Clinical trial NCT03882957: Trial on the Effect of Media Multi-tasking on Attention to Food Cues and Cued Overeating
Official title: Media Multi-tasking and Cued Overeating: Assessing the Pathway and Piloting an Intervention Using an Attentional Network Framework
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Attention Concentration Difficulty
Obesity, Childhood
Keywords: Attention
Food cues
Media multi-tasking
Lead sponsor: Dartmouth-Hitchcock Medical Center
Sponsor class: OTHER
Collaborators: name: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
name: Dartmouth College
First posted: 2019-03-20
Enrollment: 92
Sex: ALL
Minimum age (years): 13
Maximum age (years): 17
Standard ages: CHILD
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Intervention model description: This is a within-subject design where each participant is randomly assigned to all three arms.
Primary purpose: PREVENTION

Brief summary: Childhood obesity is a critical public health problem in the United States. One factor known to contribute to childhood obesity is excess consumption. Importantly, excess consumption related to weight gain is not necessarily driven by hunger. For example, environmental food cues stimulate brain reward regions and lead to overeating even after a child has eaten to satiety. This type of cued eating is associated with increased attention to food cues; the amount of time a child spends looking at food cues (e.g., food advertisements) is associated with increased caloric intake. However, individual susceptibility to environmental food cues remains unknown. It is proposed that the prevalent practice of media multi-tasking-simultaneously attending to multiple electronic media sources-increases attention to peripheral food cues in the environment and thereby plays an important role in the development of obesity. It is hypothesized that multi-tasking teaches children to engage in constant task switching that makes them more responsive to peripheral cues, many of which are potentially harmful (such as those that promote overeating). The overarching hypothesis is that media multi-tasking alters the attentional networks of the brain that control attention to environmental cues. High media multi-tasking children are therefore particularly susceptible to food cues, thereby leading to increased cued eating. It is also predicted that attention modification training can provide a protective effect against detrimental attentional processing caused multi-tasking, by increasing the proficiency of the attention networks. These hypotheses will be tested by assessing the pathway between media-multitasking, attention to food cues, and cued eating. It will also be examined whether it is possible to intervene on this pathway by piloting an at-home attention modification training intervention designed to reduce attention to food cues. It is our belief that this research will lead to the development of low-cost, scalable tools that can train attention networks so that children are less influenced by peripheral food cues, a known cause of overeating. For example, having children practice attention modification intervention tasks regularly (which could be accomplished through user-friendly computer games or cell phone/tablet apps) might offset the negative attentional effects of media multi-tasking.

Detailed description: \[3/14/2020\]: Study recruitment temporarily halted due to the COVID-19 pandemic

Eligibility criteria: Inclusion Criteria:

* N/A.

Exclusion Criteria:

* Inadequate English proficiency, a vision disorder that is not corrected with corrective lenses, and relevant food allergies.

Primary outcomes:
measure: Amount of Time Spent Looking at Food Cues While Playing a Media Game
timeFrame: approximately 15 minutes post-intervention
measure: Amount of Snack Foods Consumed Post-intervention
timeFrame: approximately 30 minutes post-intervention
measure: Daily Usual Media Multi-tasking
timeFrame: approximately 10 minutes prior to the intervention
Secondary outcomes:
Other outcomes:
Locations:
city: Lebanon
country: United States
facility: Dartmouth-Hithchock Medical Center
state: New Hampshire
Study officials:
affiliation: Dartmouth College
name: Diane Gilbert-Diamond, ScD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Rapuano KM, Zieselman AL, Kelley WM, Sargent JD, Heatherton TF, Gilbert-Diamond D. Genetic risk for obesity predicts nucleus accumbens size and responsivity to real-world food cues. Proc Natl Acad Sci U S A. 2017 Jan 3;114(1):160-165. doi: 10.1073/pnas.1605548113. Epub 2016 Dec 19.
