Food Insecurity Moderates the Relationship Between Momentary Affect and Adherence in a Dietary Intervention Study

Overview

Journal Obesity (Silver Spring)

Specialties Endocrinology
Nutritional Sciences
Physiology

Date 2022 Jan 28

PMID 35088549

Authors

Coley C Andersen

Tomas Cabeza De Baca

Susanne B Votruba

Emma J Stinson

Scott G Engel

Jonathan Krakoff

Marci E Gluck

Affiliations

Soon will be listed here.

Abstract

Objective: Negative affect and food insecurity have been proposed to impede adherence to weight loss interventions. Therefore, this study examined the role of these variables on dietary adherence using Ecological Momentary Assessment.

Methods: A total of 50 participants (19 male participants; age = 49 [SD 14] years) participated in an outpatient dietary study. Lean participants (n = 22; BMI ≤ 25 kg/m ) received a weight-maintaining energy needs (WMEN) diet, and participants with obesity (BMI ≥ 30) were randomized to receive either a WMEN diet (n = 14) or a 35% calorie-reduced diet (n = 14). Food insecurity was measured, and, twice daily, Ecological Momentary Assessment captured real-time affect ratings and adherence. Between-person (trait-level) and lagged within-person (state-level) scores were calculated.

Results: Greater food insecurity and trait-level negative affect were associated with reduced adherence (p = 0.0015, p = 0.0002, respectively), whereas higher trait-level positive affect was associated with greater adherence (p < 0.0001). Significant interactions between affect and food insecurity revealed an association between higher trait positive affect and increased adherence at lower levels of food insecurity. Higher trait negative affect was more strongly associated with decreased adherence in participants with greater levels of food insecurity (-1 SD: B = -0.21, p = 0.22; mean: B = -0.46, SE = 0.13, p = 0.0004; +1 SD: B = -0.71, SE = 0.17, p < 0.0001).

Conclusions: Trait-level affect may be crucial in predicting dietary adherence, especially in those with greater food insecurity.

Citing Articles

Barriers and Facilitators to Adherence to a Healthy Diet Across the Spectrum of Chronic Kidney Disease.

Trigueros-Flores X, Luna-Hernandez G, Santos-Lopez M, Perez-Galvan L, Flores-Camacho K, Diaz-Canchola L Patient Prefer Adherence. 2025; 19():123-137.

PMID: 39834886 PMC: 11745046. DOI: 10.2147/PPA.S494390.

Dietary Adherence Is Associated with Perceived Stress, Anhedonia, and Food Insecurity Independent of Adiposity.

Booker J, De Baca T, Trevino-Alvarez A, Stinson E, Votruba S, Chang D Nutrients. 2024; 16(4).

PMID: 38398850 PMC: 10892668. DOI: 10.3390/nu16040526.

References

Wang D, Leung C, Li Y, Ding E, Chiuve S, Hu F . Trends in dietary quality among adults in the United States, 1999 through 2010. JAMA Intern Med. 2014; 174(10):1587-95. PMC: 5924699. DOI: 10.1001/jamainternmed.2014.3422. View

Gibson A, Sainsbury A . Strategies to Improve Adherence to Dietary Weight Loss Interventions in Research and Real-World Settings. Behav Sci (Basel). 2017; 7(3). PMC: 5618052. DOI: 10.3390/bs7030044. View

Van Gaal L, Mertens I, De Block C . Mechanisms linking obesity with cardiovascular disease. Nature. 2006; 444(7121):875-80. DOI: 10.1038/nature05487. View

Smith K, Mason T, Crosby R, Engel S, Crow S, Wonderlich S . State and trait positive and negative affectivity in relation to restraint intention and binge eating among adults with obesity. Appetite. 2017; 120:327-334. PMC: 5969992. DOI: 10.1016/j.appet.2017.09.020. View

Trofholz A, Tate A, Keithahn H, de Brito J, Loth K, Fertig A . Family meal characteristics in racially/ethnically diverse and immigrant/refugee households by household food security status: A mixed methods study. Appetite. 2020; 157:105000. PMC: 7855270. DOI: 10.1016/j.appet.2020.105000. View

Myers C, Martin C, Apolzan J, Arnold C, Davis T, Johnson W . Food Insecurity and Weight Loss in an Underserved Primary Care Population: A Post Hoc Analysis of a Cluster Randomized Trial. Ann Intern Med. 2021; 174(7):1032-1034. PMC: 8292163. DOI: 10.7326/M20-6326. View

