title: Restrictive food intake as a choice--a paradigm for study.
abstract: OBJECTIVE
  Inadequate intake and preference for low-calorie foods are salient behavioral features of Anorexia Nervosa (AN). The neurocognitive mechanisms underlying pathological food choice have not been characterized. This study aimed to develop a new paradigm for experimentally modeling maladaptive food choice in AN.
  
  
  METHODS
  Individuals with AN (n = 22) and healthy controls (HC, n = 20) participated in a computer-based Food Choice Task, adapted for individuals with eating disorders. Participants first rated 43 food images (including high-fat and low-fat items) for Healthiness and Tastiness; an item rated neutral on both blocks was then selected as the Reference item. On each of 42 subsequent trials participants were asked to choose between the food item presented and the Reference item.
  
  
  RESULTS
  The AN group was less likely to choose high-fat foods relative to HC, as evidenced both in multilevel logistic regression (z = 2.59, p = .009) and ANOVA (F(1,39) = 7.80, p = .008) analyses. Health ratings influenced choice significantly more in AN relative to HC (z = 2.7, p = .006), and were more related to Taste among AN (χ(2) = 4.10, p = .04). Additionally, taste ratings declined with duration of illness (r = -.50, p = .02).
  
  
  CONCLUSIONS
  The Food Choice Task captures the preference for low-fat foods among individuals with AN. The findings suggest that the experience of tastiness changes over time and may contribute to perpetuation of illness. By providing an experimental quantitative measure of food restriction, this task opens the door to new experimental investigations into the cognitive, affective, and neural factors contributing to maladaptive food choices characteristic of AN.
authors.affiliation: Department of Psychiatry, Columbia University Medical Center, New York, New York; Psychology Department, New York State Psychiatric Institute, New York, New York.
authors.forename: Joanna
authors.initials: J
authors.lastname: Steinglass
authors.forename: Karin
authors.initials: K
authors.lastname: Foerde
authors.forename: Katrina
authors.initials: K
authors.lastname: Kostro
authors.forename: Daphna
authors.initials: D
authors.lastname: Shohamy
authors.forename: B Timothy
authors.initials: BT
authors.lastname: Walsh
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000503:physiopathology / Q000523:psychology*; D016022:Case-Control Studies; D002755:Choice Behavior; D004435:Eating / Q000523:psychology*; D005260:Female; D005518:Food Preferences / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D011795:Surveys and Questionnaires; D013649:Taste; D014584:User-Computer Interface; D055815:Young Adult
keywords: anorexia nervosa; cognitive neuroscience; eating behavior; eating disorders; neuropsychology