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Neuwald NV, Pearce AL, Cunningham PM, Koczwara L, Setzenfand MN, Rolls BJ, Keller KL. Switching between foods is reliably associated with intake across eating events in children. Appetite 2024; 197:107325. [PMID: 38548135 DOI: 10.1016/j.appet.2024.107325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024]
Abstract
Emerging evidence suggests switching between foods during an eating event is positively associated with intake. However, it is unclear whether switching is a stable behavior that predicts consumption across multiple eating events. The current study explored whether switching is consistent within children and reliably associated with intake across varied eating events. We analyzed data from 88 (45 F), 7-8-year-old children without obesity participating in a 7-visit prospective cohort study (ClinicalTrials.gov NCT03341247). Amount consumed and energy intake were measured at 4 separate meals of foods that varied by portion sizes served. Meals included macaroni and cheese, chicken nuggets, broccoli, and grapes (all 0.7-2.5 kcal/g). Children's intake was also assessed during 2 eating in the absence of hunger (EAH) paradigms separated by ≥ 1 year. The EAH paradigm included 9 sweet and savory snack foods (all 1.9-5.7 kcal/g). All eating events were video-recorded and switching was assessed by counting the number of times a child shifted between different food items. Results demonstrated that switching was reliably associated with intake at both the meals and the EAH paradigms (ps < 0.01). Specifically, at meals each additional switch was associated with 11.7 ± 1.3 kcal (7.7 ± 0.8 g) more consumed, and during EAH each additional switch was associated with 8.1 ± 2.1 kcal (2.1 ± 0.5 g) more consumed. Switching behavior was also moderately consistent across meals (ICC = 0.70) and EAH paradigms (ICC = 0.50). However, switching at meals was not related to switching at EAH paradigms. This study demonstrates the consistency of switching behavior and its reliable association with intake across eating events, highlighting its potential to contribute to chronic overconsumption and childhood obesity.
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Affiliation(s)
- N V Neuwald
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - A L Pearce
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - P M Cunningham
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA; Department of Food Science, The Pennsylvania State University, University Park, PA, USA
| | - L Koczwara
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - M N Setzenfand
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - B J Rolls
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - K L Keller
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA; Department of Food Science, The Pennsylvania State University, University Park, PA, USA.
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Keller KL, Pearce AL, Fuchs B, Rolls BJ, Wilson SJ, Geier CF, Rose E, Garavan H. PACE: a novel eating behavior phenotype to assess risk for obesity in middle childhood. J Nutr 2024:S0022-3166(24)00296-7. [PMID: 38795747 DOI: 10.1016/j.tjnut.2024.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 04/05/2024] [Accepted: 05/21/2024] [Indexed: 05/28/2024] Open
Abstract
BACKGROUND Behavioral phenotypes that predict future weight gain are needed to identify children susceptible to obesity. OBJECTIVE This prospective study developed an eating behavior risk score to predict change in adiposity across 1 year in children. METHODS Data from 6 baseline visits (Time 1 - T1) and a 1-year follow-up visit (Time 2 - T2) were collected from 76, 7-8-year-old healthy children recruited from Central Pennsylvania. At T1, children had body mass index (BMI) percentiles < 90 and were classified as either high- (n=33; maternal BMI ≥ 30 kg/m2) or low- (n=43; maternal BMI ≤ 25 kg/m2) familial risk for obesity. Appetitive traits and eating behaviors (e.g., portion susceptibility, eating in absence of hunger, loss of control eating, eating rate) were assessed at T1. Adiposity was measured at T1 and T2 using dual-energy x-ray absorptiometry, with a main outcome of fat mass index (FMI; total body fat mass / height, m2). Hierarchical linear regressions determined which eating measures improved prediction of T2 FMI after adjustment for covariates in the baseline model (T1 FMI, sex, income, familial risk, and Tanner stage). RESULTS Four eating measures -Portion susceptibility, Appetitive traits, loss of Control eating, and Eating rate-were combined into a standardized summary score called PACE. PACE improved the baseline model to predict 80% variance in T2 FMI. PACE was positively associated with the increase in child FMI from T1 to T2 among children, independent of familial risk (r=0.58, p<0.001). Although PACE was higher in girls than boys (p<0.05), it did not differ by familial risk, income, or education. CONCLUSION PACE represents a cumulative eating behavior risk score that predicts adiposity gain across 1 year in middle childhood. If PACE similarly predicts adiposity gain in a cohort with greater racial and socioeconomic diversity, it will inform the development of interventions to prevent obesity. REGISTRY Registered on NCT03341247.
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Affiliation(s)
- Kathleen L Keller
- The Pennsylvania State University, Department of Nutritional Sciences; The Pennsylvania State University, Department of Food Science.
| | - Alaina L Pearce
- The Pennsylvania State University, Department of Nutritional Sciences
| | - Bari Fuchs
- The Pennsylvania State University, Department of Nutritional Sciences
| | - Barbara J Rolls
- The Pennsylvania State University, Department of Nutritional Sciences
| | | | - Charles F Geier
- The Pennsylvania State University, Department of Human Development and Family Studies
| | - Emma Rose
- The Pennsylvania State University, Department of Psychology
| | - Hugh Garavan
- University of Vermont, Department of Psychological Sciences
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Fox CK, Molitor SJ, Vock DM, Peterson CB, Crow SJ, Gross AC. Appetitive and psychological phenotypes of pediatric patients with obesity. Pediatr Obes 2024; 19:e13101. [PMID: 38290813 DOI: 10.1111/ijpo.13101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 12/15/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Obesity is a heterogeneous disease with variable treatment response. Identification of the unique constellation of contributors to obesity may allow for targeted interventions and improved outcomes. OBJECTIVE Identify empirically derived phenotypes of pediatric patients with obesity based on appetitive and psychological correlates of obesity. METHODS This cross-sectional study included patients aged 5-12 years who were treated in a weight management clinic and completed standard intake questionnaires including Child Eating Behavior Questionnaire (CEBQ), Vanderbilt ADHD Scale and Pediatric Symptom Checklist. Phenotypes were elicited using latent profile analysis of 12 indicators: eight CEBQ subscales, inattention, hyperactivity/impulsivity, internalizing and externalizing symptoms. RESULTS Parents/guardians of 384 patients (mean age 9.8 years, mean BMI 30.3 kg/m2 ) completed the intake questionnaires. A 4-phenotype model best fits the data. Hedonic Impulsive phenotype (42.5%) exhibited high food enjoyment and hyperactivity/impulsivity. Inattentive Impulsive phenotype (27.4%) exhibited overall low food approach and high food avoid behaviours, and highest inattention. Hedonic Emotional phenotype (20.8%) scored the highest on food enjoyment, internalizing and externalizing symptoms. Picky Eating phenotype (9.3%) scored the lowest on food approach, inattention, hyperactivity/impulsivity, internalizing and externalizing symptoms. CONCLUSION Appetitive traits and psychological symptoms appear to cluster in distinct patterns, giving rise to four unique phenotypic profiles, which, if replicated, may help inform the development of tailored treatment plans.
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Affiliation(s)
- Claudia K Fox
- Center for Pediatric Obesity Medicine and Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Stephen J Molitor
- Division of Pediatric Psychology and Developmental Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - David M Vock
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Amy C Gross
- Center for Pediatric Obesity Medicine and Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
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Woo S, Jung S, Lim H, Kim Y, Park KH. Exploring the Effect of the Dynamics of Behavioral Phenotypes on Health Outcomes in an mHealth Intervention for Childhood Obesity: Longitudinal Observational Study. J Med Internet Res 2023; 25:e45407. [PMID: 37590040 PMCID: PMC10472181 DOI: 10.2196/45407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 05/14/2023] [Accepted: 06/30/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Advancements in mobile health technologies and machine learning approaches have expanded the framework of behavioral phenotypes in obesity treatment to explore the dynamics of temporal changes. OBJECTIVE This study aimed to investigate the dynamics of behavioral changes during obesity intervention and identify behavioral phenotypes associated with weight change using a hybrid machine learning approach. METHODS In total, 88 children and adolescents (ages 8-16 years; 62/88, 71% male) with age- and sex-specific BMI ≥85th percentile participated in the study. Behavioral phenotypes were identified using a hybrid 2-stage procedure based on the temporal dynamics of adherence to the 5 behavioral goals during the intervention. Functional principal component analysis was used to determine behavioral phenotypes by extracting principal component factors from the functional data of each participant. Elastic net regression was used to investigate the association between behavioral phenotypes and weight change. RESULTS Functional principal component analysis identified 2 distinctive behavioral phenotypes, which were named the high or low adherence level and late or early behavior change. The first phenotype explained 47% to 69% of each factor, whereas the second phenotype explained 11% to 17% of the total behavioral dynamics. High or low adherence level was associated with weight change for adherence to screen time (β=-.0766, 95% CI -.1245 to -.0312), fruit and vegetable intake (β=.1770, 95% CI .0642-.2561), exercise (β=-.0711, 95% CI -.0892 to -.0363), drinking water (β=-.0203, 95% CI -.0218 to -.0123), and sleep duration. Late or early behavioral changes were significantly associated with weight loss for changes in screen time (β=.0440, 95% CI .0186-.0550), fruit and vegetable intake (β=-.1177, 95% CI -.1441 to -.0680), and sleep duration (β=-.0991, 95% CI -.1254 to -.0597). CONCLUSIONS Overall level of adherence, or the high or low adherence level, and a gradual improvement or deterioration in health-related behaviors, or the late or early behavior change, were differently associated with weight loss for distinctive obesity-related lifestyle behaviors. A large proportion of health-related behaviors remained stable throughout the intervention, which indicates that health care professionals should closely monitor changes made during the early stages of the intervention. TRIAL REGISTRATION Clinical Research Information Science KCT0004137; https://tinyurl.com/ytxr83ay.
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Affiliation(s)
- Sarah Woo
- Department of Medical Sciences, College of Medicine, Hallym University, Chuncheon-si, Republic of Korea
| | - Sunho Jung
- School of Management, Kyung Hee University, Seoul, Republic of Korea
| | - Hyunjung Lim
- Department of Medical Nutrition, Kyung Hee University, Yongin-si, Republic of Korea
| | - YoonMyung Kim
- University College, Yonsei University International Campus, Incheon, Republic of Korea
| | - Kyung Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang-si, Gyeonggi-do, Republic of Korea
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Naets T, Vermeiren E, Vervoort L, Van Eyck A, Ysebaert M, Verhulst S, De Winter B, Van Hoorenbeeck K, Bruyndonckx L, Tanghe A, De Guchtenaere A, Verbeken S, Braet C. Self-control training supplementing inpatient multidisciplinary obesity treatment in children and adolescents. Behav Res Ther 2023; 167:104335. [PMID: 37327533 DOI: 10.1016/j.brat.2023.104335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 03/31/2023] [Accepted: 05/15/2023] [Indexed: 06/18/2023]
Abstract
Research points to self-control as a possible mechanism for facilitating health behaviour and weight loss. The dual pathway model underpins the role of strong bottom-up reactivity towards food and weak top-down executive functions in obesity. Despite flourishing lab studies on attention bias modification or inhibition trainings, relatively few focused on training both processes to improve self-control in children and adolescents in inpatient multidisciplinary obesity treatment (MOT). Being part of the WELCOME project, this study investigated the effectiveness of Brain Fitness training (using the Dot Probe and Go/No-Go) as an adjunct to inpatient MOT in 131 Belgian children and adolescents. Changes in self-control (performance-based inhibitory control and attention bias as well as self-reported eating behaviour) in the experimental group were compared to sham training. Multiple Imputation was used to handle missing data. Inhibitory control and external eating improved over time (pre/post/follow-up), but we found no evidence for a significant interaction between time and condition. Future research should pay more attention to the role of individual variability in baseline self-control, sham training, and ecological validity of self-control training to improve real-life health behaviour and treatment perspectives for children and adolescents with weight problems.