Burgess E, Hassmen P, Pumpa K . Determinants of adherence to lifestyle intervention in adults with obesity: a systematic review. Clin Obes. 2017; 7(3):123-135. DOI: 10.1111/cob.12183. View

Forman E, Schumacher L, Crosby R, Manasse S, Goldstein S, Butryn M . Ecological Momentary Assessment of Dietary Lapses Across Behavioral Weight Loss Treatment: Characteristics, Predictors, and Relationships with Weight Change. Ann Behav Med. 2017; 51(5):741-753. PMC: 5591758. DOI: 10.1007/s12160-017-9897-x. View

Walker R, Chawla A, Garacci E, Williams J, Mendez C, Ozieh M . Assessing the relationship between food insecurity and mortality among U.S. adults. Ann Epidemiol. 2019; 32:43-48. PMC: 6441375. DOI: 10.1016/j.annepidem.2019.01.014. View

10.

Lemstra M, Bird Y, Nwankwo C, Rogers M, Moraros J . Weight loss intervention adherence and factors promoting adherence: a meta-analysis. Patient Prefer Adherence. 2016; 10:1547-59. PMC: 4990387. DOI: 10.2147/PPA.S103649. View

11.

Carels R, Douglass O, Cacciapaglia H, OBrien W . An ecological momentary assessment of relapse crises in dieting. J Consult Clin Psychol. 2004; 72(2):341-8. DOI: 10.1037/0022-006X.72.2.341. View

12.

DInnocenzo S, Biagi C, Lanari M . Obesity and the Mediterranean Diet: A Review of Evidence of the Role and Sustainability of the Mediterranean Diet. Nutrients. 2019; 11(6). PMC: 6627690. DOI: 10.3390/nu11061306. View

13.

Banerjee S, Radak T, Khubchandani J, Dunn P . Food Insecurity and Mortality in American Adults: Results From the NHANES-Linked Mortality Study. Health Promot Pract. 2020; 22(2):204-214. DOI: 10.1177/1524839920945927. View

14.

Dinour L, Bergen D, Yeh M . The food insecurity-obesity paradox: a review of the literature and the role food stamps may play. J Am Diet Assoc. 2007; 107(11):1952-61. DOI: 10.1016/j.jada.2007.08.006. View

15.

Hazzard V, Barry M, Leung C, Sonneville K, Wonderlich S, Crosby R . Food insecurity and its associations with bulimic-spectrum eating disorders, mood disorders, and anxiety disorders in a nationally representative sample of U.S. adults. Soc Psychiatry Psychiatr Epidemiol. 2021; 57(7):1483-1490. PMC: 8235999. DOI: 10.1007/s00127-021-02126-5. View

16.

Kumanyika S, Obarzanek E, Stettler N, Bell R, Field A, Fortmann S . Population-based prevention of obesity: the need for comprehensive promotion of healthful eating, physical activity, and energy balance: a scientific statement from American Heart Association Council on Epidemiology and Prevention, Interdisciplinary.... Circulation. 2008; 118(4):428-64. DOI: 10.1161/CIRCULATIONAHA.108.189702. View

17.

Engel S, Crosby R, Thomas G, Bond D, Lavender J, Mason T . Ecological Momentary Assessment in Eating Disorder and Obesity Research: a Review of the Recent Literature. Curr Psychiatry Rep. 2016; 18(4):37. DOI: 10.1007/s11920-016-0672-7. View

18.

Simoni J, Pantalone D, Plummer M, Huang B . A randomized controlled trial of a peer support intervention targeting antiretroviral medication adherence and depressive symptomatology in HIV-positive men and women. Health Psychol. 2007; 26(4):488-95. PMC: 4044097. DOI: 10.1037/0278-6133.26.4.488. View

19.

WATSON D, Clark L, Tellegen A . Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988; 54(6):1063-70. DOI: 10.1037//0022-3514.54.6.1063. View

20.

Berge J, Fertig A, Trofholz A, Neumark-Sztainer D, Rogers E, Loth K . Associations between parental stress, parent feeding practices, and child eating behaviors within the context of food insecurity. Prev Med Rep. 2020; 19:101146. PMC: 7334818. DOI: 10.1016/j.pmedr.2020.101146. View