Typology of eating episodes in children and adolescents with overweight/obesity

BACKGROUND

Research suggests that youth with overweight/obesity can be subtyped according to disinhibited eating tendencies. No research has attempted to subtype classes of eating episodes along sensational, psychological, and hedonic dimensions.

METHODS

Youth (N = 39; 55% female) aged 8-14 y with overweight/obesity completed a 2-week ecological momentary assessment protocol in which they reported on all eating episodes and their sensational, environmental, affective, and interpersonal contexts. Latent profile analysis (LPA) was used to classify episodes based on loss of control (LOC) while eating, self-reported overeating, food palatability, hunger, and cravings. Classes were compared on affective, interpersonal, appearance-related, and environmental correlates using Wald chi-square tests.

RESULTS

LPA identified three classes of eating episodes involving high levels of LOC/self-reported overeating ("binge-like" class), low levels of hunger ("eating-in-the-absence-of-hunger" class), and high hunger and cravings ("appetitive eating" class). Binge-like eating was associated with the highest levels of body dissatisfaction, interpersonal distress, and positive affect, and was most likely to occur in the after-school hours.

CONCLUSIONS

Binge-like eating tends to occur in a psychological context relative to other types of eating episodes in youth with overweight/obesity. Future research should explore whether certain classes of eating episodes are associated with distinct weight trajectories over time.

Multi-state modeling of thought-shape fusion using ecological momentary assessment

Body dissatisfaction (BD) and preoccupation with thoughts of food (PTF) are intertwined and are components of thought-shape fusion. Thought-shape fusion describes the process by which PTF lead to beliefs about weight and shape. To study thought-shape fusion in daily life and explore various transitions between BD and PTF, 30 women with binge eating completed ecological momentary assessment for 14 days. BD and PTF were assessed using continuous rating scales at each prompt. Multi-state modeling, which analyzes micro-temporal transitions between discrete states, was used to examine transitions among four states created with BD and PTF ratings. The four states included low BD/low PTF, low BD/high PTF, high BD/low PTF, and high BD/high PTF. Affect and disordered eating were examined as covariates of state transitions. Results showed high BD states were self-perpetrating, such that when in high BD states, transition to low BD states were less likely. Regarding covariates, positive affect buffered against maladaptive transitions whereas negative affect and disordered eating increased risk. Findings highlighted high BD states as influential, and negative affect and disordered eating as risk factors and positive affect as preventive. This study enhances theory of thought-shape fusion and implicates transitions from BD to PTF as possible underlying transitions.

An updated transdiagnostic review of social cognition and eating disorder psychopathology

Existing data suggest that deficits in social cognitive functioning are transdiagnostic phenomena that are observed across various forms of psychopathology. The goal of the present review was to provide an updated systematic review of the literature on social cognitive functioning across eating disorders (EDs), including anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Studies that assessed six areas of social cognition were included: theory of mind, social perception, social knowledge, attributional bias, emotion perception, and emotion processing. A systematic search identified 71 studies, the majority of which examined adult women with AN. Research typically focused on alexithymia, theory of mind, empathy, social processing, emotion recognition, or emotion processing. Results suggested some deficits in social cognition in EDs. AN had the most studies with some evidence for deficiencies in social cognition but a fair amount of variability. Research on BN and BED was limited and inconsistent, though there appear to be some deficits in social cognition. Together, the limited coverage across EDs and heterogeneous methodology preclude firm conclusions regarding general or ED-specific deficits, as well as understanding the role of social cognition in ED etiology and maintenance. Therefore, several key questions and future directions are outlined for research moving forward.

Momentary affective response to bouts of moderate-to-vigorous physical activity predicts changes in physical activity and sedentary behavior during behavioral weight loss

BACKGROUND

Affective responses are posited to be key predictors of the uptake and maintenance of health behaviors. However, few studies have examined how individuals' affective response to physical activity, as well as the degree to which their affect response changes, may predict changes in physical activity and sedentary time during behavioral weight loss treatment.

