Cognitive Bias to Unhealthy Food is Related to Coping and Family History of Anxiety in Adults




Franks, Susan
Tiu, Cindy
Lee, Michelle
Fulda, Kimberly


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Purpose: 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.