Food insecurity affects approximately 8.4 million people in the UK, one of the worst levels in Europe.Food insecurity is associated with poor diet quality and obesity; however, the drivers of this relationship are unclear. This study used a qualitative approach to explore factors that influence food choice and eating behaviour in a food-insecure population in Liverpool, UK. Face-to-face interviews were conducted with adults (N=24) who were clients at foodbanks. The interviews were informed by a semi-structured interview schedule, which focussed on access to food, factors influencing food choices, and strategies used to conserve food. Interview transcripts were analysed using inductive thematic analysis. Six themes were identified; 'Income', 'Cost of food', 'Accessibility of shops', 'Health issues', 'Food rationing strategies' and 'Worsened health outcomes'. Income was the most salient factor influencing participants' food choices with all participants reporting a constant struggle to afford food. Food decisions were primarily based on cost; most participants valued eating healthily but could not afford to do so. Strategies to ration food included skipping meals, consuming small portions, cooking in bulk, and prioritising children's food intake. The majority of participants reported pre-existing physical and/or mental health issues, but these were exacerbated by poor access to food leading to a vicious cycle of stress and worsening health issues. In conclusion, participants' food choices and eating behaviour seemed to be most strongly influenced by their level of income. Findings also highlight the mental health impact of food insecurity. Initiatives addressing income and the cost of healthy food are required.

Objectives Bariatric surgery is an effective weight loss tool, but an under-communicated side effect may include the increased risk for alcohol problems. Few studies have examined contributors towards alcohol problems following surgery using a qualitative approach. Therefore, the current study aimed to generate insight informed by participants with problematic alcohol use following bariatric surgery, in comparison with participants without. Methods Participants (14; females, n = 9; males, n = 5) completed semi-structured interviews using questions relating to alcohol use, relationship to food, support and surgical experiences. Thematic analysis was conducted to provide insight into the factors which influenced drinking behaviours that participants engaged in following bariatric surgery, and motivations for drinking or limiting alcohol. Results Five core themes were identified between both participants with and without problematic alcohol use: (1) drinking motivations, (2) self-image, (3) impact of restriction on eating behaviour, (4) support needs and (5) surgical preparedness. A sixth core theme (Bresilience^) was identified specifically amongst participants without problematic alcohol use. Divergent experiences, cognitions and behaviours formed sub-themes within the five core themes and highlighted the differences between participants with and without problematic alcohol use within the core themes. Conclusion This study is the first to qualitatively assess themes relating to the development of problematic alcohol use after bariatric surgery while additionally using a comparison group without problematic alcohol use. The findings highlight key features which contribute to problematic alcohol use, as well as experiences and cognitions that may be helpful in preventing this phenomenon in bariatric populations.

Food insecurity affects approximately 8.4 million people in the UK, one of the worst levels in Europe.Food insecurity is associated with poor diet quality and obesity; however, the drivers of this relationship are unclear. This study used a qualitative approach to explore factors that influence food choice and eating behaviour in a food-insecure population in Liverpool, UK. Face-to-face interviews were conducted with adults (N=24) who were clients at foodbanks. The interviews were informed by a semi-structured interview schedule, which focussed on access to food, factors influencing food choices, and strategies used to conserve food. Interview transcripts were analysed using inductive thematic analysis. Six themes were identified; 'Income', 'Cost of food', 'Accessibility of shops', 'Health issues', 'Food rationing strategies' and 'Worsened health outcomes'. Income was the most salient factor influencing participants' food choices with all participants reporting a constant struggle to afford food. Food decisions were primarily based on cost; most participants valued eating healthily but could not afford to do so. Strategies to ration food included skipping meals, consuming small portions, cooking in bulk, and prioritising children's food intake. The majority of participants reported pre-existing physical and/or mental health issues, but these were exacerbated by poor access to food leading to a vicious cycle of stress and worsening health issues. In conclusion, participants' food choices and eating behaviour seemed to be most strongly influenced by their level of income. Findings also highlight the mental health impact of food insecurity. Initiatives addressing income and the cost of healthy food are required.

Background Participation in temporary alcohol abstinence campaigns such as ‘Dry January’ may prompt enduring reductions in alcohol consumption. A randomized controlled trial (RCT) is required to establish any long-term benefits or negative consequences of temporary abstinence. In the present study, we randomized heavy drinkers to complete or intermittent alcohol abstinence for 4 weeks, in order to evaluate the feasibility of conducting a large-scale RCT. Methods This was a mixed methods feasibility study in which we explored recruitment and retention to a randomized trial, compliance with alcohol abstinence instructions and barriers to compliance, and acceptability of study procedures (primary feasibility outcomes). A community sample of women aged between 40 and 60 who drank in excess of 28 alcohol units per week were randomized to abstain from alcohol for 4 weeks either completely or intermittently (at least four abstinent days per week). To monitor compliance, both groups provided regular breath samples on a cellular breathalyser. A subsample completed a semi-structured interview that probed barriers to compliance with abstinence instructions and acceptability of study procedures. Results Within 5 months, we recruited, screened and randomized 25 participants (20% of participants who responded to advertisements: 14 in the complete abstinence group, 11 in the intermittent abstinence group), 24 of whom were retained throughout the 28-day intervention period. Participants in both groups tended to comply with the instructions: the median number of breathalyser-verified abstinent days was 24 (IQR = 15.5–25.0; 86% of target) in the complete abstinence group versus 12 (IQR = 10–15; 75% of target) in the intermittent abstinence group. Semi-structured interviews identified some barriers to compliance and methodological issues that should be considered in future research. No adverse events were reported. Conclusions It is feasible to recruit heavy drinking women from community settings and randomize them to either complete or intermittent abstinence from alcohol for 4 weeks. The majority of participants were retained in the study and compliance with the abstinence instructions was good, albeit imperfect. A comprehensive RCT to compare temporary alcohol abstinence with other alcohol reduction strategies on long-term alcohol consumption is feasible. Findings from such a trial would inform implementation of alcohol campaigns and interventions.

Background: Negative personality characteristics have been implicated in promoting overconsumption of both alcohol and food. Furthermore, positive motivations (enhancement) and negative motivations (coping) may mediate the association between personality and alcohol or food (over)consumption. Objectives: The present study hypothesised that i.) drinking to cope and ii.) eating to cope would mediate the association between hopelessness/anxiety sensitivity and hazardous drinking/unhealthy snacking, respectively, and iii.) eating and drinking to cope would represent separate strategies. Methods:Participants were recruited via opportunity sampling through university schemes, social media, email and web page advertisements. Questionnaires included the Alcohol Use Disorders Identification Test, Substance Use Risk Profile Scale, Modified Drinking Motives Questionnaire Short Form, Palatable Eating Motives Scale and Snack/Meal Food Intake Measure. Results: Participants were 198 undergraduates, weight-related research volunteers and the public (83% female; 90% university educated). The hypothesised structural model fit the data well. As predicted, there were significant indirect associations between negative personality characteristics, hazardous drinking and unhealthy snacking via coping; specifically, individuals higher in anxiety sensitivity/hopelessness used food or alcohol to cope which, in turn, significantly predicted unhealthy snacking, and hazardous drinking, respectively. Importantly, drinking and eating to cope represented outcome-specific strategies, indicated by no significant association between eating to cope and hazardous drinking, or between drinking to cope and snacking. Conclusions: The current study demonstrates that coping motivations are critical to the relationship between negative personality characteristics and unhealthy behaviors and highlights the distinct negativereinforcement pathways associated with hazardous drinking and unhealthy snacking in majority university-educated females from the U.K.