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Affiliation(s)
- Tiffany Naets
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium.
| | - Eline Vermeiren
- Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Leentje Vervoort
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium; Department of Developmental Psychology, Radboud University, Nijmegen, the Netherlands
| | - Annelies Van Eyck
- Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | | | - Stijn Verhulst
- Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | - Benedicte De Winter
- Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | - Kim Van Hoorenbeeck
- Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | - Luc Bruyndonckx
- Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | | | | | - Sandra Verbeken
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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Roe LS, Keller KL, Rolls BJ. Food Properties and Individual Characteristics Influence Children's Intake Across Multiple Days of Weighed Assessments in Childcare Programs. J Nutr 2023; 153:1646-1655. [PMID: 36965692 PMCID: PMC10367225 DOI: 10.1016/j.tjnut.2023.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/27/2023] [Accepted: 03/15/2023] [Indexed: 03/27/2023] Open
Abstract
BACKGROUND Because children often consume substantial proportions of their diets in childcare programs, it is critical to determine what they eat when served menus meeting dietary recommendations and how intake is related to individual characteristics. OBJECTIVES Using weighed assessments, we characterized children's consumption across 15 daily menus and investigated the relationship between properties of the food consumed and child characteristics. METHODS In 3 crossover trials in childcare centers that followed dietary guidelines, we provided and weighed all meals and snacks for 5 consecutive days. For this descriptive secondary analysis, we characterized primary outcomes (daily food weight, energy density, and energy intake) by including the most typical set of menus from each trial, yielding 603 daily intakes for 128 preschool children (15% with overweight or obesity). Physical activity was measured by accelerometry during childcare sessions. Children's appetitive traits were assessed by parental questionnaires. RESULTS Both food properties and child characteristics were related to daily intake. More food was consumed from menus with greater food weight, and the energy density of consumed food was greater from menus with higher energy density (both P < 0.0001); these menu differences resulted in greater energy intake (P = 0.009). Children with overweight and obesity had greater energy intake as a proportion of requirements than did children with healthy weight (113 ± 6% versus 101 ± 2%; P = 0.039). Vegetable intake was 39 ± 2% of the recommended amounts and boys had lower consumption than girls (P = 0.004). Children with appetitive traits of lower satiety responsiveness or higher food responsiveness had greater daily energy intake (both P < 0.003). CONCLUSIONS Weighed intakes showed that when children were served daily menus with substantial portions of foods that met dietary recommendations, they selectively consumed higher-energy-dense items and ate few vegetables. A particular concern was that children with overweight ate amounts that exceeded their energy needs. The trials were registered at clinicaltrials.gov (NCT02963987, NCT03010501, NCT03242863).
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Affiliation(s)
- Liane S Roe
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States
| | - Kathleen L Keller
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States; Department of Food Science, The Pennsylvania State University, University Park, PA, United States
| | - Barbara J Rolls
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States.
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Calderón García A, Alaminos-Torres A, Pedrero Tomé R, Prado Martínez C, Martínez Álvarez JR, Villarino Marín A, Marrodán Serrano MD. Eating Behavior and Obesity in a Sample of Spanish Schoolchildren. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4186. [PMID: 36901196 PMCID: PMC10001860 DOI: 10.3390/ijerph20054186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/16/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
From the point of view of prevention, it is convenient to explore the association between eating behavior and the obese phenotype during school and adolescent age. The aim of the present study was to identify eating behavior patterns associated with nutritional status in Spanish schoolchildren. A cross-sectional study of 283 boys and girls (aged 6 to 16 years) was carried out. The sample was evaluated anthropometrically by Body Mass Index (BMI), waist-to-height ratio (WHtR) and body fat percentage (%BF). Eating behavior was analyzed using the CEBQ "Children's Eating Behavior Questionnaire". The subscales of the CEBQ were significantly associated with BMI, WHtR and %BF. Pro-intake subscales (enjoyment of food, food responsiveness, emotional overeating, desire for drinks) were positively related to excess weight by BMI (β = 0.812 to 0.869; p = 0.002 to <0.001), abdominal obesity (β = 0.543-0.640; p = 0.02 to <0.009) and high adiposity (β = 0.508 to 0.595; p = 0.037 to 0.01). Anti-intake subscales (satiety responsiveness, slowness in eating, food fussiness) were negatively related to BMI (β = -0.661 to -0.719; p = 0.009 to 0.006) and % BF (β = -0.17 to -0.46; p = 0.042 to p = 0.016).
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Affiliation(s)
- Andrea Calderón García
- Research Group EPINUT (Nutritional Epidemiology), Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
- Department of Nursing and Nutrition, Faculty of Biomedical Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
- Department of Biology, Faculty of Sciences, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Ana Alaminos-Torres
- Research Group EPINUT (Nutritional Epidemiology), Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
- Department of Biodiversity, Ecology and Evolution, Faculty of Biology, Complutense University of Madrid, 28040 Madrid, Spain
| | - Roberto Pedrero Tomé
- Research Group EPINUT (Nutritional Epidemiology), Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
- Department of Biodiversity, Ecology and Evolution, Faculty of Biology, Complutense University of Madrid, 28040 Madrid, Spain
| | - Consuelo Prado Martínez
- Research Group EPINUT (Nutritional Epidemiology), Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
- Department of Biology, Faculty of Sciences, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Jesús Román Martínez Álvarez
- Research Group EPINUT (Nutritional Epidemiology), Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Antonio Villarino Marín
- Research Group EPINUT (Nutritional Epidemiology), Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - María Dolores Marrodán Serrano
- Research Group EPINUT (Nutritional Epidemiology), Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
- Department of Biodiversity, Ecology and Evolution, Faculty of Biology, Complutense University of Madrid, 28040 Madrid, Spain
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Russell A, Jansen E, Burnett AJ, Lee J, Russell CG. Children's eating behaviours and related constructs: conceptual and theoretical foundations and their implications. Int J Behav Nutr Phys Act 2023; 20:19. [PMID: 36793039 PMCID: PMC9933409 DOI: 10.1186/s12966-023-01407-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 01/06/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND There is a substantial body of research on children's eating behaviours (e.g., food responsiveness and fussiness) and related constructs (e.g., eating in the absence of hunger, appetite self-regulation). This research provides a foundation for understanding children's dietary intakes and healthy eating behaviours, as well as efforts at intervention, whether in relation to food avoidance, overeating and/or trajectories to excess weight gain. The success of these efforts and their associated outcomes is dependent on the theoretical foundation and conceptual clarity of the behaviours and constructs. This, in turn contributes to the coherence and precision of the definitions and measurement of these behaviours and constructs. Limited clarity in these areas ultimately creates uncertainty around the interpretation of findings from research studies and intervention programs. At present there does not appear to be an overarching theoretical framework of children's eating behaviours and associated constructs, or for separate domains of children's eating behaviours/constructs. The main purpose of the present review was to examine the possible theoretical foundations of some of the main current questionnaire and behavioural measures of children's eating behaviours and related constructs. METHODS We reviewed the literature on the most prominent measures of children's eating behaviours for use with children aged ~ 0-12 years. We focused on the explanations and justifications for the original design of the measures and whether these included theoretical perspectives, as well as current theoretical interpretations (and difficulties) of the behaviours and constructs. RESULTS We found that the most commonly used measures had their foundations in relatively applied or practical concerns rather than theoretical perspectives. CONCLUSIONS We concluded, consistent with Lumeng & Fisher (1), that although existing measures have served the field well, to advance the field as a science, and better contribute to knowledge development, increased attention should be directed to the conceptual and theoretical foundations of children's eating behaviours and related constructs. Suggestions for future directions are outlined.
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Affiliation(s)
- Alan Russell
- grid.1014.40000 0004 0367 2697College of Education, Psychology and Social Work, Flinders University, Bedford Park, South Australia Australia
| | - Elena Jansen
- grid.21107.350000 0001 2171 9311Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Alissa J. Burnett
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Jookyeong Lee
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia ,grid.1021.20000 0001 0526 7079CASS Food Research Centre, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Catherine G. Russell
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Hampl SE, Hassink SG, Skinner AC, Armstrong SC, Barlow SE, Bolling CF, Avila Edwards KC, Eneli I, Hamre R, Joseph MM, Lunsford D, Mendonca E, Michalsky MP, Mirza N, Ochoa ER, Sharifi M, Staiano AE, Weedn AE, Flinn SK, Lindros J, Okechukwu K. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics 2023; 151:e2022060640. [PMID: 36622115 DOI: 10.1542/peds.2022-060640] [Citation(s) in RCA: 189] [Impact Index Per Article: 189.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 01/10/2023] Open
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Measuring adolescents' eating in the absence of hunger in the home environment using subjective and objective measures. Appetite 2023; 180:106354. [PMID: 36309230 DOI: 10.1016/j.appet.2022.106354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/09/2022] [Accepted: 10/17/2022] [Indexed: 12/15/2022]
Abstract
Eating in the absence of hunger (EAH) has been identified as a behavioral phenotype for obesity. Few studies have reported on objective measures of EAH in adolescents, and fewer yet have objectively measured EAH in a naturalistic, home setting. The purpose of this paper was to examine relations between objective, adolescent-report and parent-report measures of EAH, and to examine variation by sex and race. Participants included 295 predominantly low-income and rural adolescents (mean age = 14.2 ± 0.6 years) and their parents, drawn from the Family Life Project. An EAH task was administered in the home following an ad-libitum meal and compulsory milkshake; EAH was also reported on a web-based survey (both adolescent and parent reports) and adolescents' BMIz was calculated from height and weight, measured in the home or self-reported on the web survey. A high degree of variability in EAH intake was observed (range = 8-741 kcals). Parent and adolescent reports of EAH were weakly correlated and unrelated to observed EAH consumption; only adolescent reports of EAH were related to their BMIz. Several relations varied by sex and race. Positive associations between reported and observed EAH was only observed in girls, and positive associations between observed EAH and BMI was only observed in boys and in white adolescents. Overall EAH consumption was significantly greater in boys and in white adolescents. These findings suggest that EAH can be measured in adolescents in the home. In this sample of youth experiencing rural poverty, this home-based measure appears most valid for white adolescent girls.
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Alshurafa NI, Stump TK, Romano CS, F. Pfammatter A, Lin AW, Hester J, Hedeker D, Forman E, Spring B. Rationale and design of the SenseWhy project: A passive sensing and ecological momentary assessment study on characteristics of overeating episodes. Digit Health 2023; 9:20552076231158314. [PMID: 37138585 PMCID: PMC10150430 DOI: 10.1177/20552076231158314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 02/01/2023] [Indexed: 05/05/2023] Open
Abstract
Objectives Overeating interventions and research often focus on single determinants and use subjective or nonpersonalized measures. We aim to (1) identify automatically detectable features that predict overeating and (2) build clusters of eating episodes that identify theoretically meaningful and clinically known problematic overeating behaviors (e.g., stress eating), as well as new phenotypes based on social and psychological features. Method Up to 60 adults with obesity in the Chicagoland area will be recruited for a 14-day free-living observational study. Participants will complete ecological momentary assessments and wear 3 sensors designed to capture features of overeating episodes (e.g., chews) that can be visually confirmed. Participants will also complete daily dietitian-administered 24-hour recalls of all food and beverages consumed. Analysis Overeating is defined as caloric consumption exceeding 1 standard deviation of an individual's mean consumption per eating episode. To identify features that predict overeating, we will apply 2 complementary machine learning methods: correlation-based feature selection and wrapper-based feature selection. We will then generate clusters of overeating types and assess how they align with clinically meaningful overeating phenotypes. Conclusions This study will be the first to assess characteristics of eating episodes in situ over a multiweek period with visual confirmation of eating behaviors. An additional strength of this study is the assessment of predictors of problematic eating during periods when individuals are not on a structured diet and/or engaged in a weight loss intervention. Our assessment of overeating episodes in real-world settings is likely to yield new insights regarding determinants of overeating that may translate into novel interventions.
