Annika Lutz

Food cravings discriminate differentially between successful and unsuccessful dieters and non-dieters. Validation of the Food Cravings Questionnaires in German☆

Food cravings have been strongly associated with triggering food consumption. However, definitions and measurements of food cravings are heterogeneous. Therefore, Cepeda-Benito and colleagues (2000) have suggested the Food Cravings Questionnaires (FCQs) to measure food cravings as a multidimensional construct at trait- and state-level. In the current study, we validated a German version of the FCQs in an online study (N=616). The factor structure of the state and trait versions could partially be replicated, but yielded fewer than the originally proposed factors. Internal consistencies of both versions were very good (Cronbachs α>.90), whereas retest reliability of the state version was expectedly lower than that of the trait version. Construct validity of the trait version (FCQ-T) was demonstrated by high correlations with related eating behavior questionnaires and low correlations with questionnaires unrelated to eating. Most importantly, FCQ-T-subscales were able to discriminate between successful and unsuccessful dieters and non-dieters. Validity of the state version was supported by positive relations with food deprivation and current negative affect. Taken together, the German version of the FCQs has good psychometric properties. Moreover, this study provided first evidence that distinct dimensions of food cravings are differentially related to success and failure in dieting.

Women with elevated food addiction symptoms show accelerated reactions, but no impaired inhibitory control, in response to pictures of high-calorie food-cues

Addictive behaviors are accompanied by a lack of inhibitory control, specifically when individuals are confronted with substance-related cues. Thus, we expected women with symptoms of food addiction to be impaired in inhibitory control, when confronted with palatable, high-calorie food-cues. Female college students (N=50) were divided in low and high food addiction groups based on the symptom count of the Yale Food Addiction Scale. Participants performed a Go/No-go-task with high-calorie food-cues or neutral pictures presented behind the targets. Self-reported impulsivity was also assessed. The high food addiction group had faster reaction times in response to food-cues as compared to neutral cues and reported higher attentional impulsivity than the low food addiction group. Commission and omission errors did not differ between groups or picture types. Hence, women with food addiction symptoms reported higher attentional impulsivity and reacted faster in response to food-cues, although neither increased self-reported motor impulsivity nor impaired behavioral inhibition was found. Food addiction symptoms seem to be related to attentional aspects of impulsivity but not other facets of impulsivity.

Impulsive reactions to food-cues predict subsequent food craving

Low inhibitory control has been associated with overeating and addictive behaviors. Inhibitory control can modulate cue-elicited craving in social or alcohol-dependent drinkers, and trait impulsivity may also play a role in food-cue reactivity. The current study investigated food-cue affected response inhibition and its relationship to food craving using a stop-signal task with pictures of food and neutral stimuli. Participants responded slower to food pictures as compared to neutral pictures. Reaction times in response to food pictures positively predicted scores on the Food Cravings Questionnaire - State (FCQ-S) after the task and particularly scores on its hunger subscale. Lower inhibitory performance in response to food pictures predicted higher FCQ-S scores and particularly those related to a desire for food and lack of control over consumption. Task performance was unrelated to current dieting or other measures of habitual eating behaviors. Results support models on interactive effects of top-down inhibitory control processes and bottom-up hedonic signals in the self-regulation of eating behavior, such that low inhibitory control specifically in response to appetitive stimuli is associated with increased craving, which may ultimately result in overeating.

Food-cue affected motor response inhibition and self-reported dieting success: a pictorial affective shifting task

Behavioral inhibition is one of the basic facets of executive functioning and is closely related to self-regulation. Impulsive reactions, that is, low inhibitory control, have been associated with higher body mass index (BMI), binge eating, and other problem behaviors (e.g., substance abuse, pathological gambling, etc.). Nevertheless, studies which investigated the direct influence of food-cues on behavioral inhibition have been fairly inconsistent. In the current studies, we investigated food-cue affected behavioral inhibition in young women. For this purpose, we used a go/no-go task with pictorial food and neutral stimuli in which stimulus-response mapping is reversed after every other block (affective shifting task). In study 1, hungry participants showed faster reaction times to and omitted fewer food than neutral targets. Low dieting success and higher BMI were associated with behavioral disinhibition in food relative to neutral blocks. In study 2, both hungry and satiated individuals were investigated. Satiation did not influence overall task performance, but modulated associations of task performance with dieting success and self-reported impulsivity. When satiated, increased food craving during the task was associated with low dieting success, possibly indicating a preload-disinhibition effect following food intake. Food-cues elicited automatic action and approach tendencies regardless of dieting success, self-reported impulsivity, or current hunger levels. Yet, associations between dieting success, impulsivity, and behavioral food-cue responses were modulated by hunger and satiation. Future research investigating clinical samples and including other salient non-food stimuli as control category is warranted.