PURPOSE

The current study examined how baseline momentary affective response (i.e., stress and anxiety) to moderate-to-vigorous physical activity (MVPA) and the degree of pre--post intervention change in this response predicted change in daily sedentary, light, and MVPA time during a three-month internet-based weight loss program.

METHODS

Women with overweight/obesity (final N=37) completed 14-day ecological momentary assessment (EMA) protocols with objective measurement of physical activity (i.e., bout-related MVPA time) before and after the intervention.

RESULTS

Women who had more reinforcing responses to MVPA (i.e., greater reductions in anxiety and stress response following MVPA bouts) at baseline had greater increases in overall MVPA at the end of the intervention. Those who had greater anxiety reductions after MVPA bouts at baseline also evidenced less sedentary time at the end of the intervention. Changes in affective responses across the intervention were not related to changes in physical activity levels.

CONCLUSIONS

Findings suggest initial levels of affective reinforcement from MVPA bouts predict future change in MVPA and sedentary time during behavioral weight loss. Future work is needed to examine the utility of more precisely targeting affective responses to physical activity to optimize intervention approaches.

Delineating the role of binge eating in cancer research

PURPOSE

Binge eating is defined as consumption of a large amount of food accompanied by a sense of loss of control over eating. While binge eating is associated with poor physical, behavioral, and psychosocial health, it has not been studied in cancer research. Therefore, the overarching goal of this review is to delineate the role of binge eating in cancer research and to spur new research in this area. Specifically, in this review, we outlined (1) binge eating as a possible risk factor that contributes to cancer risk, (2) how binge eating may develop after cancer diagnosis, and (3) how binge eating may be associated with health and relapse during survivorship.

CONCLUSIONS

It is critical to elucidate the role of binge eating in the prevention of cancer and long-term cancer survivorship. This review suggested a number of ways that binge eating may increase risk for cancer as well as several pathways that may lead to the development of binge eating after cancer diagnosis.

LEVEL OF EVIDENCE

Level V: narrative review.

Longitudinal Associations Between Neighborhood Park and Open Space Access and Children's Accelerometer-Assessed Measured Physical Activity: The Evidence From the MATCH Study

BACKGROUND

Cross-sectional studies have shown positive associations between neighborhood park access and children's physical activity (PA); however, research that examines the relationship longitudinally is lacking. This study investigates how neighborhood park access affects the longitudinal trajectory of PA in 192 children across 3 years.

METHODS

Accelerometer-assessed PA data of children (N = 202) were collected across 6 semi-annual waves (7 d each) between 2014 and 2018. Geographical information systems was used to measure neighborhood park access (ie, coverage, density, and proximity) at baseline. Mixed-effects models examined the associations of park access with children's baseline and trajectory of moderate to vigorous PA (MVPA) minutes across 3 years and whether the associations differed by sex or weekends versus weekdays.

RESULTS

Higher neighborhood park density, coverage, and proximity were positively associated with children's baseline MVPA minutes per day. Longitudinally, higher park coverage was associated with smaller decreases in children's MVPA minutes per day, but only during weekends. Park density and proximity were not associated with change in MVPA minutes per day. The above associations did not differ by sex.

CONCLUSIONS

Having access to more neighborhood parklands protected against age-related declines in children's PA. These findings suggest that neighborhood park coverage should be considered by urban planners when evaluating the health impacts of their policies.

Dynamic Stress Responses and Real-Time Symptoms in Binge-Eating Disorder

BACKGROUND

Stress is a dynamic construct that predicts a range of health behaviors and conditions, including binge eating and excess weight. Thus far, there have been limited and inconsistent findings regarding stress responses in binge-eating disorder (BED) and insufficient consideration of temporal patterns of stress responses across the weight spectrum.

PURPOSE

The present study used ecological momentary assessment (EMA) to examine stress reactivity (i.e., the magnitude of the initial stress response), recovery (i.e., how long the stress response lasts before returning to baseline), and pileup (i.e., accumulation of repeated experiences of stressors and responses over time) as predictors of binge-eating symptoms (BES) and food craving in BED.

