JMIR Publications

ABSTRACT

Background:

Unhealthy behaviors, such as poor food choices, contribute to obesity and numerous negative health outcomes, including multiple types of cancer and cardiovascular and metabolic diseases. Despite known risks, roughly 75% of adults in America and England are not meeting fruit and vegetable intake recommendations. To promote healthy food choice and weight loss maintenance, diet interventions should build on the dual-system model to target both the regulation and reward mechanisms that guide eating behavior. Episodic future thinking (EFT) has been shown to strengthen regulation mechanisms by reducing unhealthy food choice and temporal discounting, a process of placing greater value on smaller immediate rewards over larger future rewards. However, these interventions do not target the reward mechanisms that could support healthy eating and strengthen the impact of EFT-anchored programs. Increasing positive affect (PosA) related to healthy food choices may target reward mechanisms by enhancing the rewarding effects of healthy eating. An intervention that increases self-regulation regarding unhealthy foods and the reward value of healthy foods is likely to have a greater impact on eating behavior compared to interventions focused on either process alone.

Objective:

Introduce a protocol that tests the independent and interactive effects of EFT and PosA on temporal discounting, food choice, and food demand in overweight and obese adults.

Methods:

This protocol describes a factorial, randomized, controlled pilot study protocol that employs a 2 (affective imagery: positive, neutral) x 2 (EFT: yes, no) design in which participants are randomized to one of four guided imagery intervention arms. One hundred and fifty-six eligible participants will complete two laboratory visits separated by one week. At visit 1 participants will complete surveys, listen to the audio guided imagery intervention, and complete temporal discounting, food demand, behavioral food choice tasks. At visit 2 participants will complete temporal discounting, food demand, behavioral food choice tasks and surveys. Participants will complete a daily food frequency questionnaire between visit 1 and 2. Analyses will compare primary outcome measures at baseline, post-intervention, and at follow-up across treatment arms. Secondary analyses will examine associations among changes in primary outcome measures and psychological (e.g., trait impulsivity, mindfulness) and behavioral health (e.g., physical activity, smoking and alcohol use) variables.

Conclusions:

Our research goal is to develop novel, theory-based interventions to promote and improve healthy decision-making and behaviors. The current study focuses on obesity and presents a protocol testing an intervention targeting regulation and reward mechanisms of eating behavior. Findings will advance decision-making research and have the potential to generate new neuroscience and psychological research to further understand these mechanisms and their interactions.