Self-reported dieting success is associated with cardiac autonomic regulation in current dieters.

Restrained eating, eating disorders and obesity have been associated with cardiac autonomic dysregulation. The current study investigated cardiac autonomic regulation in current dieters. Female students (N=50) indicated if they were currently trying to control their weight and completed the Perceived Self-Regulatory Success in Dieting Scale (PSRS). Heart beat intervals were recorded during two 10 min relaxation periods from which parameters of vagal-cardiac control (high frequency power in normalized units, HF n.u.) and sympathovagal balance (ratio of low and high frequency power, LF/HF) were calculated. In current dieters, self-reported dieting success was positively associated with HF and negatively associated with LF/HF. These associations were independent of current body-mass and food deprivation (i.e. hours since the last meal). We conclude that vagal-cardiac control reflects self-regulatory strength, rather than nutritional status, in current dieters.

Short-term food deprivation increases amplitudes of heartbeat-evoked potentials.

Nutritional state (i.e., fasting or nonfasting) may affect the processing of interoceptive signals, but mechanisms underlying this effect remain unclear. We investigated 16 healthy women on two separate days: when satiated (standardized food intake) and after an 18-h food deprivation period. On both days, heartbeat-evoked potentials (HEPs) and cardiac and autonomic nervous system activation indices (heart rate, normalized low frequency heart rate variability [nLF HRV]) were assessed. The HEP is an EEG pattern that is considered an index of cortical representation of afferent cardiovascular signals. Average HEP activity (R wave +455-595 ms) was enhanced during food deprivation compared to normal food intake. Cardiac activation did not differ between nutritional conditions. Our results indicate that short-term food deprivation amplifies an electrophysiological correlate of the cortical representation of visceral-afferent signals originating from the cardiovascular system. This effect could not be attributed to increased cardiac activation, as estimated by heart rate and nLF HRV, after food deprivation.

The Water Load Test As a Measure of Gastric Interoception: Development of a Two-Stage Protocol and Application to a Healthy Female Population.

The sensitivity for one’s own internal body signals (i.e., interoception) has been demonstrated to play an important role in the pathogenesis of eating and weight disorders. Most previous measures assessing interoceptive processing have not, or only partly, captured perception of hunger and satiety cues, which is a core aspect of interoceptive deficits in eating disorders. In addition, methods used to measure sensitivity to gastric signals are heterogeneous and findings inconsistent. The primary aim of the present study was to establish a standardised test to measure gastric interoception, and to provide normative data using a non-clinical adult sample. The two-step Water Load Test (WLT-II) involves ingestion of non-caloric water until perceived satiation (step 1) and until maximum fullness (step 2). The WLT-II consists of several variables: Besides volumes of water ingested until satiation and maximum fullness expressed in ml, percentage of satiation to maximum fullness is calculated as an individual index of gastric interoception that is not confounded with stomach capacity. Ninety-nine healthy women participated in the study. Measures included the WLT-II, the heartbeat tracking test, a self-report questionnaire assessing subjective sensations, and the Eating Disorder Inventory-2. Twenty-eight participants underwent test-retest of the WLT-II. Results suggest that the WLT-II is a valid and reliable measure of gastric interoception. Importantly, satiation volume and percentage of satiation to maximum fullness were strongly positively related to self-reported bulimic symptoms, indicating that the WLT-II could emerge as a useful clinical tool to measure interoceptive processing in the field of eating disorders.

Gastric modulation of startle eye blink

Previous assessment methods of gastric interoception either rely on self-reports, or imply invasive procedures. We investigated the reliability of startle methodology as a non-invasive alternative for the assessment of afferent gastric signals. Twenty-four participants were tested on three separate days, on which they were requested to ingest water (either 0, 300 or 600ml), after 8h of fasting. On each assessment day, eye blink responses (EMG) to 10 acoustic startle stimuli (105dB) were assessed at 4 measurement points (before, 0, 7, 14min. after ingestion). Increased normogastric responses (EGG), ratings of satiety and fullness, and higher heart rate variability (RMSSD) suggested effective non-invasive induction of gastric distention. Startle responses were lower directly after ingestion of 600ml as compared to earlier and later measurements. These results suggest that startle methodology provides a reliable method to investigate afferent gastric signals. It could be useful to study possible dissociations between subjective reports and objective afferent gastric signals in eating or somatoform disorders.