citation: Folkvord F, Anschutz DJ, Wiers RW, Buijzen M. The role of attentional bias in the effect of food advertising on actual food intake among children. Appetite. 2015 Jan;84:251-8. doi: 10.1016/j.appet.2014.10.016. Epub 2014 Oct 22.
citation: Corbetta M, Patel G, Shulman GL. The reorienting system of the human brain: from environment to theory of mind. Neuron. 2008 May 8;58(3):306-24. doi: 10.1016/j.neuron.2008.04.017.
citation: Corbetta M, Shulman GL. Control of goal-directed and stimulus-driven attention in the brain. Nat Rev Neurosci. 2002 Mar;3(3):201-15. doi: 10.1038/nrn755.
citation: Hou Y, Liu T. Neural correlates of object-based attentional selection in human cortex. Neuropsychologia. 2012 Oct;50(12):2916-2925. doi: 10.1016/j.neuropsychologia.2012.08.022. Epub 2012 Sep 4.
citation: Moisala M, Salmela V, Hietajarvi L, Salo E, Carlson S, Salonen O, Lonka K, Hakkarainen K, Salmela-Aro K, Alho K. Media multitasking is associated with distractibility and increased prefrontal activity in adolescents and young adults. Neuroimage. 2016 Jul 1;134:113-121. doi: 10.1016/j.neuroimage.2016.04.011. Epub 2016 Apr 8.
citation: Yap JY, Lim SWH. Media multitasking predicts unitary versus splitting visual focal attention. Journal of Cognitive Psychology. Routledge; 2013 Nov;25(7):889-902.
citation: Ophir E, Nass C, Wagner AD. Cognitive control in media multitaskers. Proc Natl Acad Sci U S A. 2009 Sep 15;106(37):15583-7. doi: 10.1073/pnas.0903620106. Epub 2009 Aug 24.
citation: Boutelle KN, Kuckertz JM, Carlson J, Amir N. A pilot study evaluating a one-session attention modification training to decrease overeating in obese children. Appetite. 2014 May;76:180-5. doi: 10.1016/j.appet.2014.01.075. Epub 2014 Feb 8.
citation: Posner MI, Petersen SE. The attention system of the human brain. Annu Rev Neurosci. 1990;13:25-42. doi: 10.1146/annurev.ne.13.030190.000325. No abstract available.
citation: Pozuelos JP, Paz-Alonso PM, Castillo A, Fuentes LJ, Rueda MR. Development of attention networks and their interactions in childhood. Dev Psychol. 2014 Oct;50(10):2405-15. doi: 10.1037/a0037469. Epub 2014 Jul 28.
citation: Hill LJ, Coats RO, Mushtaq F, Williams JH, Aucott LS, Mon-Williams M. Moving to Capture Children's Attention: Developing a Methodology for Measuring Visuomotor Attention. PLoS One. 2016 Jul 19;11(7):e0159543. doi: 10.1371/journal.pone.0159543. eCollection 2016.
citation: Birch LL, Fisher JO. Development of eating behaviors among children and adolescents. Pediatrics. 1998 Mar;101(3 Pt 2):539-49.
citation: Rideout VJ, Foehr UG, Roberts DF. Generation M2: Media in the lives of 8- to 10-year olds. 2010 Jan.
citation: Rideout VJ. Zero to eight: Children's media use in America 2013. New York, New York: Common Sense Media.
citation: Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014 Feb 26;311(8):806-14. doi: 10.1001/jama.2014.732.
citation: Han JC, Lawlor DA, Kimm SY. Childhood obesity. Lancet. 2010 May 15;375(9727):1737-48. doi: 10.1016/S0140-6736(10)60171-7. Epub 2010 May 5.
citation: Daniels SR, Arnett DK, Eckel RH, Gidding SS, Hayman LL, Kumanyika S, Robinson TN, Scott BJ, St Jeor S, Williams CL. Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation. 2005 Apr 19;111(15):1999-2012. doi: 10.1161/01.CIR.0000161369.71722.10.
