The Development and Validation of the Food Memory Bias Test for a Large-Scale Epidemiological Study in a Multiethnic Asian Population.

BACKGROUND: Memory influences decision-making regarding eating behaviour. However, marketing utilises our memory to exploit our consumptive habits. Whether we have an inherent bias towards memorising visual cues associated with high-calorie foods and how such bias contributes to our health outcomes remains to be determined. We therefore aimed to develop and validate a computerized, image-based Food Memory Bias Task (FMBT) for use in multiethnic Asian populations. METHODS: In the development phase involving 172 participants, 91.9% rated the instrument as user-friendly and we optimised the instrument format into 12 visual food cues and 30-min delay period to avoid a ceiling effect. In the validation phase involving 184 multi-ethnic Asian participants (49.3 (14.5) years old, 44.6% male, 71.7% Chinese), FMBT memory score was associated with the brief assessment of cognition memory (β(p) = 0.23 (5.1 × 10-6)), and general cognition score 'g' (β(p) = 0.30 (6.5 × 10-9)). RESULTS: Higher memory bias was associated with lower memory score in the low-calorie bias group (r=-0.33, p=0.002), but not in the hig h-calorie bias group. In this present study, despite randomly administering two versions of the test across visits, the FMBT bias score demonstrates a significant learning effect and low reproducibility (r(p) = -0.14 (0.11) across visits). Food memory bias score is associated with higher food approach traits according to the Adult-Eating Behaviour Questionnaire (β(p) = 0.23(0.015)), independent of age, sex, and ethnicity. CONCLUSION: FMBT provides an opportunity to address epidemiological questions on how food memory bias influences dietary habit and cardiometabolic health, and how it is in turn shaped by our built environment.