Eating attentively: a systematic review and meta-analysis of the effect of food intake memory and awareness on eating1,2,3,4
Eric Robinson, Paul Aveyard, Amanda Daley, Kate Jolly, Amanda Lewis, Deborah Lycett, and Suzanne Higgs
+ Author Affiliations
1From the University of Birmingham, Edgbaston, United Kingdom.
+ Author Notes
↵2 Supported by the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, and the Department of Health, under the auspices of the UK Clinical Research Collaboration (an NIH National School for Primary Care grant) (all to PA). PA was supported by The UK Centre for Tobacco Control Studies—a UKCRC Public Health Research Centre of Excellence.
↵3 The new affiliation for PA is Department of Primary Care, University of Oxford, Oxford, United Kingdom.
↵4 Address correspondence to E Robinson, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, L69 7ZA, UK. E-mail: firstname.lastname@example.org.
Background: Cognitive processes such as attention and memory may influence food intake, but the degree to which they do is unclear.
Objective: The objective was to examine whether such cognitive processes influence the amount of food eaten either immediately or in subsequent meals.
Design: We systematically reviewed studies that examined experimentally the effect that manipulating memory, distraction, awareness, or attention has on food intake. We combined studies by using inverse variance meta-analysis, calculating the standardized mean difference (SMD) in food intake between experimental and control groups and assessing heterogeneity with the I2 statistic.
Results: Twenty-four studies were reviewed. Evidence indicated that eating when distracted produced a moderate increase in immediate intake (SMD: 0.39; 95% CI: 0.25, 0.53) but increased later intake to a greater extent (SMD: 0.76; 95% CI: 0.45, 1.07). The effect of distraction on immediate intake appeared to be independent of dietary restraint. Enhancing memory of food consumed reduced later intake (SMD: 0.40; 95% CI: 0.12, 0.68), but this effect may depend on the degree of the participants' tendencies toward disinhibited eating. Removing visual information about the amount of food eaten during a meal increased immediate intake (SMD: 0.48; 95% CI: 0.27, 0.68). Enhancing awareness of food being eaten may not affect immediate intake (SMD: 0.09; 95% CI: −0.42, 0.35).
Conclusions: Evidence indicates that attentive eating is likely to influence food intake, and incorporation of attentive-eating principles into interventions provides a novel approach to aid weight loss and maintenance without the need for conscious calorie counting.
Received June 21, 2012.
Accepted December 27, 2012.