Psychological Strategies for the Development of Healthy Eating Habits and Self-Care

Dear Colleagues,

Obesity has reached epidemic proportions globally. In Spain, around 16% of the population, aged 18 years and over, suffer from obesity, and 38% are overweight [1]. Increased adiposity is widely recognized as among the major public health threats, as it increases the risk of most leading causes of death around the world, such as cardiovascular disease, diabetes, and cancer [2,3]. People suffering from obesity are also more vulnerable to infectious diseases [4]. In the context of the current coronavirus pandemic, obesity has been shown to be an important risk factor for severe COVID-19, including in young patients with no other risk factors [5,6]. Therefore, the development of effective weight management strategies for obesity is paramount. Evidence suggests that even a modest weight loss, as low as 5% of initial body weight, produces significant health benefits and decreases risk factors related to obesity [7,8]. One of the key causes of obesity lies in habits that lead to excessive energy consumption, such as eating too large portions of food [9]. In this regard, studies show that the size of food portions has increased over time and changed the population’s perception of what an appropriate amount to eat in a single eating occasion should look like, a phenomenon known as portion distortion [10]. However, urging people to “eat less” of all foods might be challenging as individuals are used to consuming a certain volume of food to feel [11,12]. Instead, a more effective approach may be to help people lower the energy density of their meals, that is, the amount of energy (kcal) provided by the given weight of food (g). This may be achieved by increasing the amount of low-energy-dense foods in the diet, such as fruits and vegetables, and foods rich in water and low in fat (e.g., broth-based soups), while limiting amounts of high-energy-dense foods, such as starchy and fatty foods [13,14]. The above-mentioned changes in eating patterns would allow individuals not only to eat satisfying portions, reducing post-meal hunger sensations, but also to increase their diet quality, leading to beneficial health effects [15,16].

Over the past few years, different portion control tools have been commercialized that claim to help people manage their weight and eat healthier. A recent systematic review identified and categorized a wide variety of such instruments, which ranged from different components of tableware to cooking utensils, educational aids, and web-based or mobile software [17]. Therefore, and bearing in mind the above, the objective of this topic is to present a body of knowledge related to the development of studies on psychological strategies aimed at controlling intake and developing healthier eating habits (nutritional self-care). 

References

1. EESE. Encuesta Europea de Salud en España 2020. Avalible online: https://www.sanidad.gob.es/estadEstudios/estadisticas/EncuestaEuropea/EncuestaEuropea2020/
Metodologia_EESE_2020.pdf (accessed on 15 November 2022).
2. WHO. Obesity: Health consequences of being overweight. 2013. Avalible one: https://www.who.int/news-room/questions-and-answers/item/obesity-health-consequences-of-being-overweight (accessed on 15 November 2022).
3. NHLBI. Managing Overweight and Obesity in Adults: Systematic Evidence Review from the Obesity Expert Panel. 2013. Avalible online: https://www.nhlbi.nih.gov/health-topics/managing-overweight-obesity-in-adults (accessed on 15 November 2022).
4. Falagas, M.E.; Kompoti, M. Obesity and infection. Lancet Infect. Dis. 2006, 6, 438–446.
5. WOB. COVID-19 and Obesity: The 2021 Atlas. 2021. Avalible online: https://www.worldobesity.org/resources/resource-library/covid-19-and-obesity-the-2021-atlas (accessed on 15 November 2022).
6. Chua, M.W.J.; Zheng, S. Obesity and COVID-19: The clash of two pandemics. Obes. Res. Clin. Pract. 2020, 14, 380–382.
7. Blackburn, G. Effect of Degree of Weight Loss on Health Benefits. Obes. Res. 1995, 3, 211s-216s.
8. Wing, R.R.; Lang, W.; Wadden, T.A.; Safford, M.; Knowler, W.C.; Bertoni, A.G. Hill, J.O.; Brancati, f.l.; Peters, A.; Wagenknecht,L.; et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011, 34, 1481–1486.
9. Borer, K.T. Why we eat too much, have an easier time gaining than losing weight, and expend too little energy: Suggestions for counteracting or mitigating these problems. Nutrients 2021, 13, 3812.
10. Steenhuis, I.H.; Vermeer, W.M. Portion size: review and framework for interventions. Int. J. Behav. Nutr. Phys. Act. 2009, 6, 58.
11. Bell, E.A.; Rolls, B.J. Energy density of foods affects energy intake across multiple levels of fat content in lean and obese women. Am. J. Clin. Nutr. 2001, 73, 1010–1018.
12. Shrapnel, B. Is energy density a useful concept for understanding and preventing obesity? Nutr. Diet. 2010, 67, 281–286.
13. Smethers, A.D.; Rolls, B.J. Dietary Management of Obesity: Cornerstones of Healthy Eating Patterns. Med. Clin. North Am. 2018, 102, 107–124.
14. Rolls, B.J. Dietary energy density: Applying behavioural science to weight management. Nutr. Bull. 2017, 42, 246–253.
15. Rolls, B.J. What is the role of portion control in weight management? Int. J. Obes. 2014, 38, S1-S8.
16. Gil, Á., de Victoria, E.M.; Olza, J. Indicadores de evaluación de la calidad de la dieta. Nutr. Hosp. 2015, 31, 128–144.
17. Vargas-Alvarez, M.A.; Navas-Carretero, S.; Palla, L.; Martínez, J.A.; Almiron-Roig, E. Impact of portion control tools on portion size awareness, choice and intake: Systematic review and meta-analysis. Nutrients 2021, 13, 1978.

Dr. Elkin O. Luis
Dr. Martín Martínez Villar
Guest Editors

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