Effects of screen time behaviors on food and beverage intake
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Transcript of Effects of screen time behaviors on food and beverage intake
Effects of screen time behaviors on food and beverage intake
Elizabeth J. Lyons, PhD, MPH
June 13, 2014
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Presentation overview
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Background
• Theories of distraction
• Media and distraction
• Distraction and energy expenditure
Paper 1: Secondary data analysis
Paper 2: Review
Thoughts for discussion
Why might TV eating?
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Priming
Associative learning
Distraction from satiety cues & dietary restraint
Greater cognitive load overwhelms self-regulatory capacity
Theories of distraction
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Interdisciplinary, messy definitions
Presence/immersion/engagement/transportation…
• Used synonymously
• Sometimes have specific definitions
• Example: immersion refers to the capacity of the hardware to produce presence
• …except when it doesn’t
Engagement
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According to the Temple group, a more surface level of mental immersion
• According to others, a broader category that includes flow and presence
A measure of attentional allocation
Occurs when perception is directed towards a technologically mediated world, away from the physical world
Presence
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Sense of “being there”
Perceptual illusion of non-mediation
Sometimes specified as spatial presence
Transportation
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Specific to narratives
Absorption in a storyline
Attentional allocation + imagery and feelings associated with a story
• Requires active participation to imagine story
• Likely to produce a greater cognitive load
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Specific to narratives
Absorption in a storyline
Attentional allocation + imagery and feelings associated with a story
• Requires active participation to imagine story
• Likely to produce a greater cognitive load
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Transportation
Distraction and media: predictors
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Better graphics
Better sound
First-person point of view
Better, more immersive equipment (larger, more pixels, etc.)
Haptic feedback
Character identification
Distraction and energy expenditure
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Distract from emotions of pain & fatigue
Distract from unpleasant physiological sensations
• Appears to be more useful for MVPA than PA than approaches/exceeds the ventilatory threshold
• It’s pretty hard to ignore bodily cues at that point!
Distraction and energy intake
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We’ll get to this in paper 2…
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Paper 1: The PRESENCE 2 study
Addressed both sides of energy balance
120 participants (60 female) randomized to
• TV watching• Traditional video gaming• Motion-controlled video gaming
1 hour with access to snacks, beverages
Choice of content in each group
Fasted 2 hours
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Snacks and beverages
Snacks
• Doritos• M & Ms• Trail mix• Baked Lays
Beverages
• Coke• Mountain Dew• Diet Coke• Water
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Measures
SenseWear Pro Armband
• Accelerometry• Galvanic skin response• Estimates MET values
Tanita food scale
• Measures to nearest gram• Weighed containers before and after
study period
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TV group
Netflix instant streaming
100s of TV shows available
No commercials
Most popular shows
• 30 Rock (5)• The Office (5)• Weeds (3)• Dexter (3)
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Video game groups
Traditional
• 10 games• Playstation 3• Rated at least 75 on
Metacritic• No more than 2 per genre
Motion-controlled
• 10 games• Wii and Xbox 360• Included motions
• Throwing• Punching• Hitting
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Participant characteristics
62% White, 17% Black, 14% Asian, 7% Other, 8% Hispanic
63% normal weight, 26% overweight, 11% obese
TV(N = 40)
VG(N = 40)
Motion(N = 40)
Total (N = 120)
Age (years) 24.6 (4.7) 23.6 (4.2) 24.0 (4.4) 24.1 (4.4)
Height (cm) 171.1 (9.0) 171.8 (11.1) 170.1 (9.3) 171.0 (9.8)
Weight (kg) 72.6 (17.1) 72.0 (16.0) 70.0 (10.9) 71.5 (14.8)
BMI (kg/m2) 24.7 (4.6) 24.3 (4.0) 24.3 (4.2) 24.4 (4.1)
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Energy expenditure
ab
P < .001; Trend toward difference between VG and TV, P = .069; Gender effect P < .001 20
PRESENCE 2 energy intake
21Institute for Translational SciencesP = .065; likelihood of eating 500 kcals or more TV vs. motion, OR = 3.2 (1.2 – 8.4)
But why?
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Tested presence, engagement, and narrative transportation
Only narrative transportation mediated the effect of TV on energy intake
Other potential predictors/moderators?
• Gender?
• Type of show/game?
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Gender differences: TV genres
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Gender differences: VG genres
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Gender differences: Motion VG genres
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Take-home messages
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Screen-based behaviors affect eating
• TV and sedentary video gaming worse than motion-controlled gaming
What you watch/play impacts how much you eat
Greater distraction/cognitive load is likely worse for you
• But more fun!
Paper 2: a review of eating studies
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Possible reasons for screen effects on energy intake:
• Distraction/attentional allocation
• Interruption of physiologic food regulation
• Screen-based activities as conditioned cues to eat
• Memory
• Stress-induced reward system
Distraction
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Distract from
• Restriction (self-regulation, self-control)
• Satiety signals
• As you eat, your body attempts habituation to food stimuli
• ending the meal, eventually
• Slows rate of habituation to satiety cues
• Keep eating
Continuous TV > 1.5 minute TV clips
• Meaningful vs. meaningless distraction
Physiologic food regulation
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Interrupt not just mental processes related to intake regulation
• Decrease ability of a glucose preload to decrease intake
• Overrides physiological signals
…Basically the same thing as the last one
Conditioned cues
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TV always paired with food TV is associated with food
Superbowl = junk food, etc.
Can be specific to type of food and type of activity
Memory
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Amnesiacs will eat a second meal
• Remembering a recent meal will decrease intake
Impairs ability to accurately estimate food intake
• Which then leads to greater intake later, since memory of intake is impaired
This, too, is ultimately due to distraction
Stress-induced reward system
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Games are stressful & biologically demanding
• Even sedentary games increase heart rate, etc.
Eating feels pleasurable, reduces stress
• people eat when stressed
Take-home messages
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Basically, distraction is the key ingredient in most of these
• Distraction from cognitive or behavioral cues
• Distraction from physiological signals
• Distraction leading to poor memory for meal
Stress and cues likely also contribute
This is all excluding clear influence of food ads
Thoughts for discussion
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Variance was a huge issue in PRESENCE 2. What other variables are likely to be contributing to this variance?
Gender is clearly a moderator. What other moderators could plausibly exist?
What do you think is the most important mechanism by which distraction affects intake?
Acknowledgements and thanks
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Funding• NIH BIRCWH K12 (K12HD05023)
• NIH CTSA (UL1RR029876)
• NIH Pepper OAIC (P30AG024832)• AHA (13BGIA17110021)
Current mentors & collaborators
• Tom Baranowski (BCM)
• Karen Basen-Engquist (MDA)
• Abbey Berenson
• Jim Goodwin
• Koyya Lewis
• Eloisa Martinez
• Ken Ottenbacher
• Jennifer Rowland
• Elena Volpi