Dr Janelle Skinner

Introduction Codesign is a meaningful end-user engagement in research design. The integrated knowledge translation (IKT) framework involves adopting a collaborative research approach to produce and apply knowledge to address real-world needs, resulting in useful and useable recommendations that will more likely be applied in policy and practice. In the field of food addiction (FA), there are limited treatment options that have been reported to show improvements in FA symptoms. Objectives The primary aim of this paper is to describe the step-by-step codesign and refinement of a complex intervention delivered via telehealth for adults with FA using an IKT approach. The secondary aim is to describe our intervention in detail according to the TIDieR checklist. Design This study applies the IKT process and describes the codesign and refinement of an intervention through a series of online meetings, workshops and interviews. Participants This study included researchers, clinicians, consumers and health professionals. Primary outcome measure The primary outcome was a refined intervention for use in adults with symptoms of FA for a research trial. Results A total of six female health professionals and five consumers (n=4 female) with lived overeating experience participated in two interviews lasting 60 min each. This process resulted in the identification of eight barriers and three facilitators to providing and receiving treatment for FA, eight components needed or missing from current treatments, telehealth as a feasible delivery platform, and refinement of key elements to ensure the intervention met the needs of both health professionals and possible patients. Conclusion Using an IKT approach allowed for a range of viewpoints and enabled multiple professions and disciplines to engage in a semiformalised way to bring expertise to formulate a possible intervention for FA. Mapping the intervention plan to the TIDieR checklist for complex interventions, allowed for detailed description of the intervention and the identification of a number of areas that needed to be refined before development of the finalised intervention protocol.

(1) Background: Research suggests that certain foods may have addictive effects; however, no reviews have systematically appraised studies in this area. The aims of this review were to determine the nutrients, foods and dietary patterns associated with addictive eating. (2) Methods: Published studies up to November 2020 were identified through searches of 6 electronic databases. Eligible studies included those in in children and adults that reported dietary intakes of individuals with ¿food addiction¿. (3) Results: Fifteen studies (n = 12 in adults and n = 3 in children/adolescents with Yale Food Addiction Scale defined ¿food addiction¿) were included. Foods commonly associated with addictive eating were those high in a combination of fat and refined carbohydrates. Generally, intakes of energy, carbohydrates and fats were significantly higher in individuals with addictive eating compared to those without. (4) Conclusions: Due to the heterogeneity in study methodologies and outcomes across included studies, it is difficult to conclude if any specific foods, nutrients or dietary patterns facilitate an addictive process. Further research is needed to elucidate potential associations. However, present addictive eating treatment approaches could incorporate individualised dietary advice targeting foods high in fat and refined carbohydrates.

In human research, images of food are often used as cues in place of real foods. To elicit anticipatory responses in targeted populations (e.g. prompting changes in metabolic hormones, invoking food cravings), cultural differences and population norms with regard to food preferences need to be considered. This pilot study aimed to construct two image paradigms (healthy vs. hyperpalatable foods) for experimental use within the Australian population. A dataset of 200 images (from the licenced database Food-pics and internet sources), representative of healthy and hyperpalatable foods commonly consumed in Australia, was compiled by research dietitians. Ten male and female adults volunteered to view the images. Participants categorised each image as either healthy food or ¿junk food¿ (i.e. hyperpalatable food), and rated each image according to three criteria: 1) familiarity of the food displayed; 2) recognisability of the food; and 3) appetisingness of the food. Overall, agreement with a priori categories was high for both healthy and hyperpalatable food images, 87.3% and 87.7% respectively. The food images with the lowest overall ratings (score <7 out of possible 9) were removed from the dataset and the final paradigms each contain 75 images. The healthy food paradigm contains foods from the five core food groups (fruit, vegetables, grains and cereals, meat and meat alternatives, dairy foods), and the hyperpalatable food paradigm contains non-core foods (sweet and savoury discretionary choice foods). The paradigms represent a broad range of commonly consumed foods that will be relevant for prospective projects utilising food cues in Australian adults.

The neuropeptide oxytocin has been associated with food intake and feeding behaviour. This systematic review aimed to investigate the impact of oxytocin on dietary intake and feeding behaviour in rodent studies. Six electronic databases were searched to identify published studies to April 2018. Preclinical studies in mice and rats were included if they reported: (1) a dietary measure (i.e. food or nutrient and/or behaviour (2) an oxytocin measure, and (3) relationship between the two measures. A total of 75 articles (n = 246 experiments) were included, and study quality appraised. The majority of studies were carried out in males (87%). The top three oxytocin outcomes assessed were: exogenous oxytocin administration (n = 126), oxytocin-receptor antagonist administration (n = 46) and oxytocin gene deletion (n = 29). Meta-analysis of exogenous studies in mice (3 studies, n = 43 comparisons) and rats (n = 8 studies, n = 82 comparisons) showed an overall decrease in food intake with maximum effect shown at 2 h post-administration.

Background: The present study systematically reviewed the literature aiming to determine the relationships between food addiction, as measured by the Yale Food Addiction Scale (YFAS), and mental health symptoms. Methods: Nine databases were searched using keywords. Studies were included if they reported: (i) YFAS diagnosis or symptom score and (ii) a mental health outcome, as well as the association between (i) and (ii). In total, 51 studies were included. Results: Through meta-analysis, the mean prevalence of food addiction diagnosis was 16.2%, with an average of 3.3 (range 2.85¿3.92) food addiction symptoms being reported. Subanalyses revealed that the mean number of food addiction symptoms in populations seeking treatment for weight loss was 3.01 (range 2.65¿3.37) and this was higher in groups with disordered eating (mean 5.2 3.6¿6.7). Significant positive correlations were found between food addiction and binge eating [mean r¿=¿0.602 (0.557¿0.643), P¿<¿0.05], depression, anxiety and food addiction [mean r¿=¿0.459 (0.358¿0.550), r¿=¿0.483 (0.228¿0.676), P¿<¿0.05, respectively]. Conclusions: A significant, positive relationship exists between food addiction and mental health symptoms, although the results of the present study highlight the complexity of this relationship.

Food addiction research in children is limited, and to date addictive-like eating behaviors within families have not been investigated. The aim of this study is to understand factors associated with addictive-like eating in children. The association between food addiction in children with obesity, parental food addiction, and parental feeding practices (i.e., restriction, pressure to eat, monitoring) was investigated. Parents/primary caregivers (aged¿=¿18¿years) of children aged 5¿12¿years, recruited and completed an online cross-sectional survey including demographics, the Yale Food Addiction Scale (YFAS), and the Child Feeding Questionnaire (CFQ). Parents, reporting on themselves and one of their children, were given a food addiction diagnosis and symptom score according to the YFAS predefined criteria. The total sample consisted of 150 parents/primary caregivers (48% male) and 150 children (51% male). Food addiction was found to be 12.0% in parents and 22.7% in children. In children, food addiction was significantly associated with higher child BMI z-scores. Children with higher food addiction symptoms had parents with higher food addiction scores. Parents of FA children reported significantly higher levels of Restriction and Pressure to eat feeding practices, but not Monitoring. Children with elevated YFAS-C scores may be at greater risk for eating-related issues.