METHODS

Adults with BED (N = 115) completed a 7 day EMA protocol assessing stressful events, perceived stress, binge eating, and food craving prior to being randomized to a behavioral intervention.

RESULTS

Generalized estimating equations indicated that moments of greater stress pileup predicted greater subsequent BES (within-person effect). Participants with higher perceived stress and pileup reported greater overall BES and craving, and those with better recovery reported higher overall craving (between-person effects).

CONCLUSIONS

Findings highlight the importance of considering the dynamic nature of stress responses and, particularly, that the accumulation of stress over the day is an important trigger for BES.

Momentary associations between stress and physical activity among children using ecological momentary assessment

Chronic and acute stress may have a detrimental effect on children's physical activity. Research on stress as a predictor of children's physical activity has mostly focused on stress between children, rather than how children's within-day variation in stress may predict physical activity. The current study assessed the within- and between-effects of stress on subsequent physical activity in three different time windows using ecological momentary assessment (EMA) and accelerometry. Children (N = 190; M_{Baseline Age} =10.1±0.9, 53% female, 56% self-identified Hispanic/Latino) completed six semi-annual assessment bursts across three years. During each burst, participants responded to up to seven (weekend) or three (weekday) randomly prompted EMA surveys on smartphones for seven days and wore a waist-worn accelerometer. Multi-level structural equation modeling examined within- and between-subjects effects of stress as a predictor of children's subsequent moderate-to-vigorous physical activity (MVPA) in the 15, 30, and 60 minutes following the EMA prompt. Latent variables were created for within- and between-subjects stress were comprised of three EMA stress items. Higher than average levels of stress (within-subjects) significantly predicted lower MVPA in the subsequent 15, 30 and 60 minutes (ps < .05). Between-subjects stress was not significantly associated with subsequent MVPA (ps > .05). Results indicate that elevated momentary stress predicts less subsequent MVPA. These findings suggest that within-day fluctuations in stress may be a barrier for children engaging in physical activity. Childhood physical activity promotion and interventions should consider the role of children's stress, aim to reduce the stress children experience throughout the day, and incorporate stress coping strategies.

Examining prospective mediational relationships between momentary rumination, negative affect, and binge eating using ecological momentary assessment

BACKGROUND

Rumination is linked to negative affect (NA), and there is accumulating support for an association between rumination and eating disorder (ED) behaviors. However, no research has examined the dynamic interrelationships between negative affect, rumination, and binge eating in naturalistic settings.

METHODS

The present study used ecological momentary assessment (EMA) to assess the hypotheses that momentary rumination would mediate relationships between NA and binge eating, and momentary NA would mediate relationships between rumination and binge eating. Given that rumination may be focused on weight, shape, and food in ED samples, models were examined separately for general and ED-specific rumination. Forty women completed a 10-day EMA protocol that included measures of NA, general and ED-specific rumination, and binge eating.

RESULTS

Multilevel mediation models indicated significant within-subjects indirect effects, such that momentary general rumination mediated the association between NA and binge eating, and NA also mediated the association between general but not ED-specific rumination and binge eating. Between-subjects effects indicated women with higher overall NA reported greater ED-specific rumination, which was associated with greater binge eating.

LIMITATIONS

The study was limited by a modest sample size, and the design precludes causal inferences.

CONCLUSIONS

Results highlight the momentary interplay between rumination and NA as a mechanism underlying binge eating, as well as the specificity of ruminative thought content in relationship to binge eating. Future work is needed to address the construct of rumination in the context of eating disorder interventions.

