Food-Approach Eating Behaviors and Brain Morphology: The Generation R Study

Restrained Eating Features and Brain Morphology: A Pediatric Population-Based Study

OBJECTIVE

Anorexia nervosa, a restrictive eating disorder that is most commonly seen in females, is associated with alterations in gray matter (GM) and white matter (WM) structures. However, little is known about how restrained eating (RE) and the body mass index-standard deviation score (BMI-SDS) are related to brain morphology and whether sex differences exist in the general pediatric population.

METHOD

Participants were 9-year-old girls and boys (n = 2729) from the population-based Generation R Study. BMI-SDS was calculated by adjusting BMI for sex and age, using Dutch growth curves. RE is measured with the Dutch Eating Behavior Questionnaire. All children underwent structural magnetic resonance imaging, and brain volumes were calculated using FreeSurfer.

RESULTS

BMI-SDS in girls was positively associated with total intracranial volume and several regional brain volumes. In addition, BMI-SDS showed an inverted U-shaped association with total GM and WM. In girls, RE had a positive linear association with total intracranial, WM, and several regional brain volumes, corrected for BMI-SDS. Additionally, there was an inverted U-shaped association with the amygdala and insula volume. In boys, we found merely positive linear associations between BMI-SDