Browsing by Author "Tiu, Cindy"
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Item Cognitive Bias to Unhealthy Food is Related to Coping and Family History of Anxiety in Adults(2017-03-14) Franks, Susan; Tiu, Cindy; Lee, Michelle; Fulda, Kimberly; Mandy, FanniPurpose: Stress has shown an influence on food intake, especially for women who are emotional eaters under stressful conditions and use eating as a coping mechanism. Recent studies have aimed to determine the role of cognitive bias (CB) as a neurocognitive process of selective attention to unhealthy foods. However, food-related CB is not yet well-characterized. Thus, the purpose of this study was to explore relationships between stress (STR), emotional eating (EE), coping (COP), anxiety (ANX), and CB toward unhealthy foods. Additionally, it was hypothesized that CB would differ between men and women and between normal-weight and overweight subjects. Methods: Participants included adult men and women (n = 59) with an average age of 31.38 years (sd = 12.24) and an average BMI of 24.60 kg/m2 (sd = 5.44). Self-report surveys included demographics, the State-Trait Anxiety Inventory to measure state ANX, and the Eating and Appraisal Due to Emotions and Stress to measure STR, EE, and COP. A computerized Stroop Task measured response time (RT) to healthy and unhealthy food words as compared to neutral words. CB scores to unhealthy foods were calculated (unhealthy RT–healthy RT), and subjects were categorized into higher or lower CB based on the direction of CB from zero. CB across weight class, gender, and family histories (FH) of obesity and anxiety were analyzed using chi-square tests. EE, STR, COP, and ANX were analyzed between high and low CB with Mann-Whitney U and t-tests. Results: A higher CB to unhealthy food cues was greater among subjects without a FH of anxiety (n = 21, 58.3%) as compared to subjects with a FH of anxiety (n = 7, 33.3%). This difference approached significance (p = .069). COP was significantly lower for a higher CB to unhealthy food cues (mean = 79.68) as compared to a lower CB (mean = 83.97), (p = .031). Other comparisons were non-significant. Conclusions: An inadequate ability to cope with stress may promote a propensity to selectively attend to unhealthy foods. A family history of anxiety may be a moderating factor for developing cognitive bias toward unhealthy foods. This study reiterates the multi-factorial complexity of cognitive bias to food cues and reinforces the need for additional research. Acknowledgments: Research reported in this publication was supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number R25HL125447 to Dr. J.K. Vishwanatha. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.Item Personal, Psychological, and Family History Risk Factors for Emotional Eating Related to Obesity(2018-03-14) Franks, Susan; Williams, Trevor; Goyer, Alexandria; Muzaffar, Omair; Fulda, Kimberly; Tiu, CindyPurpose: The concept that emotion strongly influences eating, referred to as “emotional eating” (EE), recently gained interest. Previous evidence suggested that overeating by overweight individuals reduces anxiety. The obesity literature indicated EE significantly differentiates obese from normal weight individuals. However, little is known about what other factors contribute to EE. This study aims to better understand risk factors that might be associated with EE. We anticipated that people with higher EE would be more likely to have family histories of anxiety or obesity, and would have more anxiety and stress, poorer coping skills, and higher BMI than people with lower EE. Methods: Participants included adult men and women (n=97) with an average age of 30.78 years (sd=12.86) and an average BMI of 25.19 kg/m2(sd=5.69). Surveys included demographics, the State-Trait Anxiety Inventory to measure state ANX, and the Eating and Appraisal Due to Emotions and Stress to measure STR, EE, and COP.Subjects were categorized into higher and lower EE based on a mean split. Chi-square analysis was used to analyze differences in EE for FH of obesity and FH of anxiety. T-tests were used to analyze differences between high and low EE for ANX, STR, COP, and BMI. Results: FH of obesity differed significantly by EE(x2=.009). Among high EE, 46.7% had a FH of obesity whereas among low EE 27.9% had a FH of obesity. FH of anxiety differed significantly by EE (x2=.045). Among high EE, 47.8% had a FH of anxiety whereas among low EE 28.0% had a FH of anxiety. When comparing individuals with high and low EE, state anxiety was higher for high EE (mean=36.09, sd=10.47) as compared to low EE (mean=31.28, sd=9.24) (t=2.41, p=.018). Stress was higher for high EE (mean=12.72, sd=3.11) as compared to low EE (mean=13.92, sd=2.89) (t= -1.98, p=.051). Coping was lower for high EE (mean=78.24, sd=8.57) as compared to low EE (mean=82.90, sd=9.21) (t= -2.57, p=.012). BMI was higher for high EE (mean=26.52, sd=7.02) as compared to low EE (mean=23.99, sd=3.87) (t= 2.22, p=.029). Conclusions: EE is more likely with higher anxiety and poor coping skills. Additionally, a FH of obesity or anxiety appears to put individuals at risk for EE. Clinicians should be aware of the factors related to EE in order to identify patients who may be emotional eaters and provide targeted interventions in order to prevent obesity and promote weight loss.Item Personal, Psychological, and Family History Risk Factors for Emotional Eating Related to Obesity (2017)(2017-03-14) Franks, Susan; Mandy, Fanni; Lee, Michelle; Fulda, Kimberly; Tiu, CindyBackground: The concept that emotion strongly influences eating, referred to as “emotional eating” (EE), recently gained considerable interest in research. Previous evidence suggested that overeating by overweight individuals reduces anxiety and drives hyperphagia leading to obesity. The obesity literature indicated EE significantly differentiates obese from normal weight women. However, little is known about what other factors may contribute to EE. This exploratory study aims to better understand personal, psychological, and family history factors that might be associated with EE. Factors explored included gender, weight class, coping (COP), anxiety (ANX), stress (STR), and family histories (FH) of obesity and anxiety. Methods: Participants included adult men and women (n=59) with an average age of 31.38 years (sd=12.24) and an average BMI of 24.60 kg/m2 (sd=5.44). Self-report surveys included demographics, the State-Trait Anxiety Inventory to measure state ANX and the Eating and Appraisal Due to Emotions and Stress to measure STR, EE, and COP. Subjects were categorized into high and low EE based on standard error distance from the median. Chi square analyses were used to compare high and low EE with gender, weight class, FH of obesity, and FH of anxiety. T-tests were used to analyze differences between high and low EE for COP and STR. Results: EE was greater among women (n=14, 70.0%) than men (n=3, 21.4%), p=005. EE was greater with a FH of obesity (n=7, 77.8%) as compared to subjects without a FH (n=9, 37.5%), (p=.039). EE was greater among subjects with a FH of anxiety (n=10, 71.4%) as compared to subjects without a FH (n=7, 36.8%), p=.049. Coping was lower for subjects with higher EE (mean=80.00) as compared to subjects with lower EE (mean=84.94), p=.050. Anxiety was higher for subjects with higher EE (mean=36.13) as compared to subjects with lower EE (mean=29.06), p=.027. There were no differences in EE for weight class or recent stress. Conclusions: Women appear to be more at risk for EE than men. EE is also more likely with higher anxiety and poor coping skills. Additionally a FH of obesity or anxiety appears to put individuals at risk for EE. Clinicians should be aware of the factors related to EE in order to identify patients who are at risk and provide targeted interventions in order to prevent obesity and promote weight loss. Acknowledgement: Research reported in this publication was supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number R25HL125447 to Dr. J.K. Vishwanatha. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.Item Qualitative Analysis of the Reasons People with Spinal Cord Injury Opt to Enroll in an Exercise Program and their Barriers to Participation(2019-03-05) Ochoa, Christa; Froehlich-Grobe, Katherine; Tiu, CindyObjective: Understand why people with spinal cord injury (SCI) enrolled in an online exercise trial, what barriers to exercise they cited, and their plans to address these barriers. Design: Qualitative study of participant responses during a 16-week online exercise trial where they completed weekly online modules that included completing skill building activities. Participants/methods: Eligible individuals experienced a SCI [greater than] 6 months, required wheelchair use outside the home, and reported/week. Advertisements were disseminated through SCI-specific organizations across the U.S. Qualitative data from participant responses were analyzed by identifying themes that emerged from responses to online activities. Two researchers independently read and coded all responses. All disagreements were discussed and final coding decisions were unanimously achieved with the principal investigator. Results: Participants (n=111) average age was 49.6 years old and they lived average of 14.3 years post-injury. Health reasons emerged as the leading reasons participants enrolled in the exercise trial. Nearly two-thirds (64.9%) of participants stated they joined the program to improve their health while over half (56.8%) reported a desire to improve their function. Time was noted as the leading exercise barrier (53.8%) and a quarter (27.7%) reported accessibility issues. Participant-generated solutions to address time constraints included scheduling exercise (68.2%) or using friends or technology to support (15.9%) exercise efforts. Accessibility issue solutions included locating accessible facilities (30%) and obtaining equipment (25%) for home use. Conclusion: Health issues emerged as the primary reason people with SCI enrolled in the study. Health issues included those similar to the general population regarding improving cardiovascular health and longevity and SCI-specific issues, such as improving function related to activities of daily living. Exercise barriers followed a similar pattern, with the predominant concern being lack of time and the second most commonly cited barrier being accessibility problems. Accessibility issues included lack of accessible facilities, equipment, and need for self-advocacy. Intervention approaches to promote exercise for people with SCI should address issues faced by those in the general population as well as SCI-specific issues.