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Affiliation(s)
- Nabil I. Alshurafa
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern
University, Chicago, IL, USA
| | - Tammy K. Stump
- Department of Dermatology, University
of Utah, Salt Lake City, UT, USA
| | - Christopher S. Romano
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern
University, Chicago, IL, USA
| | - Angela F. Pfammatter
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern
University, Chicago, IL, USA
| | - Annie W. Lin
- Department of Nutrition, Benedictine University, Lisle, IL, USA
| | - Josiah Hester
- Department of Electrical and Computer
Engineering, McCormick School of Engineering and
Applied Science, Northwestern University, Evanston, IL, USA
| | - Donald Hedeker
- Department of Public Health Sciences,
University of Chicago, Chicago, IL, USA
| | - Evan Forman
- Department of Psychological and Brain
Sciences, Drexel University, Philadelphia, PA, USA
- Center for Weight, Eating and Lifestyle
Sciences, Drexel University, Philadelphia, PA, USA
| | - Bonnie Spring
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern
University, Chicago, IL, USA
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12
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Salemonsen E, Holm AL, Øen KG. Struggling with overweight or obesity in children – fathers’ perceptions and experiences of contributing factors, role and responsibility. Int J Qual Stud Health Well-being 2022; 17:2093912. [PMID: 35786409 PMCID: PMC9254993 DOI: 10.1080/17482631.2022.2093912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Elin Salemonsen
- Faculty of Health and Social Sciences, Department of Health and Caring Science, Western Norway University of Applied Sciences, Haugesund, Norway
| | - Anne Lise Holm
- Faculty of Health and Social Sciences, Department of Health and Caring Science, Western Norway University of Applied Sciences, Haugesund, Norway
| | - Kirsten Gudbjørg Øen
- Faculty of Health Sciences, Department of Public Health, University of Stavanger, Stavanger, Norway
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13
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Burnett AJ, Jansen E, Appleton J, Rossiter C, Fowler C, Denney-Wilson E, Russell CG. Bidirectional associations between parental feeding practices, infant appetitive traits and infant BMIz: a longitudinal cohort study. Int J Behav Nutr Phys Act 2022; 19:153. [PMID: 36517797 PMCID: PMC9753278 DOI: 10.1186/s12966-022-01392-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Little is known about the pathways linking parent feeding practices with appetitive traits and BMIz throughout infancy. This study examined bidirectional associations between parental feeding practices, infant appetitive traits, and infant BMIz. METHODS Parents (n = 380) of infants aged less than 6 months at baseline reported their feeding practices (using the Feeding Practices and Structure Questionnaire (FPSQ) for infants and toddlers), infant appetitive traits (using the Baby Eating Behaviour Questionnaire) and infant BMIz (parent-reported) at three timepoints (< 6 months, ~ 9 months, ~ 12 months) up to 12 months of age. Cross-lagged models examined bidirectional associations between parent feeding practices, infant appetitive traits and infant BMIz. RESULTS There was strong continuity across the three timepoints for maternal feeding practices, infant appetitive traits, and infant BMIz. Infant food avoidance was prospectively associated with higher parental persuasive feeding. Infant BMIz was prospectively associated with higher parent-led feeding. Parent use of food to calm was prospectively associated with lower infant BMIz, and infant BMIz was prospectively associated with higher infant food approach. Feeding on demand was prospectively associated with lower infant food approach. CONCLUSION This study highlights the complex associations between parental feeding practices, infant appetitive traits and infant BMIz. The study demonstrated that both child and parent effects are important, suggesting a need for tailored programs beginning in infancy to promote and support infant appetitive traits and parent feeding practices that support healthy development.
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Affiliation(s)
- Alissa J Burnett
- grid.1021.20000 0001 0526 7079 Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Vic Australia
| | - Elena Jansen
- grid.21107.350000 0001 2171 9311Department of Psychiatry & Behavioral Sciences, Division of Child & Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Jessica Appleton
- grid.1013.30000 0004 1936 834XSusan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, NSW Australia ,Tresillian Family Care Centres, NSW, Australia
| | - Chris Rossiter
- grid.1013.30000 0004 1936 834XSusan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, NSW Australia ,grid.117476.20000 0004 1936 7611School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, NSW Australia
| | - Cathrine Fowler
- Tresillian Family Care Centres, NSW, Australia ,grid.117476.20000 0004 1936 7611School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, NSW Australia
| | - Elizabeth Denney-Wilson
- grid.1013.30000 0004 1936 834XSusan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, NSW Australia ,grid.410692.80000 0001 2105 7653Sydney Local Health District, Sydney, NSW Australia
| | - Catherine G Russell
- grid.1021.20000 0001 0526 7079 Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Vic Australia
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14
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Pickett SM, Jacques-Tiura AJ, Echeverri-Alvarado B, Sheffler JL, Naar S. Daytime sleepiness, addictive-like eating, and obesity sequelae in Black and African American youth with obesity. Sleep Health 2022; 8:620-624. [PMID: 36274028 PMCID: PMC9771869 DOI: 10.1016/j.sleh.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/06/2022] [Accepted: 08/18/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The purpose of the current study was to examine the association between poor sleep health (ie, excessive daytime sleepiness), obesity sequelae (ie, percent overweight and serum leptin levels), and addictive-like eating behaviors, an obesity phenotype, in a sample of Black/African American (B/AA) adolescents. DESIGN The current study analyzed archival baseline data from a sample of B/AA adolescents with obesity enrolled in a sequential randomized clinical trial. SETTING Data were collected in the participants' homes by trained research assistants unaware of treatment condition. PARTICIPANTS A sample of 181 B/AA adolescents with obesity between the ages of 12 and 16 years (M = 14.26, SD = 1.46) and having a body mass index (BMI) above the 95th percentile for age and gender were sampled. MEASUREMENTS Self-report measures included the Cleveland Adolescent Sleepiness Questionnaire and the Yale Food Addiction Scale-Children (YFAS-C). Anthropomorphic data and blood samples were used to determine BMI and serum leptin levels, respectively. RESULTS Excessive daytime sleepiness was positively correlated with YFAS-C symptom count, r = 0.295, P < .001. Serum leptin levels and percent overweight were both positively correlated with each other, r = 0.445, P < .001 and with YFAS-C symptom count, r = 0.215, P = .006. After controlling for age and gender, results supported an indirect effect from daytime sleepiness to both serum leptin levels (estimate = 2.210, SE = 0.932, P = .018) and percent overweight (estimate = 2.817, SE = 1.415, P = .046) through YFAS-C symptom count. CONCLUSIONS Culturally informed interventions on eating behaviors (ie, addictive-like eating) when excessive daytime sleepiness is reported are needed. Early intervention may help prevent the onset or worsening of obesity among adolescents.
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Affiliation(s)
- Scott M Pickett
- Florida State University College of Medicine, Center for Translational Behavioral Science, Tallahassee, FL, USA.
| | - Angela J Jacques-Tiura
- Wayne State University, Department of Family Medicine & Public Health Sciences, Detroit, MI, USA
| | - Brenda Echeverri-Alvarado
- Florida State University College of Medicine, Center for Translational Behavioral Science, Tallahassee, FL, USA
| | - Julia L Sheffler
- Florida State University College of Medicine, Center for Translational Behavioral Science, Tallahassee, FL, USA
| | - Sylvie Naar
- Florida State University College of Medicine, Center for Translational Behavioral Science, Tallahassee, FL, USA
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15
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Harris HA, Bowling A, Santos S, Greaves‐Lord K, Jansen PW. Child ADHD and autistic traits, eating behaviours and weight: A population-based study. Pediatr Obes 2022; 17:e12951. [PMID: 35751176 PMCID: PMC9786764 DOI: 10.1111/ijpo.12951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/07/2022] [Accepted: 05/31/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Children with Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) have an increased obesity risk. Although these conditions commonly co-occur, shared factors relating to obesity risk are unknown. OBJECTIVES To examine the shared and unique associations of ADHD and autistic traits with eating behaviours and BMI. METHODS Children (N = 4134) from the population-based Generation R Study were categorized into subgroups based on parent-reported ADHD and autistic traits scores at 6 years: ADHDHigh , ASDHigh , ADHD+ASDHigh and REF (reference group: ADHD+ASDLow ). Multiple linear regressions examined the associations between subgroups and eating behaviours (at 10 years) and BMIz (at 14 years), relative to REF. Mediation analyses tested the indirect effect of subgroup and BMIz through eating behaviours. RESULTS ADHD + ASDHigh children expressed both food approach (increased food responsiveness and emotional overeating) and avoidant eating behaviours (increased emotional undereating, satiety responsiveness/ slowness in eating and picky eating, and decreased enjoyment in food). ASDHigh children were more food avoidant, while ADHDHigh children had more food approach behaviours and greater BMIz. ADHDHigh and BMIz were indirectly associated with food responsiveness and emotional overeating. CONCLUSIONS ADHD and autistic trait phenotypes show distinct associations with potential obesity risk factors, and further research is needed to improve targeted early intervention.
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Affiliation(s)
- Holly A. Harris
- Department of Child & Adolescent Psychiatry/PsychologyErasmus MC, University Medical CenterRotterdamThe Netherlands,Generation R StudyErasmus MC, University Medical CenterRotterdamThe Netherlands
| | - April Bowling
- Department of Public Health and NutritionMerrimack College, School of Health SciencesNorth AndoverMassachusettsUSA,Department of PsychiatryUniversity of Massachusetts Chan Medical SchoolWorcesterMassachusettsUSA
| | - Susana Santos
- Generation R StudyErasmus MC, University Medical CenterRotterdamThe Netherlands,Department of PediatricsErasmus MC – Sophia Children's Hospital, University Medical Center RotterdamRotterdamThe Netherlands
| | - Kirstin Greaves‐Lord
- Department of PediatricsErasmus MC – Sophia Children's Hospital, University Medical Center RotterdamRotterdamThe Netherlands,Department of PsychologyUniversity of GroningenGroningenThe Netherlands,Autisme Team North‐NetherlandJonx part of Lentis Psychiatric InstituteGroningenThe Netherlands
| | - Pauline W. Jansen
- Department of Child & Adolescent Psychiatry/PsychologyErasmus MC, University Medical CenterRotterdamThe Netherlands,Generation R StudyErasmus MC, University Medical CenterRotterdamThe Netherlands,Department of Psychology, Education & Child StudiesErasmus University RotterdamRotterdamThe Netherlands
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16
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Ju S, Iwinski S, Fiese BH, McBride BA, Bost KK. Infant temperament and mealtime distractions as predictors of preschool Children's bite speed during family mealtime. Appetite 2022; 177:106157. [PMID: 35780936 DOI: 10.1016/j.appet.2022.106157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 06/20/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022]
Abstract
Eating behaviors are shaped at an early age, persist into adulthood, and are implicated in the development of physical health outcomes, including obesity. Faster bite speed has been identified as an obesogenic eating behavior, prompting researchers to examine child and family factors associated with children's variability in bite speed. Child temperament, involving phenotypes of reactivity and regulation, and distractions in family food contexts are fruitful areas of investigation, but few studies have examined the interplay among these factors and their associations with bite speed. To address the gap in the literature, we examined relations between early child temperament, family mealtime distractions, and children's observed bite speed. Caregiver report of child temperament at 3 months was measured using the Infant Behavior Questionnaire Very Short Form - Revised. Child mealtime distractions and bite speed were assessed using family mealtime videos that were collected during home visits when children were 18-24 months of age (n = 109). Results revealed that children who were reported to be higher on orienting/regulation at 3 months, and who were more distracted during mealtimes at 18-24 months, had relatively slower bite speeds. No significant interactions were found. The findings from this correlational study inform further investigations into the implications of early temperament and food contexts for the development of eating behaviors implicated in obesity risk.
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Affiliation(s)
- Sehyun Ju
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, USA.
| | - Samantha Iwinski
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, USA.
| | - Barbara H Fiese
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, USA; Family Resiliency Center, University of Illinois, Urbana, IL, USA.
| | - Brent A McBride
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, USA; Family Resiliency Center, University of Illinois, Urbana, IL, USA; Child Development Laboratory, University of Illinois, Urbana, IL, USA; Division of Nutritional Sciences, University of Illinois, Urbana, IL, USA.
| | - Kelly K Bost
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, USA; Family Resiliency Center, University of Illinois, Urbana, IL, USA.
