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The high prevalence of food insecurity in the United Kingdom has been exacerbated by the cost-of-living crisis. In high-income countries, those experiencing food insecurity struggle to buy and consume foods that meet Government healthy eating recommendations, and are at increased risk of obesity, linked to poor diet quality. Individuals in high-income countries purchase most of their food to consume at home from supermarkets, making this an important context within which healthier and environmentally sustainable food purchasing should be supported. However, the lived experience of supermarket food purchasing in people living with obesity and food insecurity has not been explored in depth. Adults, living in England and Scotland, who self-identified as living with obesity and food insecurity and looking to reduce their weight, were recruited to take part in semi-structured interviews (n = 25) or focus groups (n = 8) to explore their experience of shopping for food in the supermarket. Using thematic analysis, four main themes were generated: 1) the Restricted Consumer; restrictions around the type of food purchased, where food can be purchased and the resulting emotional toll, 2) the Conscious Consumer; decision making and effortful practices both in preparation of and during the shopping trip, 3) Mitigating the Rising Cost of Food; agency and actions taken to mitigate high food prices, 4) Stigma; instances of perceived and/or experienced weight and poverty-related stigma and the physical actions and cognitive social comparisons used to minimise stigma. Findings provide insights for evidence-based policy on the need for upstream changes within the wider food system to address the social determinants of health and support people living with obesity and food insecurity to eat healthier and more sustainable diets., Competing Interests: Declaration of competing interest CAH declares research funding from the American Beverage Association (paid to institution), primary supervision of a PhD studentship funded by Coca-Cola, and personal honoraria from International Sweeteners Association and International Food Information Council for work unrelated to the submitted paper. EH, FD, RAS, AJ, HG and MD report no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Food insecurity is linked with obesity and while the mechanisms behind this association are complex, lower levels of leisure-time physical activity in those with food insecurity may contribute to this. Individual-level factors (such as concerns of performing physical activity) may partly determine levels of physical activity within individuals with food insecurity, as such individuals may seek to minimise their levels of physical activity in order to preserve energy. Using the Food Insecurity Physical Activity Concerns Scale (FIPACS) (used to measure concerns of performing leisure-time physical activity, focusing on factors specific to food insecurity), the current study investigated whether the association between household food insecurity and body mass index (BMI) is explained by a mediation pathway of FIPACS scores and leisure-time physical activity. We also investigated whether the association between food insecurity and FIPACS scores is moderated by nutrition knowledge. Participants (N = 329, food insecure = 55) completed an online survey consisting of the FIPACS, the International Physical Activity Questionnaire long-form (IPAQ), the Diet, Disease, and Weight management sub-section of the General Nutrition Knowledge Questionnaire, a measure of diet quality, and self-reported BMI. Findings revealed that FIPACS scores and leisure-time physical activity did not mediate the association between food insecurity and BMI (b < 0.01, SE = 0.01). Additionally, nutrition knowledge did not moderate the association between food insecurity and FIPACS scores (b = -0.09, SE = 0.08). Findings suggest that concerns of performing physical activity in the context of food insecurity are unrelated to leisure-time physical activity, and that these two factors do not explain the association between food insecurity and BMI. Future research should investigate other factors in the link between food insecurity, physical activity, and BMI., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Food banks have become commonplace in the UK as an emergency response to food insecurity. However, food banks are not a long-term solution to food insecurity and are often not accessed by those in need. In the context of the cost-of-living crisis, and increased food insecurity, this systematic review applied market/government failure theory, voluntary failure theory, and Radimer et al.'s (1990) domains of food insecurity to explore three important aspects relevant to the food banking experience: the drivers of food bank use; the limitations of the current food bank model; and the impacts of the food banking model for food bank clients. Empirical, peer-reviewed articles written in English with a UK food bank context and reporting relevant data to these aspects were eligible for inclusion. In total, 221 titles were identified using four databases (Web of Science, SCOPUS, PubMed, CINHAL Plus) in July 2022. The final sample of 41 articles (comprising qualitative, quantitative and mixed methods studies), were quality assessed using the Mixed Methods Appraisal Tool. Data were extracted and analysed through directed content analysis. Market and government failures were widely reported to drive food bank use. Insufficiency, paternalism and particularism represented key limitations of the food bank model. Negative health and psychological impacts of food bank use were prominent, yet social impacts were largely positive. Consequently, new solutions are needed to promote positive health and psychological impacts for food bank clients in the UK. The application of these findings to other high-income countries experiencing food insecurity should be determined., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: NT is employed by Can Cook Well-Fed, a social business working against food poverty and insecurity. Can Cook Well-Fed act as an NWSSDTP ESRC CASE organisational partner in the lead researcher's PhD studentship., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Food insecurity - defined as having limited access to nutritious foods - is linked with obesity. Previous research has also shown that food insecurity is associated with lower levels of leisure-time physical activity (physical activity performed outside of essential activities). This association may occur in part due to concerns about preserving levels of energy during times of food shortage. Currently, no scale exists which measures this construct. Therefore, we aimed to develop and validate such a scale - the food insecurity physical activity concerns scale (FIPACS). Participants (N = 603, individuals with food insecurity = 108) completed an online survey, consisting of the FIPACS, the International Physical Activity Questionnaire short-form (IPAQ), the restraint subscale of the Dutch Eating Behaviour Questionnaire (DEBQ), the amotivation subscale of the Behaviour Regulation In Exercise Questionnaire-2 (BREQ-2), and the