal control conditions.