9/8/2020 Finding Slides for Todays Webinar COPE Webinar Series for - PDF document

9/8/2020 Finding Slides for Today’s Webinar COPE Webinar Series for Health Professionals September 16, 2020 Choice is Relative: Reinforcing Value of Food www.villanova.edu/COPE and Physical Activity in Obesity Treatment Click on Carr webinar description page Moderator Lisa K. Diewald MS, RD, LDN Program Manager MacDonald Center for Obesity Prevention and Education M. Louise Fitzpatrick College of Nursing 1 2 Today’s Webinar Objectives Did you use your phone to access the webinar? If you are calling in today rather than 1.Describe how behavioral economic principles using your computer to log on, and can influence obesity treatment. need CE credit, please email 2.Discuss the role of the home environment on cope@villanova.edu and provide your obesity risk. name so we can send your certificate. 3.Learn how the use of substitutes and complements can be effective tools in obesity treatment. 3 4 Continuing Education Credit Details Continuing Education Credit Details This webinar awards 1 contact hour for nurses Villanova University M. Louise Fitzpatrick College of 1 CPEU for dietitians Nursing is accredited as a provider of nursing continuing professional development by the Level 2 American Nurses Credentialing Center’s Commission on Accreditation. CDR Performance Indicators: 6.25, 9.1.3, 9.6.1, and Villanova University College of Nursing Continuing 9.6.6 Education/COPE is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration 5 6 1

9/8/2020 Choice is relative: Reinforcing value of food Disclosures and physical activity in obesity treatment The planners and presenter of this program have no conflicts of interest to disclose. Katelyn Carr, Ph.D. Senior Research Scientist Accredited status does not imply endorsement by Villanova Jacobs School of Medicine & University, COPE or the American Nurses Credentialing Center of any commercial products or medical/nutrition Biomedical Sciences advice displayed in conjunction with an activity. University at Buffalo 7 7 8 Overview CHOICE IS RELATIVE Reinforcing value of food and activity • Reinforcing value of food and activities in obesity treatment • What modifies reinforcing value? • How do we develop reinforcers? ‘- ‘- • Katelyn Carr, PhD Behavioral Economic Principles for behavior change Senior Research Scientist • Role of the Cognitively enriched environment Division of Behavioral Medicine Department of Pediatrics McDonald Center for Obesity Prevention and Education ( COPE) Webinar Series 9 10 September 16, 2020 9 10 Types of Foods and Reinforcing Value What is Reinforcing Value? • Motivation to access a reinforcer • Food • Money ‘- ‘- • Physical activity • Sedentary Activities • Social activities • To assess motivation • How much money would you spend? • How much effort would you expend? Epstein, et al. (2015). Appetite. 91: 226-232. Musher-Eizenman, et al. (2010). Health Education & Behavior. 37: 186-192.. 11 12 11 12 2

9/8/2020 Relative food reinforcement Effect of Activity Type on Food Reinforcement When does Food reinforcement Develop? * • Relative reinforcing value of food = * • Food is a natural reinforcer measuring reinforcer motivation with 70 alternatives available 60 • Present at birth and represent a previous ‘- ‘- 50 evolutionary biological advantage • Types of alternatives can modify the Breakpoint Food relative reinforcing value of food 40 • Differences in food reinforcement at 3 months 30 predicts weight gain 20 10 0 Social Cognitive Physical Sedentary Alternative Reinforcer Class Carr and Epstein. (2018). Health Psychology. 37: 125-131. 13 14 Stunkard, et al. (2004). International Journal of Obesity and Related Metabolic Disorders. 28: 503-513. 13 14 Reinforcing Value of food & Weight Status Infant Relative Reinforcing Value & Weight Status Overweight ‘- ‘- /obese Lean Kong, et al. (2015). American Journal of Clinical Nutrition. 101: 515-522. Saelens and Epstein. (1996). Appetite. 27: 41-50. Epstein, et al. (2012). Appetite. 58: 157-62. 15 16 15 16 Reinforcing Value of Food & Weight Gain Infant Relative Reinforcing Value & Weight Status • Reinforcing value of food • Reinforcing value of ‘- ‘- alterantive Children Adults Kong, et al. (2015). American Journal of Clinical Nutrition. 101: 515-522. Hill, et al. (2009). American Journal of Clinical Nutrition. 90: 276-281. Carr, et al. (2014). Obesity (Silver Spring). 22: 254-259. 17 18 17 18 3