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17
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Bjørklund O, Wichstrøm L, Llewellyn C, Steinsbekk S. The prospective relation between eating behaviors and BMI from middle childhood to adolescence: A 5-wave community study. Prev Med Rep 2022; 27:101795. [PMID: 35656230 PMCID: PMC9152788 DOI: 10.1016/j.pmedr.2022.101795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 03/31/2022] [Accepted: 04/17/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Oda Bjørklund
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Dragvoll 7491 Trondheim, Norway
- St Olav University Hospital, 7030 Trondheim, Norway
- Corresponding author at: Department of Psychology, Norwegian University of Science and Technology (NTNU), Dragvoll 7491 Trondheim, Norway.
| | - Lars Wichstrøm
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Dragvoll 7491 Trondheim, Norway
- St Olav University Hospital, 7030 Trondheim, Norway
| | - Clare Llewellyn
- Department of Behavioural Science & Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Silje Steinsbekk
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Dragvoll 7491 Trondheim, Norway
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18
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Francis LA, Rollins BY, Keller KL, Nix RL, Savage JS. Profiles of Behavioral Self-Regulation and Appetitive Traits in Preschool Children: Associations With BMI and Food Parenting Practices. Front Nutr 2022; 9:796580. [PMID: 35308281 PMCID: PMC8931462 DOI: 10.3389/fnut.2022.796580] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Appetitive traits that contribute to appetite self-regulation have been shown to relate to non-food-related regulation in general domains of child development. Latent profile analysis (LPA) was used to identify typologies of preschool children's behavioral self-regulation (BSR) and appetitive traits related to appetite self-regulation (ASR), and we examined their relation with children's BMIz and food parenting practices. Participants included 720 children and their parents (90% mothers), drawn from the baseline assessment of a childhood obesity preventive intervention. BSR measures included teacher reports of children's inhibitory control, impulsivity and attentional focusing, as well as an observed measure of inhibitory control. ASR was assessed using parents' reports of children's appetitive traits related to food avoidance (e.g., satiety responsiveness, slowness in eating) and food approach (e.g., enjoyment of food, food responsiveness). Children's body mass index z-score (BMIz) was calculated from measured height and weight. Parents' BMI and food parenting practices were also measured. Four profiles were identified that characterized children with dysregulated behavior, higher food approach and lower food avoidance (16%), dysregulated behavior but lower food approach and higher food avoidance (33%), regulated behavior but highest food approach and lowest food avoidance (16%), and highly-regulated behavior, lowest food approach and highest food avoidance (35%). Children's BMIz was highest in the profile consisting of children with dysregulated behavior, higher food approach and lower food avoidance. BMI was similar in the profile with children with regulated behavior but highest food approach and lowest food avoidance; children in this profile also had parents who reported the highest levels of controlling food parenting practices, and the lowest levels of parental modeling of healthy eating. Compared to all other profiles, children in the profile characterized by highly-regulated behavior, lowest food approach and highest food avoidance had the lowest BMIz and had parents who reported food parenting practices characterized by the highest levels of child control in feeding and the lowest levels of pressure to eat. These findings provide evidence of differing patterns of relations between self-regulation across behavioral and eating domains, and children's obesity risk may vary based on these different patterns.
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Affiliation(s)
- Lori A. Francis
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States
- *Correspondence: Lori A. Francis
| | - Brandi Y. Rollins
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States
| | - Kathleen L. Keller
- Department of Nutrition Sciences, The Pennsylvania State University, University Park, PA, United States
| | - Robert L. Nix
- Department of Human Development and Family Studies, University of Wisconsin-Madison, Madison, WI, United States
| | - Jennifer S. Savage
- Department of Nutrition Sciences, The Pennsylvania State University, University Park, PA, United States
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19
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Papaioannou MA, Micheli N, Power TG, Fisher JO, Hughes SO. Associations Between Independent Assessments of Child Appetite Self-Regulation: A Narrative Review. Front Nutr 2022; 8:810912. [PMID: 35155527 PMCID: PMC8829138 DOI: 10.3389/fnut.2021.810912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
A variety of eating behaviors among children have been associated with obesity risk and are thought to broadly reflect child appetite self-regulation (ASR). While ASR is thought to occur on cognitive, emotional, motivational, biological, and behavioral levels, the inter-relatedness of ASR constructs as assessed by different methods/measures is not well-characterized. This narrative review describes the correspondence between different methods/measures of child ASR constructs as assessed by self-report questionnaires and/or observational tasks and their relationship to child standardized body mass index (BMIz). Research involving at least two different methods/measures is presented including observational tasks such as the Eating in the Absence of Hunger task, compensation trials, and eating rate, as well as various child eating behavior self-report questionnaires. Keyword searches in the PubMed and PsycINFO databases for articles published between 2000 and July 2021 identified 21,042 articles. Eighteen articles met the inclusion criteria and examined at least two of the targeted measures. Studies comparing questionnaire data with other questionnaire data showed the most evidence of significant associations (r values ranging from −0.45 to 0.49), whereas studies comparing questionnaires with observational tasks mostly showed weak (r values ranging from −0.17 to 0.19) or not significant associations, with only few studies finding moderate associations (r values ranging from −0.38 to 0.33). Studies comparing different observational tasks showed no significant associations. Overall, studies comparing self-report questionnaires showed the most correspondence, whereas those comparing observational tasks showed no correspondence. Studies across methods (questionnaires with tasks) showed less correspondence. Significant associations were found between ASR constructs and child BMIz across five studies using self-report questionnaires and two studies using observational tasks. Future research is needed to clearly define the various ASR constructs, their expected correspondence, and the strength of that correspondence, as well as the relations between ASR constructs and child weight among youth with and without overweight/obesity.
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Affiliation(s)
- Maria A. Papaioannou
- Department of Pediatrics, United States Department of Agriculture/Agricultural Research Service (USDA/ARS) Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Nilda Micheli
- Department of Pediatrics, United States Department of Agriculture/Agricultural Research Service (USDA/ARS) Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Thomas G. Power
- Department of Human Development, Washington State University, Pullman, WA, United States
| | - Jennifer O. Fisher
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, Temple University, Philadelphia, PA, United States
| | - Sheryl O. Hughes
- Department of Pediatrics, United States Department of Agriculture/Agricultural Research Service (USDA/ARS) Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
- *Correspondence: Sheryl O. Hughes
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20
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Russell CG, Appleton J, Burnett AJ, Rossiter C, Fowler C, Denney-Wilson E, Jansen E. Infant Appetitive Phenotypes: A Group-Based Multi-Trajectory Analysis. Front Nutr 2022; 8:749918. [PMID: 35004800 PMCID: PMC8740295 DOI: 10.3389/fnut.2021.749918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/19/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Examining appetitive traits with person-centered analytical approaches can advance the understanding of appetitive phenotype trajectories across infancy, their origins, and influences upon them. The objective of the present study was to empirically describe appetitive phenotype trajectories in infancy and examine the associations with infant and parent factors. Materials and Methods: In this longitudinal cohort study of Australian infants, parents completed three online surveys ~3 months apart, beginning when the infant was <6 months. Appetitive traits were assessed with the Baby Eating Behavior Questionnaire (BEBQ) and parent feeding practices with the Feeding Practices and Structure Questionnaire (FPSQ) infant and toddler version. Parent demographics and cognitions were also collected. Infant weight and length were transcribed from health records and converted to a BMI z-score. Group-based trajectory modeling identified appetitive phenotype trajectories using the BEBQ. Multilevel modeling examined change in feeding practices and child BMI z-score over time by appetitive phenotype trajectories. Results: At time 1, 380 participants completed the survey (mean infant age 98 days), 178 at time 2 (mean infant age 198 days), and 154 at time 3 (mean infant age 303 days). Three multi-trajectory appetitive phenotype groups were identified and labeled as (Phenotype 1) food avoidant trending toward low food approach (21.32% of infants), (Phenotype 2) persistently balanced (50.53% of infants), and (Phenotype 3) high and continuing food approach (28.16% of infants). Formula feeding was more common in Phenotype 1 (p = 0.016). Parents of infants in Phenotype 1 were more likely to rate them as being more difficult than average, compared to infants with phenotypes 2 or 3. Phenotype 2 had the greatest increase in persuasive feeding over time [0.30; 95% CI (0.12, −0.47)]. Conclusions: Distinct multi-trajectory appetitive phenotype groups emerge early in infancy. These trajectories appear to have origins in both infant and parent characteristics as well as parent behaviors and cognitions. The infant multi-trajectory appetitive phenotype groups suggest that for some infants, difficulties in self-regulating appetite emerge early in life. Investigation of infant multi-trajectory appetitive phenotype groups that utilize a range of measures, examine relationships to key covariates and outcomes, and extend from infancy into childhood are needed.
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Affiliation(s)
- Catherine G Russell
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Jessica Appleton
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, NSW, Australia.,Tresillian Family Care Centres, Belmore, Sydney, NSW, Australia
| | - Alissa J Burnett
- Faculty of Health, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
| | - Chris Rossiter
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, NSW, Australia.,Faculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Sydney, NSW, Australia
| | - Cathrine Fowler
- Tresillian Family Care Centres, Belmore, Sydney, NSW, Australia.,Faculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Sydney, NSW, Australia
| | - Elizabeth Denney-Wilson
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, NSW, Australia.,Sydney Local Health District, Sydney, NSW, Australia
| | - Elena Jansen
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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21
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Russell A, Leech RM, Russell CG. Conceptualizing and Measuring Appetite Self-Regulation Phenotypes and Trajectories in Childhood: A Review of Person-Centered Strategies. Front Nutr 2021; 8:799035. [PMID: 35004827 PMCID: PMC8727374 DOI: 10.3389/fnut.2021.799035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 11/30/2021] [Indexed: 12/26/2022] Open
Abstract
This review uses person-centered research and data analysis strategies to discuss the conceptualization and measurement of appetite self-regulation (ASR) phenotypes and trajectories in childhood (from infancy to about ages 6 or 7 years). Research that is person-centered provides strategies that increase the possibilities for investigating ASR phenotypes. We first examine the utility of examining underlying phenotypes using latent profile/class analysis drawing on cross-sectional data. The use of trajectory analysis to investigate developmental change is then discussed, with attention to phenotypes using trajectories of individual behaviors as well as phenotypes based on multi-trajectory modeling. Data analysis strategies and measurement approaches from recent examples of these person-centered approaches to the conceptualization and investigation of appetite self-regulation and its development in childhood are examined. Where relevant, examples from older children as well as developmental, clinical and educational psychology are drawn on to discuss when and how person-centered approaches can be used. We argue that there is scope to incorporate recent advances in biological and psychoneurological knowledge about appetite self-regulation as well as fundamental processes in the development of general self-regulation to enhance the examination of phenotypes and their trajectories across childhood (and beyond). The discussion and conclusion suggest directions for future research and highlight the potential of person-centered approaches to progress knowledge about the development of appetite self-regulation in childhood.
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Affiliation(s)
- Alan Russell
- College of Education, Psychology and Social Work, Flinders University, Bedford Park, SA, Australia
| | - Rebecca M. Leech
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC, Australia
| | - Catherine G. Russell
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC, Australia
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22
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How do young children eat after an obesity intervention? Validation of the Child Eating Behaviour Questionnaire using the Rasch Model in diverse samples from Australia and Sweden. Appetite 2021; 169:105822. [PMID: 34822921 DOI: 10.1016/j.appet.2021.105822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 10/27/2021] [Accepted: 11/20/2021] [Indexed: 12/11/2022]
Abstract
Child eating behaviours have consistently been linked to child weight status. Yet, changes in child eating behaviours during early obesity treatment are rarely evaluated. Psychometric evaluation of the Child Eating Behaviour Questionnaire (CEBQ) is common, but results are sample-dependent and included items may not capture the full range of the underlying traits. Rasch analysis can overcome these disadvantages. The aim of this paper was to assess child eating behaviours measured by the CEBQ after a 12-month obesity intervention applying the Rasch model for the validation of the CEBQ. The Rasch-based fit statistics were applied in children from two samples, Australian and Swedish (n = 1724). Changes in eating behaviours amongst children aged 4-6 years were examined in the More and Less RCT for obesity treatment (n = 177), which compared a parenting programme (with and without boosters) against standard treatment. Parents completed the CEBQ at four time points over 12-months. Linear mixed models were applied to estimate treatment effects on the CEBQ, refined according to Rasch, over time. We found that the validity of CEBQ was confirmed after removing 4 items (item fit statistics outside range 0.5-1.5). When the refined CEBQ was used in the assessment of the RCT, there were no differences in parental reports of changes in children's eating behaviours between the parenting programme and standard treatment (group-by-time interactions p > 0.05). However, in the total sample food approach behaviours decreased while fussy eating behaviours increased (p < 0.05). In conclusion, the refined CEBQ proved to be a valid tool for examining parent-reported child eating behaviours. Early obesity treatment may decrease eating behaviours associated with higher child weight. Future research should address the associations between changes in child weight status and eating behaviours.