citation: Biro FM, Wien M. Childhood obesity and adult morbidities. Am J Clin Nutr. 2010 May;91(5):1499S-1505S. doi: 10.3945/ajcn.2010.28701B. Epub 2010 Mar 24.
citation: Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med. 1997 Sep 25;337(13):869-73. doi: 10.1056/NEJM199709253371301.
citation: Serdula MK, Ivery D, Coates RJ, Freedman DS, Williamson DF, Byers T. Do obese children become obese adults? A review of the literature. Prev Med. 1993 Mar;22(2):167-77. doi: 10.1006/pmed.1993.1014.
citation: Guyenet SJ, Schwartz MW. Clinical review: Regulation of food intake, energy balance, and body fat mass: implications for the pathogenesis and treatment of obesity. J Clin Endocrinol Metab. 2012 Mar;97(3):745-55. doi: 10.1210/jc.2011-2525. Epub 2012 Jan 11.
citation: Lutter M, Nestler EJ. Homeostatic and hedonic signals interact in the regulation of food intake. J Nutr. 2009 Mar;139(3):629-32. doi: 10.3945/jn.108.097618. Epub 2009 Jan 28.
citation: Boswell RG, Kober H. Food cue reactivity and craving predict eating and weight gain: a meta-analytic review. Obes Rev. 2016 Feb;17(2):159-77. doi: 10.1111/obr.12354. Epub 2015 Dec 8.
citation: Demos KE, Heatherton TF, Kelley WM. Individual differences in nucleus accumbens activity to food and sexual images predict weight gain and sexual behavior. J Neurosci. 2012 Apr 18;32(16):5549-52. doi: 10.1523/JNEUROSCI.5958-11.2012.
citation: Davids S, Lauffer H, Thoms K, Jagdhuhn M, Hirschfeld H, Domin M, Hamm A, Lotze M. Increased dorsolateral prefrontal cortex activation in obese children during observation of food stimuli. Int J Obes (Lond). 2010 Jan;34(1):94-104. doi: 10.1038/ijo.2009.193. Epub 2009 Oct 6.
citation: Bruce AS, Holsen LM, Chambers RJ, Martin LE, Brooks WM, Zarcone JR, Butler MG, Savage CR. Obese children show hyperactivation to food pictures in brain networks linked to motivation, reward and cognitive control. Int J Obes (Lond). 2010 Oct;34(10):1494-500. doi: 10.1038/ijo.2010.84. Epub 2010 May 4.
citation: Lawrence NS, Hinton EC, Parkinson JA, Lawrence AD. Nucleus accumbens response to food cues predicts subsequent snack consumption in women and increased body mass index in those with reduced self-control. Neuroimage. 2012 Oct 15;63(1):415-22. doi: 10.1016/j.neuroimage.2012.06.070. Epub 2012 Jul 6.
citation: Hill JO, Peters JC. Environmental contributions to the obesity epidemic. Science. 1998 May 29;280(5368):1371-4. doi: 10.1126/science.280.5368.1371.
citation: Rodearmel SJ, Wyatt HR, Stroebele N, Smith SM, Ogden LG, Hill JO. Small changes in dietary sugar and physical activity as an approach to preventing excessive weight gain: the America on the Move family study. Pediatrics. 2007 Oct;120(4):e869-79. doi: 10.1542/peds.2006-2927.
citation: Castellanos EH, Charboneau E, Dietrich MS, Park S, Bradley BP, Mogg K, Cowan RL. Obese adults have visual attention bias for food cue images: evidence for altered reward system function. Int J Obes (Lond). 2009 Sep;33(9):1063-73. doi: 10.1038/ijo.2009.138. Epub 2009 Jul 21.
citation: Yager LM, Robinson TE. Cue-induced reinstatement of food seeking in rats that differ in their propensity to attribute incentive salience to food cues. Behav Brain Res. 2010 Dec 6;214(1):30-4. doi: 10.1016/j.bbr.2010.04.021. Epub 2010 Apr 21.
citation: Hickey C, Peelen MV. Neural mechanisms of incentive salience in naturalistic human vision. Neuron. 2015 Feb 4;85(3):512-8. doi: 10.1016/j.neuron.2014.12.049.
citation: Brockmeyer T, Hahn C, Reetz C, Schmidt U, Friederich HC. Approach bias and cue reactivity towards food in people with high versus low levels of food craving. Appetite. 2015 Dec;95:197-202. doi: 10.1016/j.appet.2015.07.013. Epub 2015 Jul 13.
citation: Hendrikse JJ, Cachia RL, Kothe EJ, McPhie S, Skouteris H, Hayden MJ. Attentional biases for food cues in overweight and individuals with obesity: a systematic review of the literature. Obes Rev. 2015 May;16(5):424-32. doi: 10.1111/obr.12265. Epub 2015 Mar 5.
citation: Kemps E, Tiggemann M, Orr J, Grear J. Attentional retraining can reduce chocolate consumption. J Exp Psychol Appl. 2014 Mar;20(1):94-102. doi: 10.1037/xap0000005. Epub 2013 Sep 30.
citation: Jha AP, Krompinger J, Baime MJ. Mindfulness training modifies subsystems of attention. Cogn Affect Behav Neurosci. 2007 Jun;7(2):109-19. doi: 10.3758/cabn.7.2.109.
citation: Hardman CA, Rogers PJ, Etchells KA, Houstoun KV, Munafo MR. The effects of food-related attentional bias training on appetite and food intake. Appetite. 2013 Dec;71:295-300. doi: 10.1016/j.appet.2013.08.021. Epub 2013 Sep 8.
citation: Kleiman T, Trope Y, Amodio DM. Cognitive control modulates attention to food cues: Support for the control readiness model of self-control. Brain Cogn. 2016 Dec;110:94-101. doi: 10.1016/j.bandc.2016.04.006. Epub 2016 May 3.
citation: Amir N, Weber G, Beard C, Bomyea J, Taylor CT. The effect of a single-session attention modification program on response to a public-speaking challenge in socially anxious individuals. J Abnorm Psychol. 2008 Nov;117(4):860-868. doi: 10.1037/a0013445.
citation: Sturm W, Thimm M, Kust J, Karbe H, Fink GR. Alertness-training in neglect: behavioral and imaging results. Restor Neurol Neurosci. 2006;24(4-6):371-84.
citation: Thimm M, Fink GR, Kust J, Karbe H, Sturm W. Impact of alertness training on spatial neglect: a behavioural and fMRI study. Neuropsychologia. 2006;44(7):1230-46. doi: 10.1016/j.neuropsychologia.2005.09.008. Epub 2005 Nov 8.
citation: Gorman TE, Green CS. Short-term mindfulness intervention reduces the negative attentional effects associated with heavy media multitasking. Sci Rep. 2016 Apr 18;6:24542. doi: 10.1038/srep24542.
citation: Robertson IH, Manly T, Andrade J, Baddeley BT, Yiend J. 'Oops!': performance correlates of everyday attentional failures in traumatic brain injured and normal subjects. Neuropsychologia. 1997 Jun;35(6):747-58. doi: 10.1016/s0028-3932(97)00015-8.
citation: Mrazek MD, Smallwood J, Schooler JW. Mindfulness and mind-wandering: finding convergence through opposing constructs. Emotion. 2012 Jun;12(3):442-448. doi: 10.1037/a0026678. Epub 2012 Feb 6.
citation: Rueda MR, Fan J, McCandliss BD, Halparin JD, Gruber DB, Lercari LP, Posner MI. Development of attentional networks in childhood. Neuropsychologia. 2004;42(8):1029-40. doi: 10.1016/j.neuropsychologia.2003.12.012.