9/8/2020 Energy Intake Mediates Reinforcing Value of Reinforcing Value of Food & Energy Intake Food & Obesity • Energy is related to reinforcing Usual value of food (Epstein, et al. (2004). Energy Physiology and Behavior. 81: 511-517.) Intake ‘- ‘- • And sugar • Energy intake mediates the relationship between Relative reinforcing value of food and BMI Reinforcing BMI (Epstein, et al. (2012). Obesity (Silver Value of Food Spring). 20: 1815-1819.) 19 Epstein, et al. (2012). Obesity (Silver Spring). 20: 1815-1819. 20 Epstein, et al. (2011). American Journal of Clinical Nutrition. 94: 12-18. 19 20 Reinforcing Value of Physical Activity Types of Physical Activity • Animals & Humans will work Less for access to Preferred ‘- ‘- Preferred Physical physical activity Physical activity activity versus versus Sedentary Sedentary Epstein, et al. (1991). Health Psychology. 10: 311-316. 21 Barkley, et al. (2009). Physiology and Behavior. 98: 31-36. 22 21 22 Weight Status and Reinforcing Value of Physical Can Social activities be reinforcers? Activity • Familiar: Adult provided supervision for children during a classroom activity ‘- ‘- • Neutral: Adult minimally interacted with child • Positive: Adult interacted individually with each child and responded to all questions/requests • Stranger: Adult did not interact with child prior to the test session Epstein, et al. (1991). Health Psychology. 10: 311-316. McCoy and Zigler. (1965). Journal of Personality and Social Psychology. 1: 604. 23 24 23 24 4

9/8/2020 Food Deprivation; Hunger So far we know • Food, Physical activities and social activities can be reinforcers for adults & children • Deprived: 4 hours post- • Reinforcing value of food is present at birth and prandial • Predicts weight status • Fed: provided caloric preload • Predicts weight gain ‘- ‘- prior to session • Energy intake mediates reinforcing value of food on BMI • Individual differences between types of foods and physical activities What can predict or modify the reinforcing value of food? Epstein, et al. (2003). Physiology and Behavior. 78: 221-227. 25 26 25 26 Social Deprivation Physical Activity Deprivation? • Deprivation: 20 minutes by-self ‘- ‘- prior to test • Non-deprivation: No wait prior to test • Satiation: 20 minutes of play with adult present Mueller, et al. (1999). Physiology and Behavior. 66: 101-7. Gewirtz and Baer. (1958). The Journal of Abnormal and Social Psychology. 57: 165-172. 27 28 27 28 Sensitization Sensitization Recent Experience with Food Recent Experience with Food ‘- ‘- Temple, et al. (2009). American Journal of Clinical Nutrition. 90: 304-313. Temple and Epstein. (2011). International Journal of Obesity. 36: 1102-1107. 29 30 29 30 5

9/8/2020 Weight Status & Alternative Reinforcers on Reinforcing Value of Food Food type and Weight Status ‘- ‘- McCullough, et al. (2017). Appetite. 111: 187-194. Temple, et al. (2008). American Journal of Clinical Nutrition. 87: 1121-1127. 31 32 31 32 How do reinforcers develop? Summary • Reinforcing value of food is related to obesity status, energy intake and weight gain • Exercise reinforcement is related to exercise engagement ‘- ‘- • Deprivation (hunger) increases reinforcing value of food and social reinforcers Control Water Water • Obesity status is related to the reinforcing value of sedentary and Forced Choice physical activities Alcohol Alcohol Intermittent free choice Water Intermittent Alcohol Continuous free choice Water Continuous Alcohol How do reinforcers develop? Wolffgramm and Heyne. (1995). Behavioural Brain Research. 70: 77-94. 33 34 33 34 Offering Choices to Kids Variety and Energy Intake • Favorite snack food • Random Access to 4 different ‘- ‘- snack foods No choice – Carrots Before Dinner choice During Dinner choice de Wild, et al. (2015). Appetite. 91: 1-6. Epstein, et al. (2009). American Journal of Clinical Nutrition. 89: 746-54. 35 36 35 36 6