Behavioural Inhibition System/Behavioural Approach System Reactivity scale (BIS/BAS) to assess convergent and divergent validity. An exploratory factor analysis revealed a four-factor model of the FIPACS - namely 'Concerns relating to hunger', 'Concerns of replenishment and calories', 'Concerns of physiological effects of exercise' and 'Compensatory behaviours' which was verified through a confirmatory factor analysis. To assess test-retest reliability, 100 participants completed the FIPACS again two weeks later. The FIPACS had good internal, test-retest reliability and divergent validity. However, there was limited evidence of convergent validity. Future studies could incorporate this scale when investigating the association between food insecurity and physical activity., Competing Interests: Declaration of competing interest CAH and PC receive research funding from the American Beverage Association for work outside of the submitted manuscript. CAH has also received speaker fees from International Sweeteners Association and the International Food Information Council., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Lower income households are at greater risk of food insecurity and poor diet quality than higher income households. In high-income countries, food insecurity is associated with high levels of obesity, and in the UK specifically, the cost of living crisis (i.e., where the cost of everyday essentials has increased quicker than wages) is likely to have exacerbated existing dietary inequalities. There is currently a lack of understanding of the impact of the current UK cost of living crisis on food purchasing and food preparation practices of people living with obesity (PLWO) and food insecurity, however this knowledge is critical in order to develop effective prevention and treatment approaches to reducing dietary inequalities. Using an online survey (N = 583) of adults residing in England or Scotland with a body mass index (BMI) of ≥30 kg/m 2 , participants self-reported on food insecurity, diet quality, perceived impact of the cost of living crisis, and their responses to this in terms of food purchasing behaviours and food preparation practices. Regression analyses found that participants adversely impacted by the cost of living crisis reported experiencing food insecurity. Additionally, food insecurity was associated with use of specific purchasing behaviours (i.e., use of budgeting, use of supermarket offers) and food preparation practices (i.e., use of energy-saving appliances, use of resourcefulness). Exploratory analyses indicated that participants adversely impacted by the cost of living crisis and who used budgeting had low diet quality, whereas use of meal planning was associated with high diet quality. These findings highlight the fragility of food budgets and the coping strategies used by PLWO and food insecurity during the cost of living crisis. Policy measures and interventions are urgently needed that address the underlying economic factors contributing to food insecurity, to improve access to and affordability of healthier foods for all., Competing Interests: Declaration of competing interest AB reports honoraria from Novo Nordisk, Office of Health Improvement and Disparity, Johnson and Johnson and Obesity UK outside the submitted work and is on the Medical Advisory Board and shareholder of Reset Health Clinics Ltd. CAH reports research funding from the American Beverage Association, and honoraria from International Sweeteners Association and International Food Information Council for work outside of the submitted manuscript. RAS, AMJ, MAG, EH, FD and ML report no declarations of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Project SWEET examined the barriers and facilitators to the use of non-nutritive sweeteners and sweetness enhancers (hereafter "S&SE") alongside potential risks/benefits for health and sustainability. The Beverages trial was a double-blind multi-centre, randomised crossover trial within SWEET evaluating the acute impact of three S&SE blends (plant-based and alternatives) vs. a sucrose control on glycaemic response, food intake, appetite sensations and safety after a carbohydrate-rich breakfast meal. The blends were: mogroside V and stevia RebM; stevia RebA and thaumatin; and sucralose and acesulfame-potassium (ace-K). At each 4 h visit, 60 healthy volunteers (53% male; all with overweight/obesity) consumed a 330 mL beverage with either an S&SE blend (0 kJ) or 8% sucrose (26 g, 442 kJ), shortly followed by a standardised breakfast (∼2600 or 1800 kJ with 77 or 51 g carbohydrates, depending on sex). All blends reduced the 2-h incremental area-under-the-curve (iAUC) for blood insulin (p < 0.001 in mixed-effects models), while the stevia RebA and sucralose blends reduced the glucose iAUC (p < 0.05) compared with sucrose. Post-prandial levels of triglycerides plus hepatic transaminases did not differ across conditions (p > 0.05 for all). Compared with sucrose, there was a 3% increase in LDL-cholesterol after stevia RebA-thaumatin (p < 0.001 in adjusted models); and a 2% decrease in HDL-cholesterol after sucralose-ace-K (p < 0.01). There was an impact of blend on fullness and desire to eat ratings (both p < 0.05) and sucralose-acesulfame K induced higher prospective intake vs sucrose (p < 0.001 in adjusted models), but changes were of a small magnitude and did not translate into energy intake differences over the next 24 h. Gastro-intestinal symptoms for all beverages were mostly mild. In general, responses to a carbohydrate-rich meal following consumption of S&SE blends with stevia or sucralose were similar to sucrose., Competing Interests: Declaration of competing interest JCGH, JAH, and CAH and are in receipt of research funding from the American Beverage Association; MMR and CEH's research centre provides consultancy to, and has received travel funds to present research results from organisations supported by food and beverage companies. ARA has received honoraria from Nestlé, Unilever and the International Sweeteners Association. CAH has received honoraria from the International Sweeteners Association. CS is an employee of Cargill, Inc. The other authors have nothing to declare., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Cognitive Bias Modification (CBM) paradigms have previously been applied to target appetite (craving, hunger) and food intake, and are hypothesised to reduce unhealthy food consumption. However, inconsistencies in relation to training outcomes raise questions regarding the efficacy of CBM as a standalone intervention. Furthermore, individual level factors (such as belief in the intervention efficacy) may influence expectations of behaviour change following training. Across two pre-registered studies, our aim was to investigate how directly manipulating beliefs in relation to training purpose and effectiveness influenced food value and choice across two popular CBM paradigms (Inhibitory Control Training (ICT: Study 1) and Evaluative Conditioning (EC: Study 2)). In online studies, participants were presented with a paragraph describing the CBM technique positively (or an unrelated control message) prior to completing either active or control CBM training. Across