The incentive sensitisation model of obesity suggests that modification of the dopaminergic associated reward systems in the brain may result in increased awareness of food-related visual cues present in the current food environment. Having a heightened awareness of these visual food cues may impact on food choices and eating behaviours with those being most aware of or demonstrating greater attention to food-related stimuli potentially being at greater risk of overeating and subsequent weight gain. To date, research related to attentional responses to visual food cues has been both limited and conflicting. Such inconsistent findings may in part be explained by the use of different methodological approaches to measure attentional bias and the impact of other factors such as hunger levels, energy density of visual food cues and individual eating style traits that may influence visual attention to food-related cues outside of weight status alone. This review examines the various methodologies employed to measure attentional bias with a particular focus on the role that attentional processing of food-related visual cues may have in obesity. Based on the findings of this review, it appears that it may be too early to clarify the role visual attention to foodrelated cues may have in obesity. Results however highlight the importance of considering the most appropriate methodology to use when measuring attentional bias and the characteristics of the study populations targeted while interpreting results to date and in designing future studies.Incentive sensitisation: Weight status: Eye tracking: Visual probe: Stroop Prevalence of overweight and obesity has now reached epidemic proportions with more than 1·4 billion adults considered as overweight and of these, over 500 million being obese worldwide (1) . On a fundamental level the cause of obesity is linked to an imbalance of energy intake v. energy expenditure; however, it is now evident that obesity is a multifactorial condition that arises from interactions between genetic and environmental factors (2) . One such factor is the present 'obesogenic' environment that is characterised by a wealth of highly palatable, energy-dense foods (3) . These foods are heavily represented in the visual environment for example, through advertising and it has been suggested that frequent exposure to these forms of food-related cues may impact on eating behaviours and food choices (4)(5)(6) .According to the theory of incentive sensitisation, 'addictive substances' modify reward-related pathways in the brain leading to hypersensitisation of rewardrelated stimuli (7) . This results in increased salience to reward-related stimuli resulting in these stimuli becoming more 'attention grabbing'. It has been proposed that this heightened awareness is the consequence of repeated exposure to a particular stimulus and the association between the stimulus and a rewarding experience, which results in related cues becoming salient. The stimulus related to the rewarding experience may then attract g...
Objective: Based on the theory of incentive sensitization, the aim of this study was to investigate differences in attentional processing of food-related visual cues between normal-weight and overweight/obese males and females. Methods: Twenty-six normal-weight (14M, 12F) and 26 overweight/obese (14M, 12F) adults completed a visual probe task and an eye-tracking paradigm. Reaction times and eye movements to food and control images were collected during both a fasted and fed condition in a counterbalanced design. Results: Participants had greater visual attention towards high-energy-density food images compared to low-energy-density food images regardless of hunger condition. This was most pronounced in overweight/obese males who had significantly greater maintained attention towards high-energy-density food images when compared with their normal-weight counterparts however no between weight group differences were observed for female participants. Conclusions: High-energy-density food images appear to capture visual attention more readily than lowenergy-density food images. Results also suggest the possibility of an altered visual food cue-associated reward system in overweight/obese males. Attentional processing of food cues may play a role in eating behaviors thus should be taken into consideration as part of an integrated approach to curbing obesity.
Objective Mild iodine deficiency has re‐emerged among school girls in the UK. We wished to study a contemporaneous pregnant population because a relationship between maternal iodine deficiency and offspring cognitive scores has recently been reported. The WHO has set a median population urinary iodine concentration (UIC) of ≥100 and ≥150 µg/L to define adequacy outside of and during pregnancy, respectively. Iodine creatinine ratio (ICR) is also used to correct for dilution effects (sufficiency ≥150 µg/g creatinine in pregnancy). Design and methods A total of 241 women were followed across trimesters (T) into the postpartum period (PPP) along with 80 offspring with spot urine sampling and food frequency questionnaires. Results Median UIC was 73 µg/L in the 1st T (ICR 102 µg/g creatinine) despite 55% taking iodine‐containing supplements. Median UICs were 94, 117 and 90 µg/L in the 2nd T, 3rd T and PPP, respectively. Corresponding ICRs were 120, 126 and 60 µg/g creatinine. ICR was associated with volume of milk consumed throughout pregnancy. Median UIC among the offspring was 148 µg/L, with no difference between the breast‐ and formula‐fed babies. Conclusions Pregnant women living in Northern Ireland may be at risk of iodine deficiency across pregnancy and into the PPP while the offspring are iodine sufficient. This is the first study of its kind in the UK with data for pregnant women and their offspring. The UK does not provide an iodine fortification programme nor offer routine iodine dietary advice in pregnancy and this requires consideration by public health agencies.
The trace element iodine is a vital constituent of thyroid hormones. Iodine requirements increase during pregnancy, when even mild deficiency may affect the neurocognitive development of the offspring. Urinary iodine concentration (UIC) is the means of assessing iodine status in population surveys; a median UIC of 100-199 µg/L is deemed sufficient in a non-pregnant population. Milk is the main dietary source of iodine in the UK and Ireland. Methods We surveyed the iodine status of 903 girls aged 14-15 years in seven sites across the island of Ireland. Urine iodine concentration was measured in spot-urine samples collected between March 2014 and October 2015. Food group intake was estimated from iodine-specific food-frequency questionnaire. Milk iodine concentration was measured at each site in summer and winter. Results The median UIC overall was 111 µg/L. Galway was the only site in the deficient range (median UIC 98 µg/L). All five of the Republic of Ireland sites had UIC ≤105µg/L. In the two sites surveyed twice, UIC was lower in summer vs winter months (117 µg/L (IQR 76-165) vs 130 µg/L (IQR 91-194) (p<0.01)). Milk samples collected from Galway and Roscommon had a lower mean iodine concentration than those from Derry/Londonderry (p<0.05). Milk intake was positively associated with UIC (p<0.001). Conclusions This is the largest survey of its kind on the island of Ireland, which currently has no iodine fortification programme. Overall, the results suggest that this young female population sits at the low end of sufficiency, which has implications if, in future, they enter pregnancy with borderline status.
The neonatal TSH database suggests iodine sufficiency in the NI population. However, the rising frequency of results >2 mIU/L may indicate an emerging mild iodine deficiency. This is one of the largest and longest studies of its kind in the UK and the first carried out in NI. The summer months may be a time of increased risk of iodine deficiency in our pregnant women whose requirements are increased and who are not currently targeted by any iodine fortification programme in the UK.
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