citation: Federico F, Marotta A, Martella D, Casagrande M. Development in attention functions and social processing: Evidence from the Attention Network Test. Br J Dev Psychol. 2017 Jun;35(2):169-185. doi: 10.1111/bjdp.12154. Epub 2016 Aug 4.
citation: Gilbert-Diamond D, Emond JA, Lansigan RK, Rapuano KM, Kelley WM, Heatherton TF, Sargent JD. Television food advertisement exposure and FTO rs9939609 genotype in relation to excess consumption in children. Int J Obes (Lond). 2017 Jan;41(1):23-29. doi: 10.1038/ijo.2016.163. Epub 2016 Sep 22.
citation: Emond JA, Lansigan RK, Ramanujam A, Gilbert-Diamond D. Randomized Exposure to Food Advertisements and Eating in the Absence of Hunger Among Preschoolers. Pediatrics. 2016 Dec;138(6):e20162361. doi: 10.1542/peds.2016-2361.
citation: Hill C, Llewellyn CH, Saxton J, Webber L, Semmler C, Carnell S, van Jaarsveld CH, Boniface D, Wardle J. Adiposity and 'eating in the absence of hunger' in children. Int J Obes (Lond). 2008 Oct;32(10):1499-505. doi: 10.1038/ijo.2008.113. Epub 2008 Jul 22.
citation: Heatherton TF, Wagner DD. Cognitive neuroscience of self-regulation failure. Trends Cogn Sci. 2011 Mar;15(3):132-9. doi: 10.1016/j.tics.2010.12.005. Epub 2011 Jan 26.
citation: Wagner DD, Altman M, Boswell RG, Kelley WM, Heatherton TF. Self-regulatory depletion enhances neural responses to rewards and impairs top-down control. Psychol Sci. 2013 Nov 1;24(11):2262-71. doi: 10.1177/0956797613492985. Epub 2013 Sep 11.
citation: Wagner DD, Boswell RG, Kelley WM, Heatherton TF. Inducing negative affect increases the reward value of appetizing foods in dieters. J Cogn Neurosci. 2012 Jul;24(7):1625-33. doi: 10.1162/jocn_a_00238. Epub 2012 Apr 23.
citation: Petersen SE, Posner MI. The attention system of the human brain: 20 years after. Annu Rev Neurosci. 2012;35:73-89. doi: 10.1146/annurev-neuro-062111-150525. Epub 2012 Apr 12.
citation: Duc AH, Bays P, Husain M. Eye movements as a probe of attention. Prog Brain Res. 2008;171:403-11. doi: 10.1016/S0079-6123(08)00659-6.
citation: Armstrong T, Olatunji BO. Eye tracking of attention in the affective disorders: a meta-analytic review and synthesis. Clin Psychol Rev. 2012 Dec;32(8):704-23. doi: 10.1016/j.cpr.2012.09.004. Epub 2012 Sep 20.
citation: Adler SA, Gallego P. Search asymmetry and eye movements in infants and adults. Atten Percept Psychophys. 2014 Aug;76(6):1590-608. doi: 10.3758/s13414-014-0667-6.
citation: Fisher JO, Birch LL. Eating in the absence of hunger and overweight in girls from 5 to 7 y of age. Am J Clin Nutr. 2002 Jul;76(1):226-31. doi: 10.1093/ajcn/76.1.226.
citation: Alzahabi R, Becker MW. The association between media multitasking, task-switching, and dual-task performance. J Exp Psychol Hum Percept Perform. 2013 Oct;39(5):1485-1495. doi: 10.1037/a0031208. Epub 2013 Feb 11.
citation: Ralph BC, Thomson DR, Seli P, Carriere JS, Smilek D. Media multitasking and behavioral measures of sustained attention. Atten Percept Psychophys. 2015 Feb;77(2):390-401. doi: 10.3758/s13414-014-0771-7.
