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Research ArticleNew Research, Cognition and Behavior

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

Nenad Medic, Hisham Ziauddeen, Suzanna E. Forwood, Kirsty M. Davies, Amy L. Ahern, Susan A. Jebb, Theresa M. Marteau and Paul C. Fletcher
eNeuro 13 April 2016, 3 (2) ENEURO.0025-16.2016; https://doi.org/10.1523/ENEURO.0025-16.2016
Nenad Medic
1Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, United Kingdom
2Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
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Hisham Ziauddeen
1Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, United Kingdom
2Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
3Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge CB21 5EF, United Kingdom
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Suzanna E. Forwood
4Department of Psychology, Anglia Ruskin University, Cambridge CB1 1PT, United Kingdom
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Kirsty M. Davies
5Department of Psychology, University of Cambridge, Cambridge CB2 3EB, United Kingdom
6MRC Human Nutrition Research, Cambridge CB1 9NL, United Kingdom
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Amy L. Ahern
6MRC Human Nutrition Research, Cambridge CB1 9NL, United Kingdom
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Susan A. Jebb
7Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, United Kingdom
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Theresa M. Marteau
8Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge CB2 0SR, United Kingdom
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Paul C. Fletcher
1Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, United Kingdom
2Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
3Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge CB21 5EF, United Kingdom
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  • Figure 1.
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    Figure 1.

    Study design and experimental task. A, Study design. B, Before the scanner session, participants rated 50 foods for their healthiness and tastiness, in two separate ratings blocks, the order of which was counterbalanced across participants. For each participant, the health- and taste-neutral food was selected as the reference food for the scanner task. C, The scanner food choice task featured the same 50 items presented as part of free and forced trials. Free and forced trials, of 8 s duration, were presented in a randomized order. After the decision trial was over, a 1 s feedback screen presented the decision that was made. This was followed by a 0.5 s blank screen. On 30 random occasions during the course of the task, a 6 s null trial with a fixation cross was presented after the blank screen.

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    Figure 2.

    Food choices in the scanner task and in the buffet lunch. A, The proportion of acceptance of food swaps (selecting “yes” or “strong yes”) in the scanner food choice task, across four categories of foods, in lean participants (n = 23) and overweight participants (n = 40). B, Buffet consumption (expressed as the weight of consumed foods) across four food categories, in lean and overweight participants. **p < 0.01, ***p < 0.001. Error bars represent the SEM.

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    Figure 3.

    Neural measures of the goal value of food. A, The neural representation of goal value in the vmPFC. The results of the fMRI analysis were rendered onto a standard SPM8 T1 template image, with coronal and sagittal sections presented at the coordinates appropriate for displaying the vmPFC cluster (pFWE < 0.05, corrected at the cluster level; p < 0.001 uncorrected threshold). B, Health and taste beta value extracted from the vmPFC activity, in lean and overweight participants. Error bars represent the SEM.

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    Figure 4.

    Model of healthy food consumption. Visual depiction of the multiple linear regression model 2 (Table 2). A, A partial residual plot of the proportion of healthy foods consumed as a function of the neural health beta value, in lean and overweight participants. B, A partial residual plot of the proportion of healthy foods consumed as a function of BIS-11 impulsivity scores, in lean and overweight participants. Each dot represents one participant.

Tables

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    Table 1.

    Study sample demographics

    MeasureLean (n = 23)Overweight/obese (n = 40)t/χ2p
    BMI (kg/m2)21.88 (1.3)30.84 (4.82)8.70<0.001
    Age (years)29.78 (6.00)29.85 (5.75)0.040.97
    Gender
        Female13230.010.99
        Male1017
    Education
        University degree13210.010.96
        No university degree1019
    Average yearly income (£)
        ≤9,9997112.410.49
        10,000–19,9991013
        20,000–29,999312
        30,000–39,99933
    Ethnicity
        White20350.900.82
        Black12
        Asian22
        Other01
        IQ107.45 (12.78)111.28 (17.45)0.900.37
    DEBQ
        Restraint22.86 (8.35)26.58 (5.87)2.050.05
        Emotional27.23 (8.15)31.58 (9.58)1.800.08
        External30.73 (4.58)32.45 (6.15)1.150.26
    • Values are reported as the mean (SD) or n, unless otherwise indicated. DEBQ, Dutch Eating Behavior Questionnaire.

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    Table 2.