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Kim M, Yang J, Ahn WY, Choi HJ. Machine Learning Analysis to Identify Digital Behavioral Phenotypes for Engagement and Health Outcome Efficacy of an mHealth Intervention for Obesity: Randomized Controlled Trial. J Med Internet Res 2021; 23:e27218. [PMID: 34184991 PMCID: PMC8277339 DOI: 10.2196/27218] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 04/28/2021] [Accepted: 05/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The digital health care community has been urged to enhance engagement and clinical outcomes by analyzing multidimensional digital phenotypes. OBJECTIVE This study aims to use a machine learning approach to investigate the performance of multivariate phenotypes in predicting the engagement rate and health outcomes of digital cognitive behavioral therapy. METHODS We leveraged both conventional phenotypes assessed by validated psychological questionnaires and multidimensional digital phenotypes within time-series data from a mobile app of 45 participants undergoing digital cognitive behavioral therapy for 8 weeks. We conducted a machine learning analysis to discriminate the important characteristics. RESULTS A higher engagement rate was associated with higher weight loss at 8 weeks (r=-0.59; P<.001) and 24 weeks (r=-0.52; P=.001). Applying the machine learning approach, lower self-esteem on the conventional phenotype and higher in-app motivational measures on digital phenotypes commonly accounted for both engagement and health outcomes. In addition, 16 types of digital phenotypes (ie, lower intake of high-calorie food and evening snacks and higher interaction frequency with mentors) predicted engagement rates (mean R2 0.416, SD 0.006). The prediction of short-term weight change (mean R2 0.382, SD 0.015) was associated with 13 different digital phenotypes (ie, lower intake of high-calorie food and carbohydrate and higher intake of low-calorie food). Finally, 8 measures of digital phenotypes (ie, lower intake of carbohydrate and evening snacks and higher motivation) were associated with a long-term weight change (mean R2 0.590, SD 0.011). CONCLUSIONS Our findings successfully demonstrated how multiple psychological constructs, such as emotional, cognitive, behavioral, and motivational phenotypes, elucidate the mechanisms and clinical efficacy of a digital intervention using the machine learning method. Accordingly, our study designed an interpretable digital phenotype model, including multiple aspects of motivation before and during the intervention, predicting both engagement and clinical efficacy. This line of research may shed light on the development of advanced prevention and personalized digital therapeutics. TRIAL REGISTRATION ClinicalTrials.gov NCT03465306; https://clinicaltrials.gov/ct2/show/NCT03465306.
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Affiliation(s)
- Meelim Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jaeyeong Yang
- Department of Psychology, Seoul National University, Seoul, Republic of Korea
| | - Woo-Young Ahn
- Department of Psychology, Seoul National University, Seoul, Republic of Korea.,Department of Brain and Cognitive Sciences, Seoul National University, Seoul, Republic of Korea
| | - Hyung Jin Choi
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Anatomy and Cell Biology, Neuroscience Research Institute, Wide River Institute of Immunology, Gangwon-do, Republic of Korea
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24
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Goldstein SP, Thomas JG, Brick LA, Zhang F, Forman EM. Identifying behavioral types of dietary lapse from a mobile weight loss program: Preliminary investigation from a secondary data analysis. Appetite 2021; 166:105440. [PMID: 34098003 DOI: 10.1016/j.appet.2021.105440] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/23/2021] [Accepted: 05/18/2021] [Indexed: 12/22/2022]
Abstract
Success in behavioral weight loss (BWL) programs depends on adherence to the recommended diet to reduce caloric intake. Dietary lapses (i.e., deviations from the BWL diet) occur frequently and can adversely affect weight loss outcomes. Research indicates that lapse behavior is heterogenous; there are many eating behaviors that could constitute a dietary lapse, but they are rarely studied as distinct contributors to weight outcomes. This secondary analysis aims to evaluate six behavioral lapse types during a 10-week mobile BWL program (eating a large portion, eating when not intended, eating an off-plan food, planned lapse, being unaware of caloric content, and endorsing multiple types of lapse). Associations between weekly behavioral lapse type frequency and weekly weight loss were investigated, and predictive contextual characteristics (psychological, behavioral, and environmental triggers for lapse) and individual difference (e.g., age, gender) factors were examined across lapse types. Participants (N = 121) with overweight/obesity (MBMI = 34.51; 84.3% female; 69.4% White) used a mobile BWL program for 10 weeks, self-weighed weekly using Bluetooth scales, completed daily ecological momentary assessment of lapse behavior and contextual characteristics, and completed a baseline demographics questionnaire. Linear mixed models revealed significant negative associations between unplanned lapses and percent weight loss. Unplanned lapses from eating a large portion, eating when not intended, and having multiple "types" were significantly negatively associated with weekly percent weight loss. A lasso regression showed that behavioral lapse types share many similar stable factors, with other factors being unique to specific lapse types. Results add to the prior literature on lapses and weight loss in BWL and provide preliminary evidence that behavioral lapse types could aid in understanding adherence behavior and developing precision medicine tools to improve dietary adherence.
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Affiliation(s)
- Stephanie P Goldstein
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University & the Miriam Hospital/Weight Control and Diabetes Research Center, United States.
| | - J Graham Thomas
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University & the Miriam Hospital/Weight Control and Diabetes Research Center, United States
| | - Leslie A Brick
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, United States
| | - Fengqing Zhang
- Department of Psychology, College of Arts and Sciences, Drexel University, United States
| | - Evan M Forman
- Department of Psychology, College of Arts and Sciences, Drexel University, United States; Center for Weight, Eating, And Lifestyle Sciences (WELL Center), Drexel University, United States
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25
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Vollmer RL. The relationship between parental food parenting practices & child eating behavior: A comparison of mothers and fathers. Appetite 2021; 162:105193. [PMID: 33675859 DOI: 10.1016/j.appet.2021.105193] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 12/30/2020] [Accepted: 02/28/2021] [Indexed: 01/27/2023]
Abstract
The objective of this study was to compare the relationships between food parenting practices and child eating behavior among mothers and fathers of young children. This cross-sectional study recruited mothers (n = 127) and fathers (n = 118) of children (4.2 ± 1.3 years old) to complete surveys (face-to-face and online). Each parent completed the Comprehensive Food Parenting Questionnaire, Children's Eating Behavior Questionnaire, and demographic questions. Linear regressions were used to compare the relationships between parental food parenting practices and children's eating behaviors with parent sex as a moderator. Child age and sex served as control variables in each regression. Parent sex was a significant moderator in several relationships between parent food parenting practices and child eating behavior. In the relationship between parental restriction for health (ß = -.14, p = .014) and monitoring (ß = -.13, p = .028) and child slowness in eating, the slope of the interaction was significantly higher for mothers, meaning that when mothers and fathers use the same level of restriction for health and monitoring, child slowness in eating is higher for children of mothers. When mothers and fathers used the same level of restriction for weight, child food responsiveness (ß = .13, p = .003) and emotional overeating (ß = .12, p = .046) was significantly higher for children of fathers. There may be differences in how mothers and fathers implement food parenting practices and/or differences in how these practices impact children. Specifically, for fathers, it seems that the use of restriction for weight is more detrimental for children's eating behaviors compared to when mothers use the same level of restriction for weight.
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Affiliation(s)
- Rachel L Vollmer
- Illinois State University, Campus Box 5060, Normal, IL, 61790, USA.
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26
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Appetite self-regulation declines across childhood while general self-regulation improves: A narrative review of the origins and development of appetite self-regulation. Appetite 2021; 162:105178. [PMID: 33639246 DOI: 10.1016/j.appet.2021.105178] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/18/2021] [Accepted: 02/21/2021] [Indexed: 02/07/2023]
Abstract
This narrative review discusses the origins and development of appetite self-regulation (ASR) in childhood (from infancy to age 6 or 7 years). The origins, or foundations, are the biological infrastructure associated with appetite regulation and appetite self-regulation. Homeostatic regulation in infancy is examined and then evidence about developmental change in components of ASR. The main ASR-related components covered are: delay-of-gratification, caloric compensation, eating in the absence of hunger, food responsiveness/hedonics and fussy eating. The research included behavioral measures, parent-reports of appetitive traits and fMRI studies. There were two main trends in the evidence: a decline across childhood in the components of ASR associated with food approach (and therefore an increase in disinhibited eating), and wide individual differences. The decline in ASR contrasts with general self-regulation (GSR) where the evidence is of an improvement across childhood. For many children, bottom-up automatic reactive processes via food reward/hedonics or food avoidance as in fussy eating, appear not to be matched by improvements in top-down regulatory capacities. The prominence of bottom-up processes in ASR could be the main factor in possible differences in developmental paths for GSR and ASR. GSR research is situated in developmental science with its focus on developmental processes, theory and methodology. In contrast, the development of ASR at present does not have a strong developmental tradition to access and there is no unifying model of ASR and its development. We concluded (1) outside of mean-level or normative changes in the components of ASR, individual differences are prominent, and (2) there is a need to formulate models of developmental change in ASR together with appropriate measurement, research designs and data analysis strategies.
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Gautron L. The Phantom Satiation Hypothesis of Bariatric Surgery. Front Neurosci 2021; 15:626085. [PMID: 33597843 PMCID: PMC7882491 DOI: 10.3389/fnins.2021.626085] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/06/2021] [Indexed: 01/26/2023] Open
Abstract
The excitation of vagal mechanoreceptors located in the stomach wall directly contributes to satiation. Thus, a loss of gastric innervation would normally be expected to result in abrogated satiation, hyperphagia, and unwanted weight gain. While Roux-en-Y-gastric bypass (RYGB) inevitably results in gastric denervation, paradoxically, bypassed subjects continue to experience satiation. Inspired by the literature in neurology on phantom limbs, I propose a new hypothesis in which damage to the stomach innervation during RYGB, including its vagal supply, leads to large-scale maladaptive changes in viscerosensory nerves and connected brain circuits. As a result, satiation may continue to arise, sometimes at exaggerated levels, even in subjects with a denervated or truncated stomach. The same maladaptive changes may also contribute to dysautonomia, unexplained pain, and new emotional responses to eating. I further revisit the metabolic benefits of bariatric surgery, with an emphasis on RYGB, in the light of this phantom satiation hypothesis.
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Affiliation(s)
- Laurent Gautron
- Department of Internal Medicine, Center for Hypothalamic Research, The University of Texas Southwestern Medical Center, Dallas, TX, United States
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28
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Qorbani M, Khashayar P, Rastad H, Ejtahed HS, Shahrestanaki E, Seif E, Daniali SS, Goudarzi M, Motlagh ME, Khodaparast Z, Heshmat R, Kelishadi R. Association of dietary behaviors, biochemical, and lifestyle factors with metabolic phenotypes of obesity in children and adolescents. Diabetol Metab Syndr 2020; 12:108. [PMID: 33372634 PMCID: PMC7720466 DOI: 10.1186/s13098-020-00617-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 11/23/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND AND AIMS To examine the association of dietary behaviors, lifestyle, and biochemical factors with metabolic phenotypes of obesity among obese Iranian children and adolescents. METHODS This cross-sectional study was conducted within the framework of the fifth phase of CASPIAN study. Of 3840 students aged 7-18 years of 30 Iranian provinces, 408 subjects were diagnosed as obese; they were divided into metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO) groups. Biochemical factors, anthropometric measures, dietary, and lifestyle habits were compared between groups. RESULTS Of the 408 obese subjects, 68 (16.7%) were the MUO; the remaining 340 (84.3%) fall in the MHO group. The MUO group had significantly higher systolic and diastolic BPs, FBS, TG, ALT, anthropometric measures, and lower HDL levels than MHO groups (all p-value < 0.05). The frequency of high birth weight (> 4000 gr) was significantly higher in the MUO group than the MHO group (p-value: 0.04). A higher percentage of individuals with breastfeeding duration ≥ 6 month was found in the MUO group (95.5% (95% CI 86.1-98.6%)) compared to MHO group (85.7% (95% CI 80.4-89.7%)) (p-value = 0.04). Among dietary and lifestyle-related behaviors, only the frequency of salty snack consumption and eating food according to the parents' request was significantly higher in the MUO group than the MHO group (p-value < 0.05). CONCLUSION Dietary habits and lifestyle factors may determine the obesity phenotypes in children and adolescents.
