Training Response Inhibition to Obesogenic Foods
Condition: Inhibitory Control Training; Gameifaction
Study type: Interventional

Summary: 
      Dietary choices, and in particular, excess calorie intake leading to obesity, are strong, but
      reversible risk factors for cancer. For example, foods high in added sugars are low-nutrient,
      high calorie foods that increase the risk of cancer by promoting weight gain. As such, the
      reduction of sweets is consistent with American Institute for Cancer Research and the
      American Cancer Society dietary recommendations. Behavioral interventions to alter diet have
      limited long-term efficacy, most likely because eating decisions are governed by automatic
      neurocognitive processes that are not addressed in conventional interventions. In particular,
      the ability to refrain from consuming unhealthy, but widely available, palatable foods, is
      increasingly understood to depend on inhibitory control, i.e., the ability to cut off action
      tendencies that are put in motion by innate drives towards rewarding behaviors. Recent work
      by our team and others have demonstrated that computer-based inhibitory control trainings
      result in short-term, specific changes in behavior, such as reducing intake of salty snack
      food, chocolate, and alcoholic beverages. An automatized, home computer-based inhibitory
      control training offers the potential of an inexpensive and highly disseminable method of
      lowering cancer risk across wide swaths of the population. As such, we aim to evaluate the
      feasibility, acceptability, mechanism of action, effectiveness and persistence of a home
      computer-based inhibitory control training. In particular, we hypothesize that a
      high-repetition training in inhibitory control will result in increased adherence to a
      low-sugar diet, and that effects will be mediated through improved inhibitory control. We
      further hypothesize that gamefying the training will improve efficacy because it will boost
      compliance with the daily trainings. We also hypothesize that the training will be most
      effective for those starting of with impaired inhibitory control, as well as those with
      strongest desire for palatable foods and those with strongest explicit health goals. Lastly,
      we aim to examine the impact of inhibitory control training on secondary outcomes, including
      on overall caloric intake, and on short-term weight loss. To achieve these aims, the proposed
      study will recruit 100 overweight and obese individuals who currently eat high-sugar diets,
      and who wish to improve their diets. Participants will be assigned a reduced-sugar diet for 8
      weeks. After a baseline period, participants will be randomized, via a 2 x 2 factorial
      design, to receive 6 weeks of either inhibitory control training or a sham training, and
      either a gamified or non-gameified training. The 6-week intervention will consist of 15
      minutes per day of home computer- based inhibitory control training, and will be followed by
      a 1-week booster and then 1-week follow-up period. Dietary adherence will be measured via a
      food frequency questionnaire and via automated 24-hour food recall. Neurocognitive variables
      will be assessed pre and post-training in order to test trainings' mechanism of action, and
      moderation will be assessed through baseline trait measures of explicit health goals,
      implicit attitudes towards appetitive stimuli, body mass index, and responsivity to food
      cues.
    


Intervention name(s): No-Added-Sugar Diet
Intervention type(s): Behavioral
Intervention description(s): All participants received a no-added-sugar dietary intervention and followed the diet during the course of the study.
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Single (Participant)
Primary purpose: Treatment