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Brand J, Yeum D, Stewart T, Emond JA, Gilbert-Diamond D. The associations between attentional bias to food cues, parent-report appetitive traits, and concurrent adiposity among adolescents. Eat Behav 2024; 53:101874. [PMID: 38636439 PMCID: PMC11144077 DOI: 10.1016/j.eatbeh.2024.101874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE To assess whether attentional bias to food cues and appetitive traits are independently and interactively associated with adiposity in adolescents. METHOD Eighty-five adolescents, 14-17-years had their attentional bias to food images measured in a sated state by computing eye tracking measures of attention (first fixation duration, cumulative fixation duration) to food and control distractor images that bordered a computer game. Parents reported adolescent appetitive traits including the food approach domains of enjoyment of food, food responsiveness, emotional overeating, and the food avoidance domains of satiety responsiveness and emotional overeating through the Children's Eating Behavior Questionnaire. RESULTS First fixation bias to food cues was positively associated with enjoyment of food, and negatively associated with satiety responsiveness. In a series of regression models adjusted for relevant covariates, first fixation bias to food cues (β = 0.83, p = 0.007), higher food responsiveness (β = 0.74, p < 0.001), higher emotional overeating (β = 0.51, p = 0.002), and a composite appetite score (β = 1.42, p < 0.001) were each significantly associated with greater BMI z-scores. In models assessing the interactive effects between attentional bias and appetitive traits, higher first fixation bias to food cues interacted synergistically with food responsiveness and emotional overeating in relation to BMI z-score. A synergistic interaction between first fixation bias to food cues and the composite appetite score in relation to BMI z-score was also observed. CONCLUSION Individuals with high attentional bias to food cues and obesogenic appetitive traits may be particularly susceptible to weight gain.
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Affiliation(s)
- John Brand
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States; Dartmouth Cancer Center, Lebanon, NH, United States.
| | - Dabin Yeum
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States
| | - Tessa Stewart
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States
| | - Jennifer A Emond
- Department of Pediatrics, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States; Department of Biomedical Data Sciences, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States; Dartmouth Cancer Center, Lebanon, NH, United States; Department of Pediatrics, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States; Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
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Yeum D, Gilbert-Diamond D, Masterson TD, Carlson DD, Ballarino GA, Lansigan RK, Renier TJ, Emond JA. Associations between behavioral self-regulation and external food cue responsiveness (EFCR) in preschool-age children and evidence of modification by parenting style. Appetite 2023; 188:106637. [PMID: 37352897 PMCID: PMC10528472 DOI: 10.1016/j.appet.2023.106637] [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: 11/15/2022] [Revised: 05/05/2023] [Accepted: 06/14/2023] [Indexed: 06/25/2023]
Abstract
Decreased behavioral regulation is hypothesized to be a risk factor for excess weight gain among children, possibly via reduced appetite-specific regulation. Little research has specifically focused on behavioral regulation and food cue responsiveness, a conditioned precursor to eating, at a young age. This study examined the association between behavioral regulation and external food cue responsiveness among preschool-age children and explored if a more structured parenting style moderated that association. Baseline data from a prospective study on media use among preschool-age children (n = 83) in Northern New England were used. Parents reported on three domains of children's behavioral regulation (attentional focusing, inhibitory control, and emotional self-regulation), the children's external food cue responsiveness (EFCR), and their parenting styles (authoritative and permissive) via validated questionnaires. Mean age among children was 4.31 (SD 0.91) years, 57% of children were male, 89% were non-Hispanic white, and 26.2% had overweight or obesity. In a series of adjusted linear regression models, lower attentional focusing (standardized β, βs = -0.35, p = 0.001), inhibitory control (βs = -0.30, p = 0.008), and emotional self-regulation (standardized beta, βs = -0.38, p < 0.001) were each significantly associated with greater EFCR. In exploratory analyses, a more structured parenting style (more authoritative or less permissive) mitigated the associations between inhibitory control and EFCR (Bonferroni-adjusted p-interaction < 0.017). Findings support that lower attentional focusing, inhibitory control, and emotional self-regulation relate to greater ECFR in preschool-age children. The association between inhibitory control and EFCR may be modified by parenting style. Further research is needed to understand if children's responsiveness to external food cues may account for reported associations between lower behavioral regulation and adiposity gain over time.
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Affiliation(s)
- Dabin Yeum
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Williamson Translational Research Building 7th Floor, 1 Medical Center Drive, Lebanon, NH, 03756, USA.