Affective response to binge eating as a predictor of binge eating disorder treatment outcome

This report examined baseline affective response to binge eating as a predictor of binge-eating disorder (BED) treatment outcome. Baseline affective response was defined as: (1) each individual's average net change (i.e., area under the curve [AUC]) of positive affect (PA) or negative affect (NA) before and after binge-eating episodes and (2) post-binge eating slope of PA or NA across seven-days of ecological momentary assessment (EMA). Adults with BED completed Integrative Cognitive-Affective Therapy (ICAT-BED) or cognitive behavioral therapy guided self-help (CBTgsh). Individuals with greater net increases in PA (AUC) following binge eating at baseline exhibited better treatment response in ICAT-BED at end-of-treatment and follow-up. NA affective response was only significant at end-of-treatment; individuals with less rapid post-binge improvements in NA (slope) did better in ICAT-BED, while individuals with lower net improvements in NA (AUC) did better in CBTgsh. Affective response to binge eating may be a marker of BED treatment response.

Interactions among Reward Sensitivity and Fast-Food Access on Healthy Eating Index Scores in Adolescents: A Cross-Sectional Study

Food cues in the environment may contribute to obesity as the consumption of unhealthy foods may reinforce reward pathways in the brain. To understand how person-level differences in reward sensitivity may be associated with diet quality, this study aimed to examine the moderating role of the availability of fast food in the environment on the relationship between reward sensitivity and diet quality in adolescents. Participants (n = 152; 55% female; Mage: 12.5 ± 0.93 y) completed the drive and reward subscales of the Behavioral Inhibition System (BIS)/Behavioral Activation System (BAS) Scale to assess reward sensitivity and completed two 24 h dietary recalls from which Healthy Eating Index (HEI) scores (total score and subscales of adequacy and moderation) were calculated. Fast-food environment (FFE) was operationalized as the total number of fast-food outlets within 1 km around participants' home address. Linear regressions were used to examine the main effects and interactions between reward sensitivity and FFE in relation to HEI score. Interactions were found between FFE and BAS drive (p = 0.02) and BAS reward (p < 0.01) on HEI adequacy. There were no interaction effects on HEI moderation or HEI total scores. For individuals who had lower access exposure to fast-food outlets (-1 SD), there was a stronger positive association between higher BAS drive (t = 2.85, p = 0.01, 95% CI (0.35, 1.94)) and HEI adequacy scores and between higher BAS reward (t = 3.27, p > 0.01, 95% CI (0.72, 2.93)) and HEI adequacy scores. By examining reward sensitivity to potential food cues in residential neighborhood food environments, it is possible to understand which adolescents are more sensitive to environmental food cues and implement interventions to buffer these influences.

Associations of Mothers' and Children's Stress With Children's Device-Measured Physical Activity and Sedentary Behavior Trajectories Across 3 Years

BACKGROUND

Psychological stress has adverse effects on health-related behaviors, yet longitudinal research is lacking. Research examined how children's and mothers' perceived stress are associated with children's physical activity and sedentary behavior trajectories across 3 years.

METHODS

Mothers and their children (N = 186 dyads; 8-12 y at baseline, 57% Hispanic) completed 6 assessments across 3 years. Children and mothers self-reported perceived stress using the Stress in Children Scale and Perceived Stress Scale, respectively. Children's moderate to vigorous physical activity (MVPA) and sedentary behavior were assessed using accelerometers. Mixed models examined interactions of mothers' and children's perceived stress by time elapsed in the study on children's MVPA and sedentary behavior.

RESULTS

The perceived stress × time elapsed interactions were significant for children's MVPA and sedentary behavior (Ps < .05). Higher average perceived stress in mothers was associated with greater decreases in children's MVPA and increases in children's sedentary behavior. The child stress × time elapsed interactions was significant for children's MVPA (P < .05) but not sedentary behavior. Higher average perceived stress in children was associated with smaller decreases in children's MVPA.

CONCLUSION

Interventions to promote physical activity and reduce screen time in children should mitigate the effects of psychological stress, especially among mothers, on these behaviors.

Bi-Directional Associations Between Real-Time Affect and Physical Activity in Weight-Discordant Siblings

Pediatric obesity confers increased risk for a host of negative psychological and physical health consequences and is reliably linked to low levels of physical activity. Affective antecedents and consequences of physical activity are thought to be important for the development and maintenance of such behavior, though research examining these associations in youth across the weight spectrum remains limited.

