Food is readily available and relatively inexpensive in developed countries, and there are frequent temptations and opportunities to eat. This easy and inexpensive food availability indirectly presents the problem of weight management. Foods, particularly those high in fat and sugar, can overpower the desire to control eating during the phase of losing weight through dieting.
Study: A Qualitative Process Evaluation of Participant Experiences in a Feasibility Randomised Controlled Trial to Reduce Indulgent Foods and Beverages. Image Credit: beats1 / Shutterstock
Background
An individual quickly gains weight by consuming energy-dense foods or fat and sugar-rich foods. Weight gain occurs when additional energy is consumed through foods that are eaten in addition to daily meals. A previous study indicated that 35% of diets consist of energy-dense, nutrient-poor (EDNP) foods that independently contribute to the manifestation of several diseases. Usually, these foods are referred to as snacks or indulgences.
In Australia, these foods are described as discretionary food, “foods and drinks not necessary to provide the nutrients the body needs, but that may add variety.” A recent Nutrients journal study referred to this type of food as “indulgences.” It must, however, be noted that snacks are not always high in fat or sugar content, nor are they always energy-dense.
The tendency to frequently eat out of home is often associated with poor diets and may increase as people become more susceptible to indulgences. Previous studies have shown that stress is linked to greater consumption of indulgences. Based on a neurobehavioural model of food temptation management in obesity, three processes were found to be induced while resisting temptation. These are temporal discounting, reward-driven attentional bias, and the cold-hot empathy gap.
Since indulgences are very palatable and provide immediate gratification, they are often challenging to resist. In addition, if individuals are hungry or thirsty, it is difficult to resist temptations. Therefore, self-regulation is pivotal to reducing temptations, which can be disrupted due to stress or insufficient sleep.
Although several studies have identified factors that affect the consumption of indulgences, very few interventions have been tested beyond standard laboratory settings or for periods longer than a few weeks. Some strategies, such as restriction/elimination and reformulation, showed potential in controlling the consumption of indulgences. Nevertheless, all these studies were associated with laboratory experiments with one-off exposure opportunities.
Scientists believe that qualitative research would provide a better in-depth understanding of factors that affect food consumption. The majority of qualitative research revealed that individuals use exercise, strategic meal formation, and manipulate the availability of tempting food to manage their intake of indulgences. However, these studies have not analyzed how healthy participants react to food temptation.
A New Study
In the current study, an international team of researchers conducted a feasibility randomized controlled trial to assess the effectiveness of an intervention associated with self-control to reduce consumption of indulgences over eight weeks. A total of 23 adult participants were recruited in this study. The control group contained five participants, Group 1 contained 8, and Group 2 contained 9 participants.
Group 1 was asked to say no to indulgences seven times/week and write down the indulgences they resisted. Group 2 was given the same instructions, but instead of writing down, they took photographs of the indulgence they rejected. The photographs were sent to the research team. A total of 23 interviews were conducted with a mean duration of 16.8 minutes.
Study Findings
All participants were motivated to reduce the intake of indulgences, both food and beverages. The mean age of the participants was 52 years, and 70% of the cohort was female. On average, participants reported consumption of 29 indulgences per week, which was reduced to 18 at follow-up. A reduction in weight gain up to 0.9 kg was observed at follow-up.
To manage environmental influences on indulgences consumption, participants made small changes based on portion control, analyzing pros and cons before consumption, and substituting foods/beverages. Importantly, self-monitoring to reduce consumption of indulgences seven days per week in order to achieve weight-reducing goals was found to be a promising approach. The findings of this study indicated the benefits of exploiting strategies that help break habits and reduce emotional eating.
Conclusions
A key strength of this study is its qualitative approach which showed whether the “Say No” strategy would work in resisting indulgences. Here, the participants provided their interpretation of how and why this strategy worked instead of hypothetical reporting. The current study has some limitations, including the dominating presence of the older population and White ethnicity, which reduces the generalization of the finding.
The authors emphasized that the intervention of “Saying No” has a positive effect on reducing the consumption of indulgences, and this strategy could be developed further by means of a public health campaign.