both studies, the results revealed that active CBM training resulted in a reduction to unhealthy food value (relative to pre-training), but only when paired with a positive manipulation message. Participants who received a control message displayed no significant changes to food value, even where active CBM training was provided. These results suggest that participant beliefs and expectancies have important consequences for CBM effectiveness. Future research should further investigate these factors within CBM contexts to identify their role within successful behaviour change interventions., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Food insecurity (a lack of stable access to nutritious food) is reliably associated with higher BMI, although the underlying mechanisms are unclear. Past research indicates that this relationship may, in part, be explained by the distress of being food insecure and using food as a coping mechanism. While previous work has focused on long-term food insecurity, the first COVID-19 national lockdown presented a unique opportunity to establish if the same relationships existed for individuals experiencing pandemic related food insecurity. Adults in the United Kingdom (N = 211) were recruited three months after the first UK lockdown via social media. They completed questionnaires on COVID-19 related food insecurity, physical stress, psychological distress, eating to cope, drinking to cope, diet quality, and changes in weight promoting eating behaviours (e.g. consuming larger portions, increased snacking) since the start of the lockdown. A structural equation model revealed that food insecurity was indirectly associated with changes in weight promoting eating behaviours. As predicted, the more instances of pandemic related food insecurity, the more distress individuals reported. Distress was then associated with eating as a way of coping, which in turn was associated with increases in weight promoting eating behaviours. Food insecurity was also indirectly associated with diet quality, but this was via distress only. These results reflect similar pathways observed in individuals reporting chronic food insecurity and strengthens the evidence that distress and eating to cope are generic mediators of food insecurity and eating behaviour., Competing Interests: Declarations of competing interest All authors declare no competing interests. However, CAH and PC have previously received research funding from the American Beverage Association for work outside of the submitted manuscript. CAH has also received speaker fees from International Sweeteners Association., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Altering the quality of episodic meal memories has been shown to affect subsequent food intake. Acute alcohol consumption disrupts memory formation and produces short-term overeating. In two studies, we investigated whether alcohol consumption can affect meal-related memories and later food intake. Study 1 (N = 60, 50% male) investigated how consumption of an alcoholic drink (0.5 g/kg) prior to consumption of a lunch meal affected meal memory of that lunch, and later food intake, compared with a placebo-alcohol. Findings revealed that alcohol consumption did not impair meal memory, and did not affect subsequent food intake. Study 2 (N = 72, 50% male) investigated whether, due to alcohol's retrograde facilitation effect (the enhancement of recall due to reduced interference at the point of exposure) consuming alcohol after consumption of a lunch meal could enhance meal memory, compared with when consumed before a lunch meal (both a dosage of 0.6 g/kg), and compared with consumption of a soft drink. Contrary to prediction, alcohol consumed after a lunch meal did not significantly increase meal memory. But, certain types of meal memory were impaired when alcohol was consumed before the meal, compared with consumption of a soft drink. Subsequent food intake did not differ between conditions. Taken together, findings suggest that alcohol intoxication can impair some forms of meal memory recall, likely due to disruption of memory formation during the encoding phase. However, there was no evidence that this impairment contributes towards alcohol-induced overeating., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Urban agriculture (UA), the growing of fruits and vegetables in urban and peri-urban areas, may improve food security and access, public health and dietary quality on both a broad and personal scale. However, there is little research on the relationship between UA and diet, and potential mediating factors are also unclear. This study aimed to investigate if proximity to and engagement with UA is associated with better diet quality, and what accounts for this relationship. UK-based adults (N = 583, 69% Female) completed measures of proximity to and engagement with UA, perceived access to fruits and vegetables, health and ethical food choice motivations, connection with nature, psychological distress and dietary quality in an online survey. Participants were recruited from UA-related groups and the general public. Proposed relationships were analysed using a structural equation model. Greater proximity to and engagement with UA was associated with greater perceived access to fruits and vegetables, more health-related food choice motivations, more ethical-related food choice, feeling more connected with nature, and, surprisingly greater psychological distress. Furthermore, proximity to and engagement with UA was indirectly associated with better diet quality via health-, and ethical-related, food choice motivations. While the direct pathway between proximity to and engagement with UA and diet quality was not significant, UA is associated with better diet quality, partly via healthier and ethical food choice motivations. Upscaling UA may have benefits for dietary quality via these factors, and more research is needed to test causal relationships and understand these complex interactions., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Acute alcohol consumption has been shown to increase food intake, and long-term alcohol consumption may be a risk for weight gain. A potential, but under-studied, mechanism for this effect is alcohol's ability to enhance food reward. In two studies, participants consumed an alcoholic drink (Study 1: 0.3 grams of alcohol per kilogram of bodyweight (g/kg); Study 2: 0.6 g/kg) and a placebo-alcohol drink in a within-subjects design. In both studies, food-related appetitive and motivational states, and attentional bias (AB) towards food-related cues were measured. In Study 1 (N = 44), participants completed a visual probe task with concurrent recording of eye-movements which measured AB towards images of palatable foods, unpalatable foods, and non-food control items. Participants also completed measures of appetite and snack urge ratings, salivary response towards palatable foods and an ad libitum food taste test. In Study 2 (N = 84), participants completed a similar procedure, but completed a modified Stroop task which measured differences in food-related and alcohol-related AB across the two drink conditions. In Study 1, there was no difference in food-related AB between drink conditions, and no differences in snack urge, appetite ratings, salivary response, or food intake. In contrast, Study 2 showed an alcohol-induced increase in AB towards food, but not alcohol. Snack urge, alcohol urge ratings and ad libitum food intake were also higher after alcohol consumption, relative to the placebo. Collectively, these findings suggest that alcohol can increase food reward and food intake, but these effects may only occur at a higher dose., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

