1. In this randomized control trial, following Pavlovian conditioning fruit consumption was associated with decreased distress.
2. Participants in the intervention group had similar improvements in negative mood when consuming traditional comfort foods.
Evidence Rating Level: 2 (Good)
Over one third of adults report experiencing high levels of stress on a daily basis. Traditional comfort foods which are high in fat and sugar are commonly used as a coping mechanism for stress by adults in the United States. Alternatively, increased fruit intake has been correlated with improved cardiovascular health and may represent a healthy alternative to traditional comfort foods for managing stress. In order to associate fruit with feelings of comfort, Pavlovian conditioning may be leveraged.
In the present randomized control trial, participants were randomized to either undergo progressive muscle relaxation while consuming fruit or progressive muscle relaxation unpaired with fruit consumption. Inclusion criteria were age over 18, English fluency, access to a smartphone with internet and camera access, moderate-to-high baseline stress, and neutral feeling about fruit consumption. Participants were excluded who were dieting, had a history of a substance use or eating disorder, current psychiatric diagnosis, or current significant illness. The primary outcome was perceived stress using the Positive and Negative Affect Schedule.
A total of 100 participants were included, of which half were randomized into the intervention (n=50) and control (n=50) groups. Following the intervention, fruit consumption significantly improved mood in the conditioning group as compared to the control group. Additionally, when compared to traditional comfort foods high in fat and sugar, fruit had a comparable positive impact on mood. However, the major limitations of the trial were that participants self-recorded fruit intake and that exclusion of those with psychiatric disorders limited generalizability of the results. In summary, Pavlovian pairing of fruit intake with progressive muscle relaxation may cause comparable improvements in distress as consumption of traditional comfort foods.
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