OBJECTIVE

This study examined bi-directional associations between affect and physical activity (i.e., moderate-to-vigorous physical activity [MVPA] and total activity counts), and the extent to which weight (body mass index z-score [z-BMI]) moderated these associations.

METHODS

Participants were drawn from a prior study of siblings (N = 77; mean age = 15.4 ± 1.4 years) discordant for weight status (39 nonoverweight siblings, 38 siblings with overweight/obesity) who completed ecological momentary assessment (EMA) with accelerometer-assessed physical activity.

RESULTS

Generalized linear mixed models indicated z-BMI moderated trait-level and momentary associations. When adolescents with higher z-BMI reported momentary negative affect, they evidenced less MVPA within the next hour. Across the sample, greater overall activity was associated with lower negative affect. However, at the momentary level, when adolescents with higher (but not lower) z-BMI evidenced greater activity, they reported decreases in negative affect.

CONCLUSIONS

Findings indicate affective experiences surrounding physical activity differ according to z-BMI. Specifically, momentary negative affect may impede momentary MVPA among youth with higher z-BMI. Further research is warranted to elucidate factors influencing these momentary associations and the extent to which these momentary associations prospectively predict weight change.

Descriptives and baseline ecological momentary assessed predictors of weight change over the course of psychological treatments for binge eating disorder

OBJECTIVE

The objectives were to examine individual variability in weight change across psychological treatments for binge-eating disorder (BED) and to examine baseline predictors (i.e., BED symptoms, affect, and appetite) of weight change using ecological momentary assessment (EMA).

METHOD

Adults with BED (N = 110) enrolled in a randomized clinical trial in which they received one of two psychological treatments for BED. At baseline, participants completed a 7-day EMA protocol measuring BED symptoms, affect, and appetite. Height and weight were measured at baseline, mid-treatment, end-of-treatment, and follow-up, and body mass index (BMI) was calculated.

RESULTS

On average, participants evidenced a 2% increase in BMI at end-of-treatment and a 1% increase between end-of-treatment and 6-month follow-up assessments. Although results showed that BMI increased over time, the quadratic term reflected a deceleration in this effect. There were interactions between positive affect and the linear trajectory across time predicting BMI, indicating that individuals reporting higher positive affect at baseline evidenced a flatter trajectory of weight gain. There was a main effect of overeating as assessed by EMA and interactions between overeating and linear and quadratic trajectories across time predicting BMI. Individuals who reported greater overeating at baseline had higher BMI across time. However, the BMI of individuals with lower overeating increased linearly, and increases in BMI among those with average or high rates of overeating appeared to stabilize over time.

CONCLUSION

Despite the variability in weight change, baseline positive affect and overeating may be ecological targets for improving weight outcomes in psychological treatments for BED.

Weight Status and Effects of Non-Tobacco Flavors on E-Cigarette Product Appeal

BACKGROUND

Flavors in tobacco products may be salient drivers of tobacco product use among people with overweight or obesity. Yet, whether perceived appeal of e-cigarettes with different flavors varies as a function of weight status is unknown. Purpose: To conduct secondary data analyses of a laboratory experiment to examine whether weight moderates differences in perceived appeal of fruit, menthol, and tobacco flavored e-cigarettes in young adults who vape. Methods: Using a within-subjects experimental design, young adults in Los Angeles, CA, USA. (Mage = 25.36 ± 4.42 Range: 18-35) with normal weight (n = 48) or overweight/obesity (n = 51) were administered standardized doses of e-cigarette solutions varying in flavor (fruit, menthol, tobacco). Following each administration, participants rated the appeal of the solution (range: 0-100). Results: The extent to which menthol (vs. tobacco)-flavored e-cigarettes were rated more appealing was amplified among participants with overweight or obesity versus normal weight participants (flavor × weight interaction Estimate = 7.54, p = .01 95% CI = [2.30, 12.80]). There were no differences in the effects of fruit (vs. tobacco) flavored e-cigarettes on appeal as a function of weight status. Conclusions: Menthol flavors in e-cigarettes may be disproportionately appealing to young adults with overweight and obesity.

Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2021.1899229.

The COMET study: Examining the effects of COVID-19-related perceived stress on Los Angeles Mothers' dysregulated eating behaviors, child feeding practices, and body mass index

The COVID-19 pandemic and associated restrictions and mandates have had pronounced implications on the well-being of individuals. This study conducted exploratory analyses of the relationship between COVID-19-related life changes and COVID-19-related perceived stress and associations between COVID-19-related perceived stress and dysregulated maternal eating behaviors, child feeding practices, and body mass index (BMI) in Los Angeles mothers. Mothers (M_age = 37.6 ± 6.9) of children aged 5-11 (N = 197, response rate 92.5%) completed an online questionnaire assessing COVID-19-related life changes, COVID-19-related perceived stress, mechanisms used to cope with COVID-19, child feeding practices, their own eating behavior, demographics, and height and weight. The highest proportion of participants reported changes to work, disruptions due to childcare challenges, and increased home responsibilities. Higher COVID-19-related perceived stress was experienced by those who reported loss of work hours (29%), loss of job (15.2%), reduced ability to afford childcare (18.8%), and reduced ability to afford rent/mortgage (19.8%) (ps < 0.05) than those who did not. The most common strategy that mothers indicated using to cope with COVID-19 related stress was eating comfort foods (e.g., candy and chips) (58.7%). COVID-19-related perceived stress was positively associated with mother's BMI and emotional eating (ps < 0.05). Rewarding their child's eating and behavior with food were both positively associated with the number of COVID-19 related life changes (ps < 0.05). This study yields new knowledge of the effects of the COVID-19 pandemic on mothers' dysregulated eating behaviors and child feeding practices. The results highlight the importance of conducting further research to confirm these findings and understand the nature of associations between COVID-19-related perceived stress and health. This is crucial in order to explore ways in which lasting impacts of the pandemic on mental and physical health can be prevented.

Relations among sweet taste preference, body mass index, and use of E-cigarettes for weight control motives in young adults

While weight control is anecdotally reported as a motive for e-cigarette use, empirical evidence on correlates of weight control vaping motives is largely absent. This study evaluated main effect and interactive associations of body mass index (BMI) and sweet taste food preference-a construct defined by difficulty resisting sweet foods and consuming foods for mood regulation- with e-cigarette weight control motives among young adult e-cigarette users. Young adults (N = 99; 35% women) between the ages of 18-35 who currently used e-cigarettes ≥1 day/week for ≥1 month were recruited in Los Angeles, CA in January-August 2016. Participants completed an e-cigarette product appeal experiment that also involved questionnaire-based measures of vaping motives and participant characteristics, which are this paper's focus. Regression analysis of e-cigarette use for weight control motive outcomes revealed no main effect of BMI, a significant main effect positive association for sweet taste food preference, and a BMI x sweet taste preference interactive relation. The interaction was underpinned by a positive association between sweet taste preference and use of e-cigarettes for weight control at mean and + 1SD levels of BMI and no relation at -1SD BMI levels. Higher sweet taste preference might increase use of e-cigarettes for weight control, particularly in young adults with higher weight. Taking into account sweet taste preference might be useful in interventions promoting healthy weight control strategies instead of e-cigarette use to address overweight/obesity in young adults.

Longitudinal associations of maternal stress and child stress with child body mass index trajectory

BACKGROUND

Although exposure to stress is common among children and their parents, longitudinal research on the effects of perceived stress on child obesity risk is lacking. This study examined the 3-year longitudinal associations of children and mothers' perceived stress with children's body mass index (BMI).

METHODS

A sample of 199 mothers and their children (8-12 years at baseline, 56% Hispanic) completed six semi-annual assessments across 3 years with questionnaire-based self-report measures of perceived stress and measured height/weight. Parallel process latent growth curve modelling specified regressions of latent intercept and slope of children's BMI on latent intercepts and slopes for mothers' and children's perceived stress.