External influences on eating behaviour, such as portion size, have been reliably shown to influence food intake in the laboratory. However, little research has examined whether laboratory settings under or overestimate the effect that external influences have on food intake compared to when studied in the real-world. In Study 1, 60 participants (mean age = 32 years) were randomized to consume a large (200 g) or small (100 g) portion of popcorn under controlled laboratory conditions and during a separate session in their home. Results showed that the effect of portion size on food intake was larger at home (d = 0.97) than in the laboratory (d = 0.56). Furthermore, participants reported feeling more relaxed eating at home compared to the laboratory. In Study 2, we examined whether comparable results were observed in a semi-naturalistic laboratory designed to resemble a home setting. 59 participants (mean age = 28 years) completed the same procedure as Study 1 in a standard and a semi-naturalistic laboratory setting. Although participants reported having higher levels of private self-awareness in the standard laboratory, the effect that portion size had on food intake did not differ between the standard laboratory (d = 0.50) and the semi-naturalistic laboratory (d = 0.49). The impact that external influences on eating, such as portion size, have on food intake in the real-world may be underestimated when studied under laboratory conditions., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

There is considerable interest in Cognitive Bias Modification (CBM) as a potential treatment for overweight/obesity. Inhibitory Control Training (ICT: also known as motor response training) and Evaluative Conditioning (EC) are two popular paradigms which rely on associatively learned responses (unhealthy food - > inhibition, or unhealthy food- > negative stimulus, respectively) through repeated cue-response contingencies. Both ICT and EC have demonstrated some effectiveness for reducing food intake, value and/or choice, when administered in the laboratory and online. However, studies have been criticised for inconsistencies in design (e.g. use of inadequate control groups) which makes it difficult to draw robust conclusions. In two pre-registered, online studies our aim was to examine active ICT (study 1: N = 170) and EC (study 2: N = 300) in multiple groups where the cue- > response contingencies were systematically varied (100%, 75%, 50%, 25%), before examining food-cue valuations and hypothetical food choice. In both studies varying the cue- > response contingencies did not lead to significant changes in food-cue devaluation following training. ICT did not substantially influence hypothetical food choice, whereas there was weak evidence that EC reduced choice for unhealthy foods, compared to a control group with 50% cue-response contingencies. Taken together both studies provide limited evidence for online CBM as a viable psychological treatment - at least through the mechanism of food-cue devaluation or changes in healthy and unhealthy food choice. Future research is needed to investigate the factors that contribute towards successful CBM training to critically evaluate the potential for these strategies within interventions., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Theoretical models suggest that food-related visual attentional bias (AB) may be related to appetitive motivational states and individual differences in body weight; however, findings in this area are equivocal. We conducted a systematic review and series of meta-analyses to determine if there is a positive association between food-related AB and: (1.) body mass index (BMI) (number of effect sizes (k) = 110), (2.) hunger (k = 98), (3.) subjective craving for food (k = 35), and (4.) food intake (k = 44). Food-related AB was robustly associated with craving (r = 0.134 (95% CI 0.061, 0.208); p < .001), food intake (r = 0.085 (95% CI 0.038, 0.132); p < .001), and hunger (r = 0.048 (95% CI 0.016, 0.079); p = .003), but these correlations were small. Food-related AB was unrelated to BMI (r = 0.008 (95% CI -0.020, 0.035); p = .583) and this result was not moderated by type of food stimuli, method of AB assessment, or the subcomponent of AB that was examined. Furthermore, in a between-groups analysis (k = 22) which directly compared participants with overweight/obesity to healthy-weight control groups, there was no evidence for an effect of weight status on food-related AB (Hedge's g = 0.104, (95% CI -0.050, 0.258); p = .186). Taken together, these findings suggest that food-related AB is sensitive to changes in the motivational value of food, but is unrelated to individual differences in body weight. Our findings question the traditional view of AB as a trait-like index of preoccupation with food and have implications for novel theoretical perspectives on the role of food AB in appetite control and obesity., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Eating, physical activity and other weight-related lifestyle behaviors may have been impacted by the COVID-19 crisis and people with obesity may be disproportionately affected. We examined weight-related behaviors and weight management barriers among UK adults during the COVID-19 social lockdown. During April-May of the 2020 COVID-19 social lockdown, UK adults (N = 2002) completed an online survey including measures relating to physical activity, diet quality, overeating and how mental/physical health had been affected by lockdown. Participants also reported on perceived changes in weight-related behaviors and whether they had experienced barriers to weight management, compared to before the lockdown. A large number of participants reported negative changes in eating and physical activity behavior (e.g. 56% reported snacking more frequently) and experiencing barriers to weight management (e.g. problems with motivation and control around food) compared to before lockdown. These trends were particularly pronounced among participants with higher BMI. During lockdown, higher BMI was associated with lower levels of physical activity and diet quality, and a greater reported frequency of overeating. Reporting a decline in mental health because of the COVID-19 crisis was not associated with higher BMI, but was predictive of greater overeating and lower physical activity in lockdown. The COVID-19 crisis may have had a disproportionately large and negative influence on weight-related behaviors among adults with higher BMI., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Consumer food waste is now a significant social issue. However, given that the modern day food environment has become characterised by larger