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

Institute for Translational Sciences 1

Presentation overview

2Institute for Translational Sciences

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?

3Institute for Translational Sciences

Priming

Associative learning

Distraction from satiety cues & dietary restraint

Greater cognitive load overwhelms self-regulatory capacity

Theories of distraction

4Institute for Translational Sciences

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

5Institute for Translational Sciences

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

6Institute for Translational Sciences

Sense of “being there”

Perceptual illusion of non-mediation

Sometimes specified as spatial presence

Transportation

7Institute for Translational Sciences

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

5Institute for Translational Sciences

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

5Institute for Translational Sciences

10Institute for Translational Sciences

Transportation

Distraction and media: predictors

11Institute for Translational Sciences

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

12Institute for Translational Sciences

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

13Institute for Translational Sciences

We’ll get to this in paper 2…

Department Name Goes Here

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

14

Department Name Goes Here

Snacks and beverages

Snacks

• Doritos• M & Ms• Trail mix• Baked Lays

Beverages

• Coke• Mountain Dew• Diet Coke• Water

15

Department Name Goes Here

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

16

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)

Institute for Translational Sciences 17

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

Institute for Translational Sciences 18

Department Name Goes Here

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)

19

Department Name Goes Here

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?

22Institute for Translational Sciences

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?

Department Name Goes Here

Gender differences: TV genres

23

Department Name Goes Here

Gender differences: VG genres

24

Department Name Goes Here

Gender differences: Motion VG genres

25

Take-home messages

26Institute for Translational Sciences

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

27Institute for Translational Sciences

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

28Institute for Translational Sciences

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

29Institute for Translational Sciences

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

30Institute for Translational Sciences

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

31Institute for Translational Sciences

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

32Institute for Translational Sciences

Games are stressful & biologically demanding

• Even sedentary games increase heart rate, etc.

Eating feels pleasurable, reduces stress

• people eat when stressed

Take-home messages

33Institute for Translational Sciences

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

34Institute for Translational Sciences

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

35Institute for Translational Sciences

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