RESULTS

Greater child self-reported perceived stress at baseline predicted greater increase in children's BMI across the six assessments whereas mother self-reported perceived stress at baseline was unrelated to change in child BMI. Baseline child BMI was unrelated to change in children or mothers' perceived stress across the six assessment waves.

CONCLUSION

Children's own perceptions of stress may play a larger contributing role in BMI progression during middle childhood than their mother's perceived stress levels. These findings underscore the importance of focusing on children's stress-coping strategies for promoting a healthy weight.

Anhedonia, positive affect dysregulation, and risk and maintenance of binge-eating disorder

Low positive affect has been identified as an antecedent of binge-eating episodes among individuals with binge-eating disorder (BED), yet positive affect has received far less attention in eating disorders research than its counterpart, negative affect. In this article, we argue that the low levels of positive affect which occur with anhedonia (i.e., loss of interest or pleasure in activities) may contribute to the onset and maintenance of BED. We introduce a theoretical model in which anhedonia increases the risk for BED through its interrelationships with dysregulated eating and weight gain, and we describe potential direct (e.g., reward-related processes) as well as indirect (e.g., influences on depressive symptoms and physical activity) pathways by which anhedonia may lead to adverse eating- and weight-related outcomes. We also propose a momentary maintenance model in which low positive affect and positive affect dysregulation occurring with anhedonia maintain binge eating directly and indirectly through maladaptive health behaviors, such as decreased physical activity, less healthy eating, and fewer social interactions, which in turn maintain anhedonia. We draw upon outside literature to present evidence that aligns with the proposed risk and maintenance models and conclude by outlining avenues for future research-including methodological/measurement, theoretical, and clinical research directions.

Associations between objective physical activity and emotional eating among adiposity-discordant siblings using ecological momentary assessment and accelerometers

BACKGROUND

Emotional eating is associated with obesity, though less is known regarding factors that predict emotional eating episodes in children and adolescents.

OBJECTIVES

To investigate whether moderate to vigorous physical activity (MVPA) or total activity counts 60 minutes prior to psychological stress predicted stress-related eating and positive emotional eating (ie, eating while happy), and whether adiposity (z-BMI) moderated these associations.

METHODS

Participants were drawn from a prior study of siblings (N = 77; mean age = 15.4 ± 1.4 years) discordant for weight status (39 non-overweight siblings, 38 siblings with overweight/obesity) who completed an ecological momentary assessment protocol with accelerometer-based assessment of physical activity.

RESULTS

Greater MVPA was associated with lower stress-related eating across the sample. Lower total activity (between-person effects) and lower MVPA (within-person effects) were associated with greater stress-related eating for siblings with greater z-BMI. Greater total activity was associated with lower positive emotional eating for siblings with lower z-BMI (between- and within-person).

CONCLUSIONS

Findings demonstrate potential regulating effects of prior physical activity on emotional eating at the individual and momentary level, though there are nuances depending on z-BMI. Future work is needed to examine underlying mechanisms and timescale of effects, and particularly the extent to which enhancing MVPA time among youth with z-BMI may mitigate momentary risk of stress-related eating episodes.

Discrimination and Eating Disorder Psychopathology: A Meta-Analysis

Eating disorders occur in diverse populations, and discrimination may be a specific factor that is related to higher eating disorder psychopathology among marginalized individuals. To evaluate the current evidence on this topic, a meta-analysis was used to quantitatively synthesize the literature on discrimination and eating disorder psychopathology across a heterogeneous range of studies. Searches were conducted in peer-reviewed journals and accessible unpublished dissertations of all years through January 2020. Studies were coded by two authors using a tailored coding form, and zero-order bivariate correlations were used as effect size measures. There were 55 cross-sectional studies extracted for inclusion in the meta-analysis. Results showed a small-to-medium association between discrimination and eating disorder psychopathology that was consistent across domains. Effect sizes were typically higher for weight discrimination. For binge eating and general eating disorder pathology, effects were smaller in studies that had larger proportions of women, and for binge eating only, effects were higher in college samples. These findings could suggest that discrimination represents a contributory factor related to eating disorder psychopathology across types of discrimination and eating disorder psychopathology. Implications are discussed for future research on discrimination and psychopathology including possible mechanisms.