portion sizes of more energy-dense foods, personal concerns about wasting food may result in eating behaviours that promote excess energy intake and weight gain. Across 3 studies, we developed a brief (5-item) measure to quantify concerns about food waste and examined the relationships between food waste concerns, eating behaviour and body weight. In Study 1, we showed that our 5-item measure of food waste concerns has acceptable convergent and divergent validity, and test-retest reliability. We also found that concerns about wasting food were predictive of greater behavioural intentions to avoid food waste (e.g. eating leftovers). In Study 2, greater food waste concerns were associated with an increased tendency to plate-clear when eating (self-reported), but not with objectively measured body weight or likelihood of having overweight or obesity. In Study 3, we examined how much food participants consumed when served a large portion size of a lunchtime meal and found that food waste concerns did not directly or indirectly predict how much participants ate. Overall, we found evidence that concerns about food waste are related to self-reported intentions to minimize food waste and plate-clearing tendencies, but no evidence that food waste concerns are related to objectively measured energy intake in the laboratory or body weight., Competing Interests: Declaration of competing interest The author(s) declare that they have no competing interests., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Food insecurity affects approximately 8.4 million people in the UK, one of the worst levels in Europe. Food insecurity is associated with poor diet quality and obesity; however, the drivers of this relationship are unclear. This study used a qualitative approach to explore factors that influence food choice and eating behaviour in a food-insecure population in Liverpool, UK. Face-to-face interviews were conducted with adults (N = 24) who were clients at foodbanks. The interviews were informed by a semi-structured interview schedule, which focussed on access to food, factors influencing food choices, and strategies used to conserve food. Interview transcripts were analysed using inductive thematic analysis. Six themes were developed; 'Income', 'Cost of food', 'Accessibility of shops', 'Health issues', 'Food rationing strategies' and 'Worsened health outcomes'. Income was the most salient factor influencing participants' food choices with all participants reporting a constant struggle to afford food. Food decisions were primarily based on cost; most participants valued eating healthily but could not afford to do so. Strategies to ration food included skipping meals, consuming small portions, cooking in bulk, and prioritising children's food intake. The majority of participants reported pre-existing physical and/or mental health issues, but these were exacerbated by poor access to food leading to a vicious cycle of stress and worsening health issues. In conclusion, participants' food choices and eating behaviour seemed to be most strongly influenced by their level of income. Our findings provide insight into the range of strategies used by participants to conserve food and also highlight the mental health impact of food insecurity. Initiatives addressing income and the cost of healthy food are required., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Previous research indicates that attachment anxiety (fear of abandonment) is predictive of overeating and higher body mass index (BMI). The current study explored the nature of the mechanisms underpinning this relationship. Study 1 assessed the relative contribution of 'emotional eating', 'susceptibility to hunger' and 'uncontrolled eating'. Study 2 assessed whether misperception of emotion and poor emotion management would mediate the relationship between attachment anxiety and stress-induced eating (and then BMI). Two cross-sectional online questionnaire studies were conducted (Study 1 N = 665, & Study 2 N = 548), in UK and US-based samples, which assessed attachment orientation and BMI alongside the potential mediators. The relative contribution of emotional eating, susceptibility to hunger and uncontrolled eating (Study 1) and difficulties in emotion regulation and stress-induced eating (Study 2) as mediators of this relationship were examined. In Study 1, parallel multiple mediation analysis (PROCESS) showed that emotional eating and susceptibility to hunger (but not uncontrolled eating) were significant mediators of the relationship between attachment anxiety and BMI. In Study 2, serial mediation analysis showed that difficulties in 'engaging with goal directed behaviours when upset' and stress-induced eating operated in series to significantly mediate the relationship between attachment anxiety and BMI. These findings suggest that attachment anxious individuals feel less capable in disengaging from negative emotions and go on to try to soothe themselves through eating which has a negative impact on their BMI. There was less support for an explanation of the relationship between attachment anxiety and BMI based around the misperception of emotion. Taken together, the findings highlight attachment anxiety and emotion regulation strategies as key targets for interventions that aim to reduce overeating and excess body weight., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Larger portion sizes of food promote increased food intake, although the mechanisms explaining the portion size effect are unclear. In the present study we examined whether the tendency to clear one's plate when eating is associated with greater food intake in response to larger portion size., Method: We recruited female participants who were either self-reported habitual plate clearers (N = 48) or non-plate clearers (N = 41) into a laboratory study. In a between-subjects design, participants were served either a 'normal' (500 g) or 'large' (1000 g) portion of pasta for lunch and ate as much as they desired., Results: There was no significant interaction found between portion size and plate-clearing tendencies; portion size had a similar sized effect on food intake in both plate clearers and non-plate clearers. A significant main effect of portion size was found, whereby participants consumed significantly more when served the large versus the normal portion (100.55 g difference, p < .001, η p  = 0.16). There was also a significant main effect of plate clearing; participants with a tendency to clear their plate when eating consumed significantly more than non-plate clearers (68.21 g difference, p = .006, η 2  = 0.16). There was also a significant main effect of plate clearing; participants with a tendency to clear their plate when eating consumed significantly more than non-plate clearers (68.21 g difference, p = .006, η p 2  = 0.08)., Conclusions: The tendency to clear one's plate when eating was associated with increased food intake during a lunchtime meal. Increasing the portion size of the lunchtime meal increased food intake, although the tendency for a larger portion size to increase food intake was observed irrespective of participant plate-clearing tendencies., (Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.)

