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Do you study eating behavior, #nutrition, food insecurity, or #obesity? If so, check out our new pub, “Experimentally Manipulated Low Social Status & Food Insecurity Alter Eating Behavior among Adolescents: A RCT” in Obesity"
Pub: https://onlinelibrary.wiley.com/doi/full/10.1002/oby.23002
Thread on findings
:
Pub: https://onlinelibrary.wiley.com/doi/full/10.1002/oby.23002
Thread on findings
:
Methods:
-Randomized 133 Hispanic adolescents to high social status (HIGH) or low status (LOW) condition using rigged Monopoly game
-Participants fasted for 12 hours prior to study
-Given standardized breakfast
-Participants completed questionnaires & told they were 'tests'
-Randomized 133 Hispanic adolescents to high social status (HIGH) or low status (LOW) condition using rigged Monopoly game
-Participants fasted for 12 hours prior to study
-Given standardized breakfast
-Participants completed questionnaires & told they were 'tests'
Acute energy intake in lunch meal measured by food scales.
24‐hr energy balance assessed via summation of resting metabolic rate (metabolic cart), physical activity energy expenditure (accelerometer), thermic effect of food, and subtraction of 24-hr energy intake (food diary).
24‐hr energy balance assessed via summation of resting metabolic rate (metabolic cart), physical activity energy expenditure (accelerometer), thermic effect of food, and subtraction of 24-hr energy intake (food diary).
At start of 40-minute rigged Monopoly game, participants randomized to HIGH were told: "Congratulations, based on your test scores, you have been given the Rolls-Royce piece."
HIGH=Rolls Royce piece, starting off w $2000, $200 when pass 'Go', use both die, role of the banker
HIGH=Rolls Royce piece, starting off w $2000, $200 when pass 'Go', use both die, role of the banker
Participants randomized to LOW were told: "I’m sorry, based on your test scores, you have been given the shoe piece."
LOW=Using Shoe game piece, starting off with $1000, $100 when pass 'Go', use only one die (AKA can't 'roll' doubles to get out of jail)
LOW=Using Shoe game piece, starting off with $1000, $100 when pass 'Go', use only one die (AKA can't 'roll' doubles to get out of jail)
What this game does in a laboratory setting is allows for an approximation of what we see in society where we have these cycles of poverty and these cycles of privilege, and where you end up often has a lot to do with the resources you start off with.
After playing the game for 40 minutes, participants were placed in a room alone for 20 minutes to consume a lunch buffet meal. We measured everything they ate in that room and assessed 24-hour energy balance.
A priori hypotheses: See differences between HIGH/LOW and by sex.
A priori hypotheses: See differences between HIGH/LOW and by sex.
Results:
Adolescent girls and boys exhibited different eating behaviors in response to being randomized to LOW or HIGH social status conditions.
HIGH boys consumed significantly more at lunch (46% of their daily energy needs) versus LOW boys (37% daily energy needs, P=0.001)
Adolescent girls and boys exhibited different eating behaviors in response to being randomized to LOW or HIGH social status conditions.
HIGH boys consumed significantly more at lunch (46% of their daily energy needs) versus LOW boys (37% daily energy needs, P=0.001)
Conversely (and consistent with our hypotheses) HIGH girls tended to consume slightly less at lunchtime (34% of their daily energy needs) versus LOW girls (38%, P=0.291).
Pretty much everyone was in positive energy balance.
When looking at 24-hr energy balance after game, HIGH boys continued to consume 445 kcal more than LOW boys. LOW girls consumed a surplus ~200 kcal more than HIGH girls. Differences in both groups trended toward significance.
When looking at 24-hr energy balance after game, HIGH boys continued to consume 445 kcal more than LOW boys. LOW girls consumed a surplus ~200 kcal more than HIGH girls. Differences in both groups trended toward significance.
During post-game lunchtime meal, study participants who were food insecure in their daily life consumed about 41% of their daily energy while participants who were food secure in their daily life ate less at lunch, consuming only about 36% of their daily energy intake (p=0.08).
Participants’ perceptions changed significantly over the course of the game as well. Those in HIGH reported significantly higher perceptions of powerfulness relative to those in LOW.
We wondered if what we were observing was simply differences in stress however, we saw no differences in:
-Perceived stress
-Salivary cortisol
-Heart rate
-Blood pressure
-Perceived stress
-Salivary cortisol
-Heart rate
-Blood pressure
Conclusion: Experiencing a lower social status position, even for a short time, could have differential effects on eating behavior by sex & may have an effect on obesity by promoting excess calorie consumption & positive energy balance among women and/or people w food insecurity.
Take Home Message for Researchers:
-Experiencing inequity, poverty, discrimination, racism, stigma or food insecurity may serve as an obesogenic environment in and of itself
-Recognize that these experiences often cluster together and could have cumulative effects
-Experiencing inequity, poverty, discrimination, racism, stigma or food insecurity may serve as an obesogenic environment in and of itself
-Recognize that these experiences often cluster together and could have cumulative effects
Take Home Message for Researchers:
-Assess factors like socioeconomic status, subjective social status (how people perceive themselves on the social ladder), experiences with stigma and discrimination, and food insecurity in your nutrition, eating behavior, & obesity studies.
-Assess factors like socioeconomic status, subjective social status (how people perceive themselves on the social ladder), experiences with stigma and discrimination, and food insecurity in your nutrition, eating behavior, & obesity studies.
Take Home Message for Clinicians:
-Take time to assess the social aspects of your patient's lives. This can *very much* influence their ability to adhere to a variety of behavioral, nutritional, physical activity, sleep, medication, ect. recommendations.
-Take time to assess the social aspects of your patient's lives. This can *very much* influence their ability to adhere to a variety of behavioral, nutritional, physical activity, sleep, medication, ect. recommendations.
Excellent drawing of these results, and the results from others by @susanprescott88 who founded @inVIVO_Planet and showed this at a past presentation.
If you want to read more, here is the link to our new 2020 study on this topic: https://onlinelibrary.wiley.com/doi/full/10.1002/oby.23002
Link to our proof of concept paper published in 2016 on this topic: https://pubmed.ncbi.nlm.nih.gov/27094920/
Link to an article published by @medpagetoday on our newest study and presentation at @ObesityWeek in the @ObesitySociety Journal Symposium: https://www.medpagetoday.com/meetingcoverage/obesityweek/89526
Most importantly, thanks to the many members in the Cardel Lab group who made this study happen and my collaborators including those on Twitter: @corossus @DarciMPH @AlexLee_AML @EmilyDhurandhar @AnnieCPhD @AliciaFMD.
Here is the final infographic (split in parts) for our RCT experimentally manipulating social status using a rigged Monopoly game to assess effects on acute eating behavior and 24-hour energy balance among Hispanic American adolescents ages 15-21 years old.
Here is the final infographic (split in two parts) for our RCT experimentally manipulating social status using a rigged Monopoly game to assess effects on acute eating behavior and 24-hour energy balance among Hispanic American adolescents ages 15-21 years old.