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Affiliation(s)
- Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 111, 19th St., North Kargar Ave, Tehran, Iran
| | - Pouria Khashayar
- Cardiovascular Department, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Hadith Rastad
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ehsan Shahrestanaki
- Dietary Supplements and Probiotic Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Ehsan Seif
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Seyede Shahrbanoo Daniali
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezar Jerib Ave, Isfahan, Iran
| | - Masoomeh Goudarzi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezar Jerib Ave, Isfahan, Iran
| | | | - Zeinab Khodaparast
- Clinical Research Development Center of Kamali Hospital, Alborz University of Medical Sciences, Karaj, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 111, 19th St., North Kargar Ave, Tehran, Iran.
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezar Jerib Ave, Isfahan, Iran.
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29
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Scott-Sheldon LAJ, Hedges LV, Cyr C, Young-Hyman D, Khan LK, Magnus M, King H, Arteaga S, Cawley J, Economos CD, Haire-Joshu D, Hunter CM, Lee BY, Kumanyika SK, Ritchie LD, Robinson TN, Schwartz MB. Childhood Obesity Evidence Base Project: A Systematic Review and Meta-Analysis of a New Taxonomy of Intervention Components to Improve Weight Status in Children 2-5 Years of Age, 2005-2019. Child Obes 2020; 16:S221-S248. [PMID: 32936038 PMCID: PMC7482126 DOI: 10.1089/chi.2020.0139] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective: To evaluate the efficacy of childhood obesity interventions and conduct a taxonomy of intervention components that are most effective in changing obesity-related health outcomes in children 2-5 years of age. Methods: Comprehensive searches located 51 studies from 18,335 unique records. Eligible studies: (1) assessed children aged 2-5, living in the United States; (2) evaluated an intervention to improve weight status; (3) identified a same-aged comparison group; (4) measured BMI; and (5) were available between January 2005 and August 2019. Coders extracted study, sample, and intervention characteristics. Effect sizes [ESs; and 95% confidence intervals (CIs)] were calculated by using random-effects models. Meta-regression was used to determine which intervention components explain variability in ESs. Results: Included were 51 studies evaluating 58 interventions (N = 29,085; mean age = 4 years; 50% girls). Relative to controls, children receiving an intervention had a lower BMI at the end of the intervention (g = 0.10, 95% CI = 0.02-0.18; k = 55) and at the last follow-up (g = 0.17, 95% CI = 0.04-0.30; k = 14; range = 18-143 weeks). Three intervention components moderated efficacy: engage caregivers in praise/encouragement for positive health-related behavior; provide education about the importance of screen time reduction to caregivers; and engage pediatricians/health care providers. Conclusions: Early childhood obesity interventions are effective in reducing BMI in preschool children. Our findings suggest that facilitating caregiver education about the importance of screen time reduction may be an important strategy in reducing early childhood obesity.
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Affiliation(s)
- Lori A J Scott-Sheldon
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Larry V Hedges
- Department of Statistics, Northwestern University, Evanston, IL, USA
| | - Chris Cyr
- Impact Genome Project, Mission Measurement, Chicago, IL, USA
| | - Deborah Young-Hyman
- Office of Behavioral and Social Sciences, Office of the Director, National Institutes of Health, Bethesda, MD, USA
| | - Laura Kettel Khan
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Heather King
- Impact Genome Project, Mission Measurement, Chicago, IL, USA
| | - Sonia Arteaga
- Office of the Director, National Institutes of Health, National Institutes of Health, Bethesda, MD, USA
| | - John Cawley
- Department of Policy Analysis and Management, Cornell University, Ithaca, NY, USA
- Department of Economics, Cornell University, Ithaca, NY, USA
| | - Christina D Economos
- Division of Nutrition Interventions, Communication, and Behavior Change, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Debra Haire-Joshu
- Center for Obesity Prevention and Policy Research, Brown School, Washington University, Saint Louis, MO, USA
| | - Christine M Hunter
- Office of Behavioral and Social Sciences, Office of the Director, National Institutes of Health, Bethesda, MD, USA
| | - Bruce Y Lee
- CUNY Graduate School of Public Health and Policy, New York, NY, USA
| | - Shiriki K Kumanyika
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Lorrene D Ritchie
- Nutrition Policy Institute, University of California, Division of Agriculture and Natural Resources, Berkeley, CA, USA
| | - Thomas N Robinson
- Departments of Pediatrics and Medicine, Stanford Solutions Science Lab, Stanford University, Stanford, CA, USA
| | - Marlene B Schwartz
- Department of Human Development and Family Studies, University of Connecticut, Hartford, CT, USA
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Vervoort L, Naets T, De Guchtenaere A, Tanghe A, Braet C. Using confidence interval-based estimation of relevance to explore bottom-up and top-down determinants of problematic eating behavior in children and adolescents with obesity from a dual pathway perspective. Appetite 2020; 150:104676. [PMID: 32198094 DOI: 10.1016/j.appet.2020.104676] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/12/2020] [Accepted: 03/12/2020] [Indexed: 10/24/2022]
Abstract
Prevalence of overweight and obesity in children and adolescents is high, not only in Western countries but also in developing countries. Efforts to improve prevention and treatment programs are needed. Given their essential role in weight problems, knowledge of determinants of problematic eating behavior ('External Eating' and 'Emotional Eating') is crucial for intervention development. Inspired by Appelhans' Dual Process Theory of Eating Behavior, the present study evaluated the importance of top-down regulative capacities and bottom-up reactivity, using the CIBER approach. CIBER is an innovative statistical approach to test the importance of behavior determinants, based on confidence intervals, instead of significance testing of point estimates. Survey data on different aspects of executive functioning (as indices of regulative capacities: Inhibition, Cognitive Flexibility, Emotional Control, Initiation, Working Memory, Planning/Organizing, Organization of materials, and Monitoring) and reward sensitivity (as an index of reactivity) were collected in a large sample of children and adolescents (n = 572) with severe obesity (adjBMI > 180%). Results showed that Emotional Eating is determined by Emotional Control, while External Eating is determined by Reward Sensitivity. The finding that differential mechanisms underlie different aspects of problematic eating suggests the need for using tailored intervention techniques to address altered reactivity and weak regulative capacities.
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Affiliation(s)
- L Vervoort
- Department of Developmental, Personality and Social Psychology, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium.
| | - T Naets
- Department of Developmental, Personality and Social Psychology, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium; Odisee University College, Department Health Care (Dietetics), Gebroeders de Smetstraat 1, 9000, Gent, Belgium.
| | - A De Guchtenaere
- Zeepreventorium, Koninklijke Baan 5, 8420, De Haan, Belgium; Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, C. Heymanslaan 10, 9000, Ghent, Belgium.
| | - A Tanghe
- Zeepreventorium, Koninklijke Baan 5, 8420, De Haan, Belgium.
| | - C Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium.
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31
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Hepworth AD, Moding KJ, Stifter CA. A laboratory-based assessment of mother-child snack food selections and child snack food consumption: Associations with observed and maternal self-report of child feeding practices. Food Qual Prefer 2020; 83. [PMID: 32483400 DOI: 10.1016/j.foodqual.2020.103898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study explored how mothers' observed and self-reported child feeding practices (child control over food choices, encouragement of balance and variety, and teaching about nutrition) were associated with mother-child snack food selections and child snack food consumption in a laboratory setting. Mothers (N = 107) and their 4.5-year-old children (52% female) selected up to 5 snack foods (out of 9 snack foods: 6 higher-energy-density [ED] and 3 lower-ED) for optional child consumption throughout a one-hour laboratory visit. Mothers' in-the-moment child feeding practices during the snack food selection task were coded using observational coding schemes, and mothers' global child feeding practices (i.e., across meals and snacking occasions) were self-reported using the Comprehensive Feeding Practices Questionnaire (Musher-Eizenman & Holub, 2007). Results of multiple linear regression analyses with covariates showed that higher-ED snack food selections were positively associated with observed child control over food choices (B = 0.35, SE = 0.12, p = .006) and self-reported teaching about nutrition (B = 0.49, SE = 0.19, p = .010), and negatively associated with self-reported encouragement of balance and variety (B = -0.66, SE = 0.24, p = .007). Lower-ED snack food selections were positively associated with self-reported encouragement of balance and variety (B = 0.53, SE = 0.20, p = .008). Child consumption of higher-ED or lower-ED snack foods were not significantly associated with mothers' child feeding practices (observed or self-reported). We discuss the implications of these findings for future research on children's snack food selection and consumption.
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Affiliation(s)
- Allison D Hepworth
- University of Maryland School of Social Work, 525 West Redwood Street, Baltimore, MD 21201, USA
| | - Kameron J Moding
- Purdue University, Fowler Memorial House, 1200 West State Street, West Lafayette, IN, 47907, USA
| | - Cynthia A Stifter
- Pennsylvania State University, 236 Health and Human Development Building, University Park, PA 16802, USA
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32
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Berthoud HR, Morrison CD, Münzberg H. The obesity epidemic in the face of homeostatic body weight regulation: What went wrong and how can it be fixed? Physiol Behav 2020; 222:112959. [PMID: 32422162 DOI: 10.1016/j.physbeh.2020.112959] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 04/23/2020] [Accepted: 05/04/2020] [Indexed: 12/14/2022]
Abstract
Ever since the pioneering discoveries in the mid nineteen hundreds, the hypothalamus was recognized as a crucial component of the neural system controlling appetite and energy balance. The new wave of neuron-specific research tools has confirmed this key role of the hypothalamus and has delineated many other brain areas to be part of an expanded neural system sub serving these crucial functions. However, despite significant progress in defining this complex neural circuitry, many questions remain. One of the key questions is why the sophisticated body weight regulatory system is unable to prevent the rampant obesity epidemic we are experiencing. Why are pathologically obese body weight levels defended, and what can we do about it? Here we try to find answers to these questions by 1) reminding the reader that the neural controls of ingestive behavior have evolved in a demanding, restrictive environment and encompass much of the brain's major functions, far beyond the hypothalamus and brainstem, 2) hypothesizing that the current obesogenic environment impinges mainly on a critical pathway linking hypothalamic areas with the motivational and reward systems to produce uncompensated hyperphagia, and 3) proposing adequate strategies for prevention and treatment.