The aim of this review is to critically evaluate the effectiveness and candidate mechanisms of action of psychological interventions which aim to either (a) improve the capacity for self-regulatory, reflective processes or (b) reduce the impact of automatic appetitive processes, in an attempt to influence food intake and associated weight-gain. Our aim was to examine three important issues regarding each type of intervention: i) whether the intervention influenced behaviour in the laboratory, ii) whether the intervention influenced behaviour and/or body mass index in the real world, and iii) whether the proposed mechanism of action was supported by evidence. We systematically searched three commonly used databases and identified 32 articles which were relevant to at least one of these issues. The majority of studies attempted to manipulate food intake in the laboratory using associative learning paradigms, in normal-weight female participants. Most of the laboratory studies demonstrated the predicted effects of interventions on behaviour in the laboratory, but studies that attempted to translate these interventions outside of the laboratory yielded more mixed findings. The hypothesised mechanisms of action received inconsistent support across studies. We identified several limitations which may complicate interpretation of findings in this area, including heterogeneity of study methods, small sample sizes, and absence of adequate control groups. We provide recommendations for future studies that aim to develop and evaluate these promising interventions for the reduction of overweight and obesity., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Despite being widely debated throughout the scientific community, the concept of food addiction remains a popular explanation for overeating and obesity amongst the lay public. Overeating is often accompanied by feelings of guilt and dietary concern, and this may lead people to attribute their eating to an addiction in order to minimise personal responsibility. Research also indicates that food addiction attributions and dietary concern may lead people to limit their exposure to tempting foods. To test these ideas, we examined the effect of perceived overeating on food addiction attributions and snack choice. Subjective ratings of guilt and dietary concern were indirectly manipulated by leading female participants (N=90) to believe they had eaten more than (overeating condition), less than (undereating condition), or roughly the same (control condition) amount of palatable foods in relation to their own estimated consumption and to previous participants. Participants then rated the relative importance of a list of explanations for their eating (including "the foods were really addictive") and selected a snack to take home with them. Ratings of guilt and dietary concern were highest in the overeating condition, and lowest in the undereating condition, indicating that the manipulation had been successful. However, findings revealed no effect of condition on food addiction attributions. As predicted, participants in the overeating condition selected less tempting snacks than in the undereating condition. However, this effect was not mediated by guilt/dietary concern. There was also no association between food-addiction attributions and snack choice. These findings suggest that perceived overeating affects snack choice but not food addiction attributions. Future research should investigate whether food addiction attributions may be driven by feelings of guilt and dietary concern following longer-term disinhibited eating patterns., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Presentation of the same amount of a food in multiple smaller units ('segmentation') has been shown to reduce food intake and increase estimates of the amount of food consumed. However, this effect has been demonstrated for ad libitum food intake only. In the majority of cases, meals are not consumed ad libitum, but are pre-selected and consumed in their entirety, Expected satiety (ES; the anticipated capacity of a portion of food to relieve hunger between meals) is an excellent predictor of portion size selection. This study tested the hypothesis that segmentation increases ES. It was also hypothesised that perceived volume (PV) may account for the relationship between segmentation and ES. Sixty-eight participants made computer-based ES and PV judgments for equicaloric portions of three test foods (salted peanuts, spaghetti Bolognese, and chicken tikka masala), which were presented in either a single unit or as multiple smaller units (three or six units). Results revealed a consistent effect of segmentation on ES - foods presented in multiple smaller units were expected to deliver significantly greater satiety than when presented in a single unit (p < 0.005). Furthermore, results indicated that the effect of segmentation on ES was attributable to an increase in PV. ES plays an important role in determining the portion sizes that people select. Therefore, awareness of the effect of segmentation on ES may help to inform the design of foods that confer benefits for healthy weight maintenance., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Because overconsumption of food contributes to ill health, understanding what affects how much people eat is of importance. The 'bogus' taste test is a measure widely used in eating behaviour research to identify factors that may have a causal effect on food intake. However, there has been no examination of the validity of the bogus taste test as a measure of food intake. We conducted a participant level analysis of 31 published laboratory studies that used the taste test to measure food intake. We assessed whether the taste test was sensitive to experimental manipulations hypothesized to increase or decrease food intake. We examined construct validity by testing whether participant sex, hunger and liking of taste test food were associated with the amount of food consumed in the taste test. In addition, we also examined whether BMI (body mass index), trait measures of dietary restraint and over-eating in response to palatable food cues were associated with food consumption. Results indicated that the taste test was sensitive to experimental manipulations hypothesized to increase or decrease food intake. Factors that were reliably associated with increased consumption during the taste test were being male, have a higher baseline hunger, liking of the taste test food and a greater tendency to overeat in response to palatable food cues, whereas trait dietary restraint and BMI were not. These results indicate that the bogus taste test is likely to be a valid measure of food intake and can be used to identify factors that have a causal effect on food intake., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Previous research indicates that many people perceive themselves to be addicted to food. These 'self-perceived food addicts' may demonstrate aberrant eating patterns which put them at greater risk of overeating. However this is yet to be empirically investigated. The current study investigated whether self-perceived food addicts would exhibit higher food reward and calorie intake in a laboratory context relative to self-perceived non-addicts. A secondary aim was to investigate whether self-perceived food addicts would demonstrate increased food liking and/or increased hunger ratings. Finally, we