Reducing Cancer Risk by Training Response Inhibition to Obesogenic Foods

 描述(由申请人提供)：饮食选择，尤其是过多的卡路里摄入导致肥胖，是导致癌症的强烈但可逆的危险因素。例如，高固体脂肪和添加糖的食物(沙发)是低营养、高卡路里的食物，通过促进体重增加而增加患癌症的风险。因此，减少沙发的数量符合美国癌症研究所和美国癌症协会的饮食建议。改变饮食的行为干预的长期效果有限，很可能是因为饮食决定是由自动的神经认知过程控制的，而传统干预没有涉及这些过程。特别是，人们越来越多地认识到，克制不食用不健康但随处可得的可口食物的能力取决于抑制控制，即切断由先天引发的行为倾向的能力 驱使人们做出有回报的行为。我们团队和其他人最近的工作表明，基于计算机的抑制控制训练会导致短期的、特定的行为变化，如减少咸味零食、巧克力和酒精饮料的摄入量。一种自动化的、基于家庭计算机的抑制控制培训提供了一种廉价且高度可传播的方法的潜力，可以在广泛的人群中降低癌症风险。因此，我们的目标是评估基于计算机的家庭抑制控制训练的可行性、可接受性、作用机制、有效性和持久性。特别是，我们假设，抑制控制的高重复训练将导致对低沙发饮食的更多坚持，并且效果将通过改善抑制控制来调节。我们进一步假设，对于那些抑制控制受损的人，以及那些对美味食物有最强烈渴望的人，以及那些具有最明确的健康目标的人，培训将是最有效的。最后，我们的目标是检查抑制控制训练对次级结果的影响，包括对总卡路里摄入量的影响，以及对短期减肥的影响。为了实现这些目标，这项拟议的研究将招募150名超重和肥胖的人，他们目前吃高沙发饮食，并希望改善自己的饮食。参与者将被分配为期12周的减少沙发饮食。在一个基准期之后，参与者将被随机地接受为期6周的抑制性控制训练或假训练。为期6周的干预包括每天15分钟的家庭计算机抑制控制训练，随后是2周的强化训练，然后是2周的随访期。饮食遵守情况将通过定制的智能手机应用程序进行衡量，该应用程序将提示重复记录目标食物消耗(即生态瞬时评估；EMA)，并通过自动24小时食物召回来衡量。训练前后将评估神经认知变量，以测试训练的作用机制，适度将通过明确的健康目标、对食欲刺激的内隐态度、男孩体重指数和对食物暗示的反应等基线特征测量来评估。

 DESCRIPTION (provided by applicant): Dietary choices, and in particular, excess calorie intake leading to obesity, are strong, but reversible risk factors for cancer. For example, foods high in solid fats and added sugars (SoFaS) are low-nutrient, high calorie foods that increase the risk of cancer by promoting weight gain. As such, the reduction of SoFaS is consistent with American Institute for Cancer Research and the American Cancer Society dietary recommendations. Behavioral interventions to alter diet have limited long-term efficacy, most likely because eating decisions are governed by automatic neurocognitive processes that are not addressed in conventional interventions. In particular, the ability to refrain from consuming unhealthy, but widely available, palatable foods, is increasingly understood to depend on inhibitory control, i.e., the ability to cut off action tendencies that are put in motion by innate drives towards rewarding behaviors. Recent work by our team and others have demonstrated that computer-based inhibitory control trainings result in short-term, specific changes in behavior, such as reducing intake of salty snack food, chocolate, and alcoholic beverages. An automatized, home computer-based inhibitory control training offers the potential of an inexpensive and highly disseminable method of lowering cancer risk across wide swaths of the population. As such, we aim to evaluate the feasibility, acceptability, mechanism of action, effectiveness and persistence of a home computer-based inhibitory control training. In particular, we hypothesize that a high-repetition training in inhibitory control will result in increased adherence to a low-SoFaS diet, and that effects will be mediated through improved inhibitory control. We further hypothesize the training will be most effective for those starting of with impaired inhibitory control, as well as those with strongest desire for palatable foods and those with strongest explicit health goals. Lastly, we aim to examine the impact of inhibitory control training on secondary outcomes, including on overall caloric intake, and on short-term weight loss. To achieve these aims, the proposed study will recruit 150 overweight and obese individuals who currently eat high-SoFaS diets, and who wish to improve their diets. Participants will be assigned a reduced-SoFaS diet for 12 weeks. After a baseline period, participants will be randomized to receive 6 weeks of either inhibitory control training or a sham training. The 6-week intervention will consist of 15 minutes per day of home computer- based inhibitory control training, and will be followed by a 2-week booster and then 2-week follow-up period. Dietary adherence will be measured via a customized smartphone app that will prompt repeated recording of targeted food consumption (i.e., ecological momentary assessment; EMA) and via automated 24-hour food recall. Neurocognitive variables will be assessed pre and post-training in order to test trainings' mechanism of action, and moderation will be assessed through baseline trait measures of explicit health goals, implicit attitudes towards appetitive stimuli, boy mass index, and responsivity to food cues.