Momentary and personal characteristics predicting maternal fruit and vegetable preparation for children using ecological momentary assessment

A large body of literature on child-focused research regarding healthy eating within the family context has focused on behavioral management strategies, such as reinforcement, or parental modeling through personal intake or encouragement. However, food preparation behaviors among mothers have been understudied. Also unknown is how maternal food preparation behaviors vary across population subgroups and contexts. The study objective was to elucidate momentary characteristics (i.e., time of day, weekday, and family meals) and personal characteristics (i.e., ethnicity, working status, household characteristics, body mass index, income, and child's age) associated with maternal fruit and vegetable (F/V) preparation through ecological momentary assessment (EMA). 186 mothers (M_age = 40.81) of children (M_age = 9.61, 49.5% female) completed six semi-annual waves, each lasting seven days. Mothers completed up to eight EMA surveys a day, which assessed family meals and F/V preparation, and reported personal characteristics through paper questionnaires. Multilevel generalized estimating equations examined the likelihood of F/V preparation. Momentary, within-day characteristics (i.e., occurrence of family meals, weekdays, afternoons) were associated with greater likelihood of mothers' fresh F/V preparation (ps < 0.05). Additionally, personal characteristics such as non-Hispanic ethnicity, not working full-time, having a child aged six months to five years in the household, and lower child BMI-z were associated with greater fresh F/V preparation among mothers (ps < 0.05). Findings may inform family-based obesity and nutrition intervention programs by understanding which families and in what contexts mothers are more likely to prepare F/Vs.

A systematic review of neural correlates of dysregulated eating associated with obesity risk in youth

Dysregulated eating among children and adolescents is associated with a wide range of negative mental and physical health outcomes, including obesity. However, less is known regarding underlying neural mechanisms underlying such behaviors. Therefore, the present manuscript systematically reviewed neuroimaging research examining dysregulated eating behavior linked to excess weight in children and adolescents. A systematic literature search identified 23 eligible studies, the majority of which were cross-sectional functional magnetic resonance imaging (fMRI) studies and excluded participants with psychiatric disorders. Dysregulated eating was captured by measures of eating styles and eating self-regulation, eating disorder behaviors, food addiction, objective measures of non-homeostatic eating and caloric restriction. While preliminary, findings suggested eating dysregulation was related to aberrant functioning within the frontostriatal and frontoparietal regions involved in self-regulatory processes, as well as regions involved in satiety signaling and interoception. This heterogeneous body of research is continually growing and may have potential to inform future prevention and intervention approaches. Results also identified several important limitations to consider and highlight key areas for future research.

Interactions of approach motivation and self-regulation in relation to obesity in children

BACKGROUND

Motivation and self-regulation are two psychological systems that have been shown to be related to childhood obesity.

OBJECTIVE

This study evaluated independent and interactive associations of approach-oriented motivation (i.e., drive and reward responsiveness) and self-regulation (i.e., self-control and behavioral regulation) in relation to age- and sex-adjusted body mass index-z scores (BMI-z) in children.

METHODS

Children (55% female; M_age = 12.5 years ± .93) completed questionnaires assessing motivation and self-regulation, and anthropometric measurements were taken by research staff cross-sectionally.

RESULTS

Regressions revealed no independent associations of approach motivation or self-regulation and BMI-z. There were interactions between the drive facet of approach motivation, which assesses motivation to follow goals, and self-regulation in relation to BMI-z. Children with lower motivation to follow goals and lower self-regulation had higher BMI-z, and children with lower motivation to follow goals and higher self-regulation had lower BMI-z. Children with higher motivation to follow goals had similar BMI-z at all levels of self-regulation.

CONCLUSION

For children with low motivation to follow goals, self-regulation may be an important buffer of high BMI-z.

LEVEL OF EVIDENCE

Level V: cross-sectional descriptive study.