explored whether self-perceived food addicts demonstrate patterns of aberrant eating, beyond that predicted by measures of trait dietary disinhibition and restraint. Female participants (self-perceived food addicts n = 31, non-addicts n = 29) completed measures of hunger, food reward (desire-to-eat, willingness-to-pay ratings, and an operant response task) and liking for high- and low-fat foods. Participants completed all measures when they were hungry, and again when they were satiated after consuming a fixed-lunch meal. Finally, participants were provided with ad-libitum access to high-and low-fat foods. Results indicated that self-perceived food addicts consumed more calories from high-fat food compared to non-addicts, despite the absence of any between-group differences in hunger or overall liking ratings. Self-perceived food addicts also displayed higher desire-to-eat ratings across foods compared to non-addicts, but groups did not differ on other measures of food reward. However, the differences in calorie intake and desire-to-eat between self-perceived food addicts and non-addicts were no longer significant after controlling for dietary disinhibition and restraint. These findings suggest that self-perceived food addicts experience food as more rewarding and have a tendency to overeat. However, this may be attributable to increased dietary disinhibition and decreased restraint rather than reflecting a unique pattern of aberrant eating behaviour., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Attachment anxiety (fear of abandonment) is associated with disinhibited eating in adults. Both maternal disinhibited eating and use of emotional feedings strategies are associated with emotional eating in children. On this basis, the current study sought to determine whether attachment anxiety is an underlying maternal characteristic that predicts parental reports of child emotional over-eating via its effects on maternal disinhibited eating and emotional feeding. Mothers of a preadolescent child (N = 116) completed an internet-delivered questionnaire. Maternal attachment anxiety and dietary disinhibition were assessed by the Experiences in Close Relationships questionnaire and the Three Factor Eating Questionnaire, respectively. The Parental Feeding Strategies Questionnaire and the Child Eating Behaviour Questionnaire were used to quantify emotional feeding and child emotional over-eating, respectively. Bias-corrected bootstrapping indicated a significant direct effect of maternal attachment anxiety on child emotional over-eating (i.e., controlling for maternal disinhibited eating and emotional feeding). There was also a significant indirect effect of maternal attachment anxiety on child emotional over-eating via emotional feeding strategies. In a subsequent model to investigate bi-directional relationships, the direct effect of maternal attachment anxiety on emotional feeding strategies was not statistically significant after controlling for child emotional over-eating. There was, however, a significant indirect effect of maternal attachment anxiety on emotional feeding strategies via child emotional over-eating. These findings highlight the influence of maternal attachment anxiety on parental reports of aberrant eating behaviour in children. While this may be partly due to use of emotional feeding strategies, there is stronger evidence for a "child-responsive" model whereby anxiously-attached mothers use these feeding practices in response to perceived emotional over-eating in the child., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Portion sizes of many foods have increased in recent times. In three studies we examined the effect that repeated visual exposure to larger versus smaller food portion sizes has on perceptions of what constitutes a normal-sized food portion and measures of portion size selection. In studies 1 and 2 participants were visually exposed to images of large or small portions of spaghetti bolognese, before making evaluations about an image of an intermediate sized portion of the same food. In study 3 participants were exposed to images of large or small portions of a snack food before selecting a portion size of snack food to consume. Across the three studies, visual exposure to larger as opposed to smaller portion sizes resulted in participants considering a normal portion of food to be larger than a reference intermediate sized portion. In studies 1 and 2 visual exposure to larger portion sizes also increased the size of self-reported ideal meal size. In study 3 visual exposure to larger portion sizes of a snack food did not affect how much of that food participants subsequently served themselves and ate. Visual exposure to larger portion sizes may adjust visual perceptions of what constitutes a 'normal' sized portion. However, we did not find evidence that visual exposure to larger portions altered snack food intake., (Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Previous studies indicate that many people perceive themselves to be addicted to food. However, little is known about how the concept of 'food addiction' is defined amongst members of the lay public. The current study examined beliefs about the cognitive and behavioural manifestations of food addiction. Participants (N = 210) completed an internet-delivered questionnaire in which they indicated whether or not they perceived themselves to be a food addict and provided a brief explanation for their response. Over a quarter of participants (28%) perceived themselves to be food addicts and self-diagnosis was predicted by increased BMI and younger age, but not by gender. Thematic analysis was conducted to explore the causal attributions provided by self-perceived food addicts and non-addicts. Six characteristics were identified: 1) Reward-driven eating (i.e. eating for psychological rather than physiological reasons), 2) A functional or psychological preoccupation with food, 3) A perceived lack of self-control around food, 4) Frequent food cravings, 5) Increased weight or an unhealthy diet, and 6) A problem with a specific type of food. The emergent themes, and their frequency, did not differ between self-perceived food addicts and non-addicts. However, self-perceived food addicts and non-addicts reported divergent cognitions, behaviours and attitudes within each common theme. This study is the first to provide qualitative insight into beliefs about food addiction in both self-perceived food addicts and non-addicts. The findings appear to reflect a view of food addiction that is identifiable through several core behaviours., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Food addiction is widely discussed in popular media in many Westernised societies. However, a potential concern is that endorsement of the food addiction model may cause people to perceive a lack of personal control over eating which could promote unhealthy dietary behaviours. To address this possibility, the current study investigated whether exposure to food addiction messages would, firstly, increase the number of participants who self-diagnosed as food addicts and, secondly, increase intake of indulgent foods. In a between-subjects design, participants (N = 60) read an article which either claimed that food addiction is real ("Real" condition) or that food addiction is a myth ("Myth" condition). Intake of indulgent and non-indulgent foods was then assessed in a disguised taste test