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Affiliation(s)
- Hans-Rudolf Berthoud
- Neurobiology of Nutrition & Metabolism Department, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA.
| | - Christopher D Morrison
- Neurobiology of Nutrition & Metabolism Department, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Heike Münzberg
- Neurobiology of Nutrition & Metabolism Department, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
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Fogel A, McCrickerd K, Aris IM, Goh AT, Chong YS, Tan KH, Yap F, Shek LP, Meaney MJ, Broekman BF, Godfrey KM, Chong MFF, Cai S, Pang WW, Yuan WL, Lee YS, Forde CG. Eating behaviors moderate the associations between risk factors in the first 1000 days and adiposity outcomes at 6 years of age. Am J Clin Nutr 2020; 111:997-1006. [PMID: 32219418 PMCID: PMC7332343 DOI: 10.1093/ajcn/nqaa052] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 02/25/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Several risk factors in the first 1000 d are linked with increased obesity risk in later childhood. The role of potentially modifiable eating behaviors in this association is unclear. OBJECTIVES This study examined whether the association between cumulated risk factors in the first 1000 d and adiposity at 6 y is moderated by eating behaviors. METHODS Participants were 302 children from the GUSTO (Growing Up in Singapore Towards healthy Outcomes) cohort. Risk factors included maternal prepregnancy and paternal overweight, excessive gestational weight gain, raised fasting plasma glucose during pregnancy, short breastfeeding duration, and early introduction of solid foods. Composite risk scores reflecting the prevalence and the importance of the risk factors present were computed. Adiposity outcomes were child BMI and sum of skinfolds (SSF), and candidate eating behavior moderators were portion size, eating rate, and energy intake during lunch and in an eating in the absence of hunger task. RESULTS Higher composite risk score predicted higher BMI z scores (B = 0.08; 95% CI: 0.04, 0.13) and larger SSF (0.70 mm; 0.23, 1.18 mm), and was associated with larger self-served food portions (5.03 kcal; 0.47, 9.60 kcal), faster eating rates (0.40 g/min; 0.21, 0.59 g/min), and larger lunch intakes (7.05 kcal; 3.37, 10.74 kcal). Importantly, the association between composite risk score and adiposity was moderated by eating behaviors. The composite risk score was unrelated to SSF in children who selected smaller food portions, ate slower, and consumed less energy, but was positively associated with SSF among children who selected larger food portions, ate faster, and consumed more energy (eating behavior × risk score interactions: P < 0.05). CONCLUSIONS The association between risk factors in the first 1000 d and adiposity at 6 y varies by eating behaviors, highlighting modifiable behavioral targets for interventions.This trial was registered at clinicaltrials.gov as NCT01174875.
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Affiliation(s)
- Anna Fogel
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore
| | - Keri McCrickerd
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore
| | - Izzuddin M. Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Ai Ting Goh
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Fabian Yap
- KK Women’s and Children’s Hospital, Singapore
| | - Lynette P. Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael J. Meaney
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore,Department of Psychiatry, McGill University & Sackler Institute for Epigenetics & Psychobiology at McGill University, Montreal, Quebec, Canada,Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, Montreal, Canada
| | - Birit F.P. Broekman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore,Department of Psychiatry, VU Medical Centre, VU University, Amsterdam
| | - Keith M. Godfrey
- Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Mary Foong Fong Chong
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Shirong Cai
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wei Wei Pang
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wen Lun Yuan
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ciarán G. Forde
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Author to whom correspondence should be addressed: Ciaran Gerard Forde: Centre for Translational Medicine, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, Singapore 117599; Tel: +65 64070104;
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Is breastfeeding associated with later child eating behaviours? Appetite 2020; 150:104653. [PMID: 32151607 DOI: 10.1016/j.appet.2020.104653] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/06/2020] [Accepted: 03/06/2020] [Indexed: 01/02/2023]
Abstract
Individual differences in children's eating behaviours emerge early. We examined the relationship between breastfeeding exposure and subsequent eating behaviours among children from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. Children (n = 970) were grouped according to their breastfeeding exposure: high (full breastfeeding ≥ 4 months with continued breastfeeding ≥ 6 months), low (any breastfeeding < 3 months or no breastfeeding) and intermediate (between low and high breastfeeding categories). Aspects of eating behaviour from ages 15 months to 6 years were captured using a combination of maternal reports (Child Eating Behaviour Questionnaire; Infant Feeding Questionnaire; Preschooler Feeding Questionnaire) and laboratory-based measures of meal size, oral processing behaviours (e.g. average eating speed and bite size) and tendency to eat in the absence of hunger. Most children had low (44%) or intermediate (44%) breastfeeding exposure; only 12% had high exposure. After adjusting for confounders, multivariable linear regression analyses indicated the high (but not intermediate) breastfeeding group was associated with significantly lower reported food fussiness at 3 years compared to low breastfeeding group (-0.38 [-0.70, -0.06]), with similar but non-significant trends observed at 6 years (-0.27 [-0.66, 0.11]). At 3 years, mothers in the high breastfeeding group also reported the least difficulty in child feeding compared to low breastfeeding group (-0.22 [-0.43, -0.01]). However, high breastfeeding was not associated with any other maternal-reports of child feeding or eating behaviours, and no significant associations were observed between breastfeeding exposure and any of the laboratory measures of eating behaviour at any of the time points. These results do not strongly support the view that increased breastfeeding exposure alone has lasting and consistent associations with eating behaviours in early childhood.
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Kaiser KA, Carson TL, Dhurandhar EJ, Neumeier WH, Cardel MI. Biobehavioural approaches to prevention and treatment: A call for implementation science in obesity research. Obes Sci Pract 2020; 6:3-9. [PMID: 32128237 PMCID: PMC7042105 DOI: 10.1002/osp4.384] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/11/2019] [Accepted: 10/24/2019] [Indexed: 12/31/2022] Open
Abstract
Much progress has been made in the last 30 years in understanding the causes and mechanisms that contribute to obesity, yet widely available and successful strategies for prevention and treatment remain elusive at population levels. This paper discusses the biobehavioural framework and provides suggestions for applying it to enable greater progress in the science of obesity prevention and treatment, including an increased focus on implementation of science strategies. The objective is to promote a re-evaluation of current views about preventing and treating obesity within a unified biobehavioural framework. Further integration of research exploring how both behavioural and biological components interact is a critical step forward.
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Affiliation(s)
- Kathryn A. Kaiser
- Department of Health Behavior, School of Public HealthUniversity of Alabama at BirminghamBirminghamAlabama
- Nutrition Obesity Research CenterUniversity of Alabama at BirminghamBirminghamAlabama
| | - Tiffany L. Carson
- Nutrition Obesity Research CenterUniversity of Alabama at BirminghamBirminghamAlabama
- Division of Preventive Medicine, School of MedicineUniversity of Alabama at BirminghamBirminghamAlabama
| | - Emily J. Dhurandhar
- Department of Kinesiology and Sport ManagementTexas Tech UniversityLubbockTexas
| | - William H. Neumeier
- United States Army Research Institute of Environmental MedicineNatickMassachusetts
| | - Michelle I. Cardel
- Department of Health Outcomes & Biomedical Informatics, College of MedicineUniversity of FloridaGainesvilleFlorida
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Bates CR, Bohnert AM, Buscemi J, Vandell DL, Lee KTH, Bryant FB. Family entropy: understanding the organization of the family home environment and impact on child health behaviors and weight. Transl Behav Med 2020; 9:413-421. [PMID: 31094439 DOI: 10.1093/tbm/ibz042] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Child obesity is a major public health issue with a high disease burden. Although numerous contributing factors have been identified, the family home environment is a central context of influence that requires deeper understanding. The level of organization in the family home environment may influence obesity and obesogenic behaviors, but the literature has suffered from the lack of a strong overarching construct and model to guide this area of research. Family entropy is a conceptual framework that fills this gap by representing the level of organization across the home environment. The current study empirically assesses family entropy using factor analysis in a longitudinal sample of 968 children measured yearly from Grades 3 to 6 as part of the NICHD Study of Early Child Care and Youth Development. Mixed modeling using MPLUS examined the influence of family entropy on child weight both directly and indirectly through weight-related health behaviors (i.e., sleep and physical activity), and considered the moderating role of socioeconomic status (SES). Results suggest that family entropy is comprised of distinct elements of household organization and disorganization, which are moderately related. Household disorganization may be particularly detrimental to child sleeping behavior both concurrently and over time in families of both high and low SES. The study concludes with recommendations for advancing understanding of the home environment by using nuanced measurement strategies, and incorporating support for household organization within child obesity prevention and intervention efforts.
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Affiliation(s)
- Carolyn R Bates
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - Amy M Bohnert
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - Joanna Buscemi
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - Deborah L Vandell
- School of Education, University of California, Irvine, Irvine, CA, USA
| | - Kenneth T H Lee
- School of Education, University of California, Irvine, Irvine, CA, USA
| | - Fred B Bryant
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
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Brugaillères P, Chabanet C, Issanchou S, Schwartz C. Caloric compensation ability around the age of 1 year: Interplay with the caregiver-infant mealtime interaction and infant appetitive traits. Appetite 2019; 142:104382. [DOI: 10.1016/j.appet.2019.104382] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 06/07/2019] [Accepted: 07/21/2019] [Indexed: 12/11/2022]
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Gowey MA, Dutton GR. It's not all in your head: Genetic underpinnings of the relationship between executive function and BMI. Am J Clin Nutr 2019; 110:793-794. [PMID: 31380558 PMCID: PMC6766437 DOI: 10.1093/ajcn/nqz175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 07/09/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Marissa A Gowey
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA,Address correspondence to MAG (e-mail: )
| | - Gareth R Dutton
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Sandvik P, Ek A, Eli K, Somaraki M, Bottai M, Nowicka P. Picky eating in an obesity intervention for preschool-aged children - what role does it play, and does the measurement instrument matter? Int J Behav Nutr Phys Act 2019; 16:76. [PMID: 31481062 PMCID: PMC6724280 DOI: 10.1186/s12966-019-0845-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 08/27/2019] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Research on picky eating in childhood obesity treatment is limited and inconsistent, with various instruments and questions used. This study examines the role of picky eating in a randomized controlled obesity intervention for preschoolers using subscales from two instruments: The Child Eating Behavior Questionnaire (CEBQ) and the Lifestyle Behavior Checklist (LBC). METHOD The study includes 130 children (mean age 5.2 years (SD 0.7), 54% girls, mean Body Mass Index (BMI) z-score 2.9 (SD 0.6)) and their parents (nearly 60% of non-Swedish background, 40% with university degree). Families were randomized to a parent-group treatment focusing on evidence-based parenting practices or to standard treatment focusing on lifestyle changes. The children's heights and weights (BMI z-score) were measured at baseline, and at 3, 6 and 12 months post baseline. At these time-points, picky eating was reported by parents using the CEBQ (Food Fussiness scale, 6 items) and 5 items from the LBC. Child food intake was reported with a Food Frequency Questionnaire (FFQ). Pearson correlation was used to study associations between baseline picky eating and baseline BMI z-scores and food intake. Mixed effects models were used to study associations between the two measurements of picky eating and changes in picky eating, to assess the effects of changes in picky eating on BMI z-scores, and to evaluate baseline picky eating as a predictor of changes in BMI z-scores. RESULTS Neither the standard treatment nor the parent-group treatment reduced the degree of picky eating (measured with CEBQ or LBC). Baseline picky eating measured with the CEBQ was associated with a lower BMI z-score and lower intake of vegetables. Children with a higher degree of picky eating at baseline (measured with the CEBQ) displayed a lower degree of weight loss. When degree of picky eating was examined, for 25% of the children, the CEBQ and the LBC yielded diverging results. CONCLUSIONS Baseline picky eating may weaken the effectiveness of obesity treatment, and assessments should be conducted before treatment to adjust the treatment approach. Different measurements of picky eating may lead to different results. The CEBQ seems more robust than the LBC in measuring picky eating. TRIAL REGISTRATION Clinicaltrials.gov , NCT01792531. Registered 15 February 2013 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT01792531.