citation: Hillman CH, Pontifex MB, Raine LB, Castelli DM, Hall EE, Kramer AF. The effect of acute treadmill walking on cognitive control and academic achievement in preadolescent children. Neuroscience. 2009 Mar 31;159(3):1044-54. doi: 10.1016/j.neuroscience.2009.01.057. Epub 2009 Feb 3.
citation: LeBlanc AG, Katzmarzyk PT, Barreira TV, Broyles ST, Chaput JP, Church TS, Fogelholm M, Harrington DM, Hu G, Kuriyan R, Kurpad A, Lambert EV, Maher C, Maia J, Matsudo V, Olds T, Onywera V, Sarmiento OL, Standage M, Tudor-Locke C, Zhao P, Tremblay MS; ISCOLE Research Group. Correlates of Total Sedentary Time and Screen Time in 9-11 Year-Old Children around the World: The International Study of Childhood Obesity, Lifestyle and the Environment. PLoS One. 2015 Jun 11;10(6):e0129622. doi: 10.1371/journal.pone.0129622. eCollection 2015.
citation: Katzmarzyk PT, Barreira TV, Broyles ST, Champagne CM, Chaput JP, Fogelholm M, Hu G, Johnson WD, Kuriyan R, Kurpad A, Lambert EV, Maher C, Maia J, Matsudo V, Olds T, Onywera V, Sarmiento OL, Standage M, Tremblay MS, Tudor-Locke C, Zhao P, Church TS. The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE): design and methods. BMC Public Health. 2013 Sep 30;13:900. doi: 10.1186/1471-2458-13-900.
citation: Mitchell JA, Pate RR, Beets MW, Nader PR. Time spent in sedentary behavior and changes in childhood BMI: a longitudinal study from ages 9 to 15 years. Int J Obes (Lond). 2013 Jan;37(1):54-60. doi: 10.1038/ijo.2012.41. Epub 2012 Mar 20.
citation: Petersen AC, Crockett L, Richards M, Boxer A. A self-report measure of pubertal status: Reliability, validity, and initial norms. J Youth Adolesc. 1988 Apr;17(2):117-33. doi: 10.1007/BF01537962.
citation: Carskadon MA, Acebo C. A self-administered rating scale for pubertal development. J Adolesc Health. 1993 May;14(3):190-5. doi: 10.1016/1054-139x(93)90004-9.
citation: Brooks-Gunn J, Warren MP, Rosso J, Gargiulo J. Validity of self-report measures of girls' pubertal status. Child Dev. 1987 Jun;58(3):829-41.
citation: Dixon HG, Scully ML, Wakefield MA, White VM, Crawford DA. The effects of television advertisements for junk food versus nutritious food on children's food attitudes and preferences. Soc Sci Med. 2007 Oct;65(7):1311-23. doi: 10.1016/j.socscimed.2007.05.011. Epub 2007 Jun 22.
citation: Owens JA, Spirito A, McGuinn M. The Children's Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep. 2000 Dec 15;23(8):1043-51.
citation: Marshall TA, Eichenberger Gilmore JM, Broffitt B, Stumbo PJ, Levy SM. Relative validity of the Iowa Fluoride Study targeted nutrient semi-quantitative questionnaire and the block kids' food questionnaire for estimating beverage, calcium, and vitamin D intakes by children. J Am Diet Assoc. 2008 Mar;108(3):465-72. doi: 10.1016/j.jada.2007.12.002.
citation: Wardle J, Guthrie CA, Sanderson S, Rapoport L. Development of the Children's Eating Behaviour Questionnaire. J Child Psychol Psychiatry. 2001 Oct;42(7):963-70. doi: 10.1111/1469-7610.00792.
citation: Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. Champaign Ill: Human Kinetics Books; 1991.
citation: CDC growth charts: United States [Internet]. Washington, DC. Available from: http://www.cdc.gov.growthcharts