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Williamson Translational Research Building 7th Floor, 1 Medical Center Drive, Lebanon, NH, 03756, USA; Department of Medicine, Geisel School of Medicine at Dartmouth College, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA; Department of Pediatrics, Geisel School of Medicine at Dartmouth College, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - Travis D Masterson
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA
| | - Delaina D Carlson
- Department of Pediatrics, Geisel School of Medicine at Dartmouth College, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - Grace A Ballarino
- Department of Pediatrics, Geisel School of Medicine at Dartmouth College, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - Reina K Lansigan
- Department of Pediatrics, Geisel School of Medicine at Dartmouth College, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - Timothy J Renier
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Williamson Translational Research Building 7th Floor, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - Jennifer A Emond
- Department of Pediatrics, Geisel School of Medicine at Dartmouth College, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA; Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth College, Williamson Translational Research Building 3rd Floor, 1 Medical Center Drive, Lebanon, NH, 03756, USA
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Schmidt R, Wandrer H, Boutelle KN, Kiess W, Hilbert A. Associations between eating in the absence of hunger and executive functions in adolescents with binge-eating disorder: An experimental study. Appetite 2023; 186:106573. [PMID: 37062306 DOI: 10.1016/j.appet.2023.106573] [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: 02/13/2023] [Revised: 04/04/2023] [Accepted: 04/13/2023] [Indexed: 04/18/2023]
Abstract
Eating in the absence of hunger (EAH) is one of the key behavioral features of binge-eating disorder (BED) in youth. Although preliminary evidence revealed that adolescent BED co-occurs with deficits in executive functions (EFs), it is unclear whether EFs are related to EAH. Thus, this study experimentally examined whether deficits in EFs predict EAH in adolescents with and without BED. Adolescents (12-20 years) with BED (n = 28) and age-, sex-, and weight-matched controls (n = 28) underwent an EAH paradigm in the laboratory, where they were offered snacks ad libitum after having established satiety during a lunch meal. Cognitive interference, cognitive flexibility, decision making, and EFs in daily life were assessed by neuropsychological tests and self-report. The BED group showed a significantly higher food intake in gram during the EAH trial than controls with medium effect, but no significant group differences in EFs emerged. Dysfunctional decision making in terms of risky decision making, but no other EFs, predicted increased EAH (g, kcal) in the total sample. Although increases in risky decision making over adolescence are well known, this study uniquely revealed that general decision-making abilities driven by short-term reward may account for disinhibited eating behavior. Interventions targeting decision making with focus on reward sensitivity should be evaluated for their efficacy in preventing and reducing disinhibited eating behavior in adolescents.
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Affiliation(s)
- Ricarda Schmidt
- Leipzig University Medical Center, Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Stephanstrasse 9a, 04103, Leipzig, Germany.
| | - Henrike Wandrer
- Leipzig University Medical Center, Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Stephanstrasse 9a, 04103, Leipzig, Germany.
| | | | - Wieland Kiess
- University of Leipzig, LIFE Leipzig Research Centre for Civilization Diseases, Philipp-Rosenthal-Strasse 27, D-04103, Leipzig, Germany; University of Leipzig Medical Center, Hospital for Children and Adolescents, Centre for Pediatric Research, Liebigstrasse 20a, 04103, Leipzig, Germany.
| | - Anja Hilbert
- Leipzig University Medical Center, Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Stephanstrasse 9a, 04103, Leipzig, Germany.
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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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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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Lanoye A, Adams E, Fuemmeler BF. Obesity and Attention-Deficit Hyperactivity Disorder. Curr Top Behav Neurosci 2022; 57:221-241. [PMID: 35505058 DOI: 10.1007/7854_2022_337] [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] [Indexed: 06/14/2023]
Abstract
An association between ADHD and obesity has been established throughout the past 20 years via animal model experiments and both correlational and longitudinal studies in humans. However, much remains to be determined regarding causality, developmental course, and effective treatments targeting both conditions. This chapter provides an overview and update on the current state of the science on the relationship between obesity and ADHD; expands the scope of the connection between obesity and ADHD to include behavioral components important to weight regulation - i.e., physical activity, eating behaviors, and sleep; and presents applications of these findings to treatment approaches and future directions.
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Affiliation(s)
- Autumn Lanoye
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Elizabeth Adams
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
- Research Center for Child Well-Being, University of South Carolina, Columbia, SC, USA
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA.
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