and participants also completed a measure of self-diagnosed food addiction. A significantly higher proportion of participants in the Real condition self-diagnosed as food addicts relative to participants in the Myth condition (57% and 27% of participants, respectively; p = .018). Variability in intake, but not mean intake, of indulgent food was higher in the Real condition than in the Myth condition. These findings suggest that endorsement of the concept of food addiction may encourage people to self-diagnose as food addicts and thus explain their eating behaviour in terms of addiction (an external attribution). The extent to which self-diagnosis of food addiction influences actual food intake and how this might vary with individual differences and eating context remains to be determined., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Larger portions increase energy intake (the 'portion size effect'); however, the mechanisms behind this effect are unclear. Although pre-meal intentions are thought to be an important determinant of energy intake, little research has examined how much of a meal individuals intend to eat when served standard versus larger portion sizes. Three studies examined the effect of manipulating portion size on intended food consumption. In Studies 1 (spaghetti bolognese) and 2 (curry and rice) male participants were shown an image of either a standard or a larger meal and indicated how much of the meal they intended to consume. In Study 3 male and female participants were served either a standard or a larger portion of ice cream for dessert, they indicated how much they intended to consume and then ate as much of the ice cream as they desired. Regardless of being shown standard or large portion sizes, in Studies 1 and 2 participants reported that they intended to eat the majority of the meal, equating to a large difference in intended energy consumption between portion size conditions (a 'pre-consumption portion size effect'). This finding was replicated in male participants in Study 3, although females intended to eat a smaller proportion of the larger portion of ice cream, compared to the standard portion. Both male and female participants tended to eat in accordance with their pre-meal intentions and a portion size effect on actual consumption was subsequently observed in males, but not in females. The portion size effect may be observed when measuring pre-meal intended consumption in males., (Copyright © 2015. Published by Elsevier Ltd.)

We investigated the contribution of hunger and food liking to food reward, and the relationship between food reward and food intake. We defined liking as the pleasantness of taste of food in the mouth, and food reward as the momentary value of a food to the individual at the time of ingestion. Liking and food reward were measured, respectively, by ratings of the pleasantness of the taste of a mouthful, and ratings of desire to eat a portion, of the food in question. Hunger, which we view as primarily the absence of fullness, was rated without food being present. Study 1 provided evidence that hunger and liking contribute independently to food reward, with little effect of hunger on liking. Food intake reduced liking and reward value more for the eaten food than uneaten foods. The results were ambiguous as to whether this food-specific decline in reward value ('sensory-specific satiety') involved a decrease in 'wanting' in addition to the decrease in liking. Studies 2 and 3 compared desire to eat ratings with work-for-food and pay-for-food measures of food reward, and found desire to eat to be equal or superior in respect of effects of hunger and liking, and superior in predicting ad libitum food intake. A further general observation was that in making ratings of food liking participants may confuse the pleasantness of the taste of food with the pleasantness of eating it. The latter, which some call 'palatability,' decreases more with eating because it is significantly affected by hunger/fullness. Together, our results demonstrate the validity of ratings of desire to eat a portion of a tasted food as a measure of food reward and as a predictor of food intake., (Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Cue reactivity may be determined by the ability of cues to evoke expectations that a reward will be imminently received. To test this possibility, the current study examined the effects of manipulating expectations about the receipt of food (pizza) on self-reported and physiological responses to pizza cues, and attentional bias to pizza pictures. It was predicted that expecting to eat pizza would increase salivation, self-reported measures of motivation and attentional bias to pizza cues relative to conditions where there was no eating expectancy. In a within-subjects counterbalanced design, 42 hungry participants completed two pizza-cue exposures in a single experimental session during which their expectation of consuming the pizza was manipulated (i.e., expectancy of eating imminently vs. no eating expectancy). They also completed a computerised attentional bias task during which the probability of receiving pizza (0%, 50% or 100%) was manipulated on a trial-by-trial basis. Participants showed reliable increases in hunger and salivation in response to the pizza cues, as well as a bias in attentional maintenance on pizza pictures. However, these responses were not influenced by eating expectancy. Contrastingly, expectancy did influence early attentional processing (initial orientation of attention) in that participants directed their first gaze towards pizza pictures more often on 100% and 50% probability trials relative to 0% trials. Overall, our findings indicate that exposure to food cues triggers appetitive responses regardless of explicit expectancy information. Methodological features of the study that may account for these findings are discussed., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Obese and overweight individuals show a marked attentional bias to food cues. Food-related attentional bias may therefore play a causal role in over-eating. To test this possibility, the current study experimentally manipulated attentional bias towards food using a modified version of the visual probe task in which cake-stationery item image pairs were presented for 500 ms each. Participants (N=60) were either trained to attend to images of cake, trained to avoid images of cake, or assigned to a no-training control group. Hunger was measured before and after the training. Post-training, participants were given the opportunity to consume cake as well as a non-target food (crisps) that was not included in the training. There was weak evidence of an increase in attentional bias towards cake in the attend group only. We found no selective effects of the training on hunger or food intake, and little evidence for any gender differences. Our study suggests that attentional bias for food is particularly ingrained and difficult to modify. It also represents a first step towards elucidating the potential functional significance of food-related attentional biases and the lack of behavioural effects is broadly consistent with single-session attentional training studies from the addiction literature. An alternative hypothesis, that attentional bias represents a noncausal proxy for the motivational impact of appetitive stimuli, is considered., (Copyright © 2013 Elsevier Ltd. All rights reserved.)