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Affiliation(s)
- Pernilla Sandvik
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Box 560, 751 22, Uppsala, Sweden.
| | - Anna Ek
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Karin Eli
- Social Science and Systems in Health, Division of Health Sciences, Warwick Medical School, University of Warwick, Warwick, England.,Unit for Biocultural Variation and Obesity, School of Anthropology and Museum Ethnography, University of Oxford, Oxford, England
| | - Maria Somaraki
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Box 560, 751 22, Uppsala, Sweden
| | - Matteo Bottai
- Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Paulina Nowicka
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Box 560, 751 22, Uppsala, Sweden.,Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
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40
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Russell CG, Russell A. A biopsychosocial approach to processes and pathways in the development of overweight and obesity in childhood: Insights from developmental theory and research. Obes Rev 2019; 20:725-749. [PMID: 30768750 DOI: 10.1111/obr.12838] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/16/2018] [Accepted: 01/07/2019] [Indexed: 12/12/2022]
Abstract
Childhood obesity has reached alarming proportions in many countries. There is consensus that both biological (especially genetic) and environmental (including psychosocial) factors contribute to weight gain and obesity in childhood. Research has identified extensive risk or predictive factors for childhood obesity from both of these domains. There is less consensus about the developmental processes or pathways showing how these risk factors lead to overweigh/obesity (OW/OB) in childhood. We outline a biopsychosocial process model of the development of OW/OB in childhood. The model and associated scholarship from developmental theory and research guide an analysis of research on OW/OB in childhood. The model incorporates biological factors such as genetic predispositions or susceptibility genes, temperament, and homeostatic and allostatic processes with the psychosocial and behavioral factors of parenting, parental feeding practices, child appetitive traits, food liking, food intakes, and energy expenditure. There is an emphasis on bidirectional and transactional processes linking child biology and behavior with psychosocial processes and environment. Insights from developmental theory and research include implications for conceptualization, measurement, research design, and possible multiple pathways to OW/OB. Understanding the developmental processes and pathways involved in childhood OW/OB should contribute to more targeted prevention and intervention strategies in childhood.
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Affiliation(s)
- Catherine G Russell
- Faculty of Health, School of Exercise and Nutrition Sciences, Centre for Advanced Sensory Science, Deakin University, Burwood, Australia
| | - Alan Russell
- College of Education, Psychology and Social Work, Flinders University, Bedford Park, South Australia
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Smethers AD, Roe LS, Sanchez CE, Zuraikat FM, Keller KL, Kling SMR, Rolls BJ. Portion size has sustained effects over 5 days in preschool children: a randomized trial. Am J Clin Nutr 2019; 109:1361-1372. [PMID: 30976782 PMCID: PMC6499504 DOI: 10.1093/ajcn/nqy383] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 12/14/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Although short-term studies have found that serving larger portions of food increases intake in preschool children, it is unknown whether this portion size effect persists over a longer period or whether energy intake is moderated through self-regulation. OBJECTIVES We tested whether the portion size effect is sustained in preschool children across 5 consecutive days, a period thought to be sufficient for regulatory systems to respond to the overconsumption of energy. METHODS With the use of a crossover design, over 2 periods we served the same 5 daily menus to 46 children aged 3-5 y in their childcare centers. In 1 period, all foods and milk were served in baseline portions, and in the other period, all portions were increased by 50%. The served items were weighed to determine intake. RESULTS Increasing the portion size of all foods and milk by 50% increased daily consumption: weighed intake increased by a mean ± SEM of 143 ± 21 g/d (16%) and energy intake increased by 167 ± 22 kcal/d (18%; both P < 0.0001). The trajectories of intake by weight and energy across the 5-day period were linear and the slopes did not differ between portion conditions (both P > 0.13), indicating that there were sustained increases in intake from larger portions without compensatory changes over time. Children differed in their response to increased portions: those with higher weight status, lower ratings for satiety responsiveness, or higher ratings for food responsiveness had greater increases in intake from larger portions (all P < 0.03). CONCLUSIONS This demonstration that preschool children failed to adjust their intake during prolonged exposure to larger portions challenges the suggestion that their self-regulatory behavior is sufficient to counter perturbations in energy intake. Furthermore, overconsumption from large portions may play a role in the development of overweight and obesity, as the magnitude of the effect was greater in children of higher weight status. This trial was registered at www.clinicaltrials.gov as NCT02963987.
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Affiliation(s)
- Alissa D Smethers
- Departments of Nutritional Sciences, The Pennsylvania State University, University Park, PA
| | - Liane S Roe
- Departments of Nutritional Sciences, The Pennsylvania State University, University Park, PA
| | - Christine E Sanchez
- Departments of Nutritional Sciences, The Pennsylvania State University, University Park, PA
| | - Faris M Zuraikat
- Departments of Nutritional Sciences, The Pennsylvania State University, University Park, PA
| | - Kathleen L Keller
- Departments of Nutritional Sciences, The Pennsylvania State University, University Park, PA,Departments of Food Science, The Pennsylvania State University, University Park, PA
| | - Samantha M R Kling
- Departments of Nutritional Sciences, The Pennsylvania State University, University Park, PA
| | - Barbara J Rolls
- Departments of Nutritional Sciences, The Pennsylvania State University, University Park, PA,Address correspondence to BJR (e-mail: )
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42
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Arteaga SS, Esposito L, Osganian SK, Pratt CA, Reedy J, Young-Hyman D. Childhood obesity research at the NIH: Efforts, gaps, and opportunities. Transl Behav Med 2019; 8:962-967. [PMID: 30329138 DOI: 10.1093/tbm/iby090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Childhood obesity is a major public health challenge. This article describes an overview of the National Institutes of Health (NIH) behavioral and social sciences childhood obesity research efforts. The overview will highlight five areas of childhood obesity research supported by the NIH: (a) basic behavioral and social sciences; (b) early childhood; (c) policies, programs, and environmental strategies; (d) health disparities; and (e) transagency and public-private collaboration. The article also describes potential gaps and opportunities in the areas of childhood obesity and severe obesity, measurement, and sleep.
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Affiliation(s)
- S Sonia Arteaga
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Layla Esposito
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Stavroula K Osganian
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Charlotte A Pratt
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jill Reedy
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Deborah Young-Hyman
- Office of Behavioral and Social Science Research, National Institutes of Health, Bethesda, MD, USA
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Family Factors Associated with Selected Childhood Nutrition Aspects in Central Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16040541. [PMID: 30781863 PMCID: PMC6406264 DOI: 10.3390/ijerph16040541] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 02/01/2019] [Accepted: 02/12/2019] [Indexed: 12/25/2022]
Abstract
Childhood diet has a significant influence on diet-related diseases in adulthood, so an understanding of environmental influences on nutrition, is important. The aim of this cross-sectional study was to indicate family factors associated with some aspects of children’s nutrition in Central Poland. A questionnaire was used to investigate 892 mothers’ approach to breastfeeding, frequency of eating with children at fast food restaurants, and serving them snacks, sugary drinks, and fried food. Prevalence of dental caries among children, based on the mothers’ self-assessment, was also assessed. Majority of the mothers breastfed for a period not longer than six months. There was a positive association between breastfeeding duration and mothers’ education level and the number of children in a family. Sweets were used as a reward, more often among younger children and in families with higher number of children. The frequency of consumption of sweet beverages rose with the child’s age and decreased with mother’s education level and family income. It was also more frequent in rural areas. Most children received snacks and fried food at least once a week. There was a negative association between eating with parents at fast food restaurants and, both, the number of children in the family and living in a village. Fast food consumption rose with the mother’s education level and family income. Prevalence of dental caries according to mothers’ declarations was much lower than in national studies but was associated with frequent consumption of snacks and sweet beverages in the examined population. Extensive activities to reduce the occurrence of dental caries at the national level and education concerning the role of a family environment in providing a proper childhood nutrition, with a special emphasis on breastfeeding benefits, seems necessary for Polish parents. Designing community-wide education campaigns referencing population-based programs and other health and disease prevention activities, need to be promoted.
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Miller AL, Miller SE, Clark KM. Child, Caregiver, Family, and Social-Contextual Factors to Consider when Implementing Parent-Focused Child Feeding Interventions. Curr Nutr Rep 2018; 7:303-309. [PMID: 30353367 PMCID: PMC6237637 DOI: 10.1007/s13668-018-0255-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW Interventions that aim to alter child eating behaviors often focus on parents as a proximal influence. Yet, parents can be difficult to engage. Therefore, intervention recommendations are often not implemented as designed. The goal of this review is to highlight factors at multiple contextual levels that are important to consider when developing interventions to address child eating, due to their implications for overcoming parent engagement challenges. RECENT FINDINGS Intervention studies suggest that parents are often the key to successfully changing child eating behaviors, and many interventions focus on feeding. Factors such as child eating phenotypes, parent stress, family system dynamics, and sociodemographic constraints have also been identified as shaping food parenting. Challenges at multiple contextual levels can affect the likelihood of parent engagement. Addressing factors at the child-, parent-, family-, and broader social-contextual levels of influence is essential in order to promote best practices for parent-focused feeding interventions.
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Affiliation(s)
- Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, SPH-I, Room 3718, Ann Arbor, MI, 48109-2029, USA.
| | - Sara E Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, SPH-I, Room 3718, Ann Arbor, MI, 48109-2029, USA
| | - Katy M Clark
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, SPH-I, Room 3718, Ann Arbor, MI, 48109-2029, USA
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45
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McCrickerd K. Cultivating self-regulatory eating behaviours during childhood: The evidence and opportunities. NUTR BULL 2018. [DOI: 10.1111/nbu.12355] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- K. McCrickerd
- Clinical Nutrition Research Centre (CNRC); Singapore Institute for Clinical Sciences (SICS); Agency of Science, Technology and Research (A*STAR); Singapore
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46
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Hayes JF, Fitzsimmons-Craft EE, Karam AM, Jakubiak J, Brown ML, Wilfley DE. Disordered Eating Attitudes and Behaviors in Youth with Overweight and Obesity: Implications for Treatment. Curr Obes Rep 2018; 7:235-246. [PMID: 30069717 PMCID: PMC6098715 DOI: 10.1007/s13679-018-0316-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF THE REVIEW Children with obesity experience disordered eating attitudes and behaviors at high rates, which increases their risk for adult obesity and eating disorder development. As such, it is imperative to screen for disordered eating symptoms and identify appropriate treatments. RECENT FINDINGS Family-based multicomponent behavioral weight loss treatment (FBT) is effective at treating childhood obesity and demonstrates positive outcomes on psychosocial outcomes, including disordered eating. FBT utilizes a socio-ecological treatment approach that focuses on the development of individual and family healthy energy-balance behaviors as well as positive self- and body esteem, supportive family relationships, richer social networks, and the creation of a broader environment and community that facilitates overall physical and mental health. Existing literature suggests FBT is an effective treatment option for disordered eating and obesity in children. Future work is needed to confirm this conclusion and to examine the progression and interaction of obesity and disordered eating across development to identify the optimal time for intervention.
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Affiliation(s)
- Jacqueline F Hayes
- Psychiatry Department, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Ellen E Fitzsimmons-Craft
- Psychiatry Department, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Anna M Karam
- Psychiatry Department, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Jessica Jakubiak
- Psychiatry Department, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Mackenzie L Brown
- Psychiatry Department, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Denise E Wilfley
- Psychiatry Department, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA.
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Longitudinal associations between eating and drinking engagement during mealtime and eating in the absence of hunger in low income toddlers. Appetite 2018; 130:29-34. [PMID: 30059768 DOI: 10.1016/j.appet.2018.07.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/27/2018] [Accepted: 07/27/2018] [Indexed: 01/07/2023]
Abstract
To develop effective obesity-related interventions during early life, it is important to identify predictors of eating in the absence of hunger during toddlerhood. Hence, this study examined longitudinal associations between child eating and drinking engagement at 27 months of age and child eating in the absence of hunger (EAH) at 33 months of age (N = 91 children; 57.1% boys). At 27 months of age, we coded child eating and drinking engagement during a videotaped naturalistic lunch meal at home. We also obtained mothers' reports of their child's food responsiveness (FR), satiety responsiveness (SR), and desire to drink (DD) using the Child Eating Behavior Questionnaire (CEBQ). Children participated in a standard EAH protocol at 27 and 33 months of age where they were presented with palatable foods and the amount of food eaten was assessed (calculated as total kilocalories consumed). Correlational analyses showed that EAH at 27 months of age was positively related to EAH at 33 months of age and that neither mother-reported child FR or SR were associated with child eating engagement. Mother-reported child DD was associated with child drinking engagement. To predict EAH at 33 months, a regression analysis was conducted in which EAH at 27 months, mother-reported and observed child eating and drinking engagement at 27 months were entered as predictors, controlling for child demographics (i.e., age, sex, race/ethnicity and weight-for-length z-score (WLZ). Findings were that children who were observed to engage in more drinking at 27 months of age consumed more energy (measured as kcal) in the EAH at 33 months of age. Implications for understanding eating, and drinking, behaviors in toddlerhood are discussed.
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