    Foods comprising the buffet lunch

    Foodkcal/100 gFat/100 gSaturated fat/100 gWeight/volume as served (g)Calories available
    Cheddar crackers50927.716.02001018
    Oatcake crackers44921.88.4200898
    Chocolate mini bites44019.83.5200880
    Eat natural cereal bar45624.716.4200912
    Fruit pastille sweets330Trace100330
    Dried mixed fruit2800.60.2100280
    Scotch eggs23515.38.0400940
    Broccoli and tomato quiche21513.24.3400860
    BLT sandwich22510.02.2354797
    Chicken salad sandwich1957.51.0400780
    Trifle1605.43.4600960
    Strawberry yogurt1112.61.7600666
    Coke421 L420
    Orange juice481 L480
    Diet coke1 L
    Water1 L
    • View popup
    Table 3.

    Mean scores of neurocognitive measures of impulsivity in lean and overweight participants

    MeasureLeanOverweighttp
    SSRT (n = 61)161.09 ms (39.5 ms)172.1 ms (58 ms)−0.800.43e
    SI (n = 62)229.03 ms (231.07 ms )243.71 ms (249.23 ms)0.230.82f
    BIS-11 (n = 63)66.74 (7.79)62.3 (9.11)1.960.06g
    • Values are reported as the mean (SD), unless otherwise indicated.

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    Table 4.

    Brain regions correlated with goal value

    RegionSideCluster size (voxels)Peak MNI coordinatesPeak scores
    xyzTZ
    Medial frontal gyrusL/R1556−844−46.35.55
    CuneusR66318−92205.254.78
    Posterior cingulateL/R544−8−46364.484.16
    • p < 0.05 whole-brain FWE correction for multiple comparisons at the cluster level (p < 0.001 uncorrected threshold).

    • View popup
    Table 5.

    Regression coefficients and corresponding p values of the best-fitting models of healthy food consumption in the buffet, as a function of neural health β value, group, and impulsivity scores

    Predictorβp
    Model 1x
        Neural health beta value0.260.03
        Group (overweight − lean)−0.370.002
    Model 2y
        BIS-110.040.83
        Neural health beta value0.220.03
        Group (overweight − lean)−0.47<0.001
        BIS-11:Group (overweight − lean)−0.430.02
    • x F(2,59) = 9.65, p < 0.001; R 2 = 0.22, ms = 0.0596.

    • y F(4,55) = 12.12, p < 0.000; R 2 = 0.43, ms = 0.0451.

    • View popup
    Table 6.

    Regression coefficients and corresponding p values of the best fitting models of healthy food consumption in the buffet, as a function of behavioral health β value, group and impulsivity scores

    PredictorβP
    Model 1z
        Behavioral health beta value0.44<0.0001
        Group (overweight − lean)−0.4<0.001
    Model 2α
        BIS-110.040.81
        Behavioral health beta value0.260.03
        Group (overweight − lean)−0.47<0.001
        BIS-11 group (overweight − lean)−0.410.02
    • z F(2,59) = 17.61, p < 0.0001, R 2 = 0.35, ms = 0.0521.

    • α F(4,55) = 12.3, p < 0.0001, R 2 = 0.43, ms = 0.0457.

    • View popup
    Table 7.

    Statistical table

    TestData structureType of testTest statisticp value[Confidence interval]/power
    a: Overweight − leanNormal distributionLinear mixed-effects modelt(61) = −1.470.15[−0.25, 0.04]
    b: Overweight – leanNormal distributionLinear mixed-effects modelt(61) = 1.220.23[−0.09, 0.37]
    c: Main effect of tasteNormal distributionLinear mixed-effects modelF(1,180) = 309.11< 0.00011
    c: Main effect of healthNormal distributionLinear mixed-effects modelF(1,180) = 2.780.10.39
    c: Main effect of groupNormal distributionLinear mixed-effects modelF(1,61) = 0.740.390.14
    c: Health × taste interactionNormal distributionLinear mixed-effects modelF(1,180) = 0.510.480.11
    c: Health × group interactionNormal distributionLinear mixed-effects modelF(1,180) = 0.20.660.07
    c: Taste × group interactionNormal distributionLinear mixed-effects modelF(1,180) = 0.030.870.05
    c: Health × taste × group interactionNormal distributionLinear mixed-effects modelF(1,180) = 0.170.680.07
    d: Main effect of tasteNormal distributionLinear mixed-effects modelF(1,180) = 1.880.170.28
    d: Main effect of healthNormal distributionLinear mixed-effects modelF(1,180) = 0.960.330.17
    d: Main effect of groupNormal distributionLinear mixed-effects modelF(1,61) = 1.740.190.27
    d: Health × taste interactionNormal distributionLinear mixed-effects modelF(1,180) = 0.370.540.09
    d: Health × group interactionNormal distributionLinear mixed-effects modelF(1,180) = 0.610.430.12
    d: Taste × group interactionNormal distributionLinear mixed-effects modelF(1,180) = 2.190.140.32
    d: Health × taste × group interactionNormal distributionLinear mixed-effects modelF(1,180) = 0.040.850.05
    e: Overweight − leanNormal distributionTwo-sample t testt(1,59) = −0.80.43[−38.4, 16.4]
    f: Overweight – leanNormal distributionTwo-sample t testt(1,60) = −0.240.81[−156, 122]
    g: Overweight – leanNormal distributionTwo-sample t testt(1,61) = 1.960.06[−0.09, 8.97]
    h: Main effect of tasteNormal distributionLinear mixed-effects modelF(1,169) = 219.13<0.00011
    h: Main effect of healthNormal distributionLinear mixed-effects modelF(1,169) = 4.350.040.56
    h: Main effect of groupNormal distributionLinear mixed-effects modelF(1,60) = 0.290.590.08
    h: Health × taste interactionNormal distributionLinear mixed-effects modelF(1,169) = 8.230.0050.83
    h: Health × group interactionNormal distributionLinear mixed-effects modelF(1,169) = 13.090.00040.96
    h: Taste × group interactionNormal distributionLinear mixed-effects modelF(1,169) = 0.130.720.07
    h: Health × taste × group interactionNormal distributionLinear mixed-effects modelF(1,169) = 9.290.0030.87
    i: Main effect of tasteNormal distributionLinear mixed-effects modelF(1,162) = 135.05< 0.00011
    i: Main effect of healthNormal distributionLinear mixed-effects modelF(1,162) = 6.20.010.71
    i: Main effect of groupNormal distributionLinear mixed-effects modelF(1,60) = 0.010.970.05
    i: Health × taste interactionNormal distributionLinear mixed-effects modelF(1,162) = 0.480.490.11
    i: Health × group interactionNormal distributionLinear mixed-effects modelF(1,162) = 8.040.0050.82
    i: Taste × group interactionNormal distributionLinear mixed-effects modelF(1,162) = 0.040.840.05
    i: Health × taste × group interactionNormal distributionLinear mixed-effects modelF(1,162) = 7.060.0090.77
    j: Main effect of tasteNormal distributionLinear mixed-effects modelF(1,92) = 59.26< 0.00011
    j: Main effect of healthNormal distributionLinear mixed-effects modelF(1,92) = 41.04< 0.00011
    j: Main effect of groupNormal distributionLinear mixed-effects modelF(1,60) = 1.10.290.19
    j: Health × taste interactionNormal distributionLinear mixed-effects modelF(1,92) = 1.520.220.24
    j: Health × group interactionNormal distributionLinear mixed-effects modelF(1,92) = 3.210.080.44
    j: Taste × group interactionNormal distributionLinear mixed-effects modelF(1,92) = 0.590.440.12
    j: Health × taste × group interactionNormal distributionLinear mixed-effects modelF(1,92) = 2.520.120.36
    k: Main effect of tasteNormal distributionLinear mixed-effects modelF(1,169) = 137.84<0.00011
    k: Main effect of healthNormal distributionLinear mixed-effects modelF(1,169) = 16.20.00010.98
    k: Main effect of groupNormal distributionLinear mixed-effects modelF(1,60) = 0.260.610.08
    k: Health × taste interactionNormal distributionLinear mixed-effects modelF(1,169) = 4.760.030.59
    k: Health × group interactionNormal distributionLinear mixed-effects modelF(1,169) = 11.860.00070.94
    k: Taste × group interactionNormal distributionLinear mixed-effects modelF(1,169) = 0.050.830.06
    k: Health × taste × group interactionNormal distributionLinear mixed-effects modelF(1,169) = 9.980.0020.89
    LNormal distributionOne-sample t testt(62) = 6.42<0.0001[0.26, 0.5]
    MNormal distributionOne-sample t testt(62) = 0.880.38[−0.04, 0.12]
    n: Main effect of attributeNormal distributionLinear mixed-effects modelF(1,61) = 23.24<0.00010.99
    n: Main effect of groupNormal distributionLinear mixed-effects modelF(1,61) = 0.210.650.07
    n: Attribute × group interactionNormal distributionLinear mixed-effects modelF(1,61) = 1.540.220.24
    o: Overweight − leanNormal distributionTwo-sample t testt(61) = −1.690.09[−0.03, 0.3]
    p: Overweight − leanNormal distributionTwo-sample t testt(61) = 0.450.66[−0.3, 0.19]
    q: Main effect of attributeNormal distributionLinear mixed-effects modelF(1,59) = 22.5<0.00010.99
    q: Main effect of groupNormal distributionLinear mixed-effects modelF(1,59) = 0.20.650.07
    q: Main effect of BIS-11Normal distributionLinear mixed-effects modelF(1,59) =0.010.830.06
    q: Attribute × group interactionNormal distributionLinear mixed-effects modelF(1,59) = 1.50.230.24
    q: Attribute × BIS-11 interactionNormal distributionLinear mixed-effects modelF(1,59) = 0.10.750.06
    q: Group × BIS-11 interactionNormal distributionLinear mixed-effects modelF(1,59) = 0.010.930.05
    q: Attribute × group × BIS-11 interactionNormal distributionLinear mixed-effects modelF(1,59) = 0.010.930.05
    rNormal distributionOne-sample t testt(62) = 21.53<0.0001[0.51, 0.61]
    sNormal distributionOne-sample t-testt(62) = 1.920.06[0, 0.15]
    t: Main effect of attributeNormal distributionLinear mixed-effects modelF(1,61) = 100.92<0.00011
    t: Main effect of groupNormal distributionLinear mixed-effects modelF(1,61) = 0.470.470.11
    t: Attribute × group interactionNormal distributionLinear mixed-effects modelF(1,61) = 0.010.940.05
    u: Overweight − leanNormal distributionTwo-sample t testt(61) = −0.390.69[−0.13, 0.19]
    v: Overweight − leanNormal distributionTwo-sample t testt(61) = −0.730.47[−0.07, 0.15]
    w: Main effect of attributeNormal distributionLinear mixed-effects modelF(1,59) = 100.9< 0.00011
    w: Main effect of groupNormal distributionLinear mixed-effects modelF(1,59) = 0.50.470.11
    w: Main effect of BIS-11Normal distributionLinear mixed-effects modelF(1,59) = 0.40.540.1
    w: Attribute × group interactionNormal distributionLinear mixed-effects modelF(1,59) = 0.010.940.05
    w: Attribute × BIS-11 interactionNormal distributionLinear mixed-effects modelF(1,59) = 3.20.080.44
    w: Group × BIS-11 interactionNormal distributionLinear mixed-effects modelF(1,59) = 0.20.650.07
    w: Attribute × group × BIS-11 interactionNormal distributionLinear mixed-effects modelF(1,59) = 0.20.670.07
    x: Neural β valueNormal distributionLinear modelt(1,59) = 2.240.03[0.02, 0.43]
    x: Overweight − leanNormal distributionLinear modelt(1,59) = −3.240.002[−0.35, −0.08]
    y: BIS-11Normal distributionLinear modelt(1,55) = −0.210.83[−0.01, 0.01]
    y: Neural β valueNormal distributionLinear modelt(1,55) = 2.210.03[0.02, 0.36]
    y: Overweight − leanNormal distributionLinear modelt(1,55) = −4.35<0.0001[−0.39, −0.15]
    y: BIS-11 × (overweight − lean) interactionNormal distributionLinear modelt(1,55) = −2.450.02[−0.03, 0]
    z: Behavioral β valueNormal distributionLinear modelt(1,59) = 4.25< 0.0001[0.2, 0.57]
    z: Overweight − leanNormal distributionLinear modelt(1,59) = −3.90.0003[−0.36, −0.11]
    α: BIS-11Normal distributionLinear modelt(1,55) = 0.240.81[−0.01, 0.01]
    α: Behavioral β valueNormal distributionLinear modelt(1,55) = 2.290.03[0.03, 0.43]
    α: Overweight − leanNormal distributionLinear modelt(1,55) = −4.35< 0.0001[−0.39, −0.15]
    α: BIS-11 x (overweight − lean) interactionNormal distributionLinear modelt(1,55) = −2.340.02[−0.03, 0]
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The Presence of Real Food Usurps Hypothetical Health Value Judgment in Overweight People
Nenad Medic, Hisham Ziauddeen, Suzanna E. Forwood, Kirsty M. Davies, Amy L. Ahern, Susan A. Jebb, Theresa M. Marteau, Paul C. Fletcher
eNeuro 13 April 2016, 3 (2) ENEURO.0025-16.2016; DOI: 10.1523/ENEURO.0025-16.2016

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The Presence of Real Food Usurps Hypothetical Health Value Judgment in Overweight People
Nenad Medic, Hisham Ziauddeen, Suzanna E. Forwood, Kirsty M. Davies, Amy L. Ahern, Susan A. Jebb, Theresa M. Marteau, Paul C. Fletcher
eNeuro 13 April 2016, 3 (2) ENEURO.0025-16.2016; DOI: 10.1523/ENEURO.0025-16.2016
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Keywords

  • Eating behavior
  • Food choices
  • impulsivity
  • obesity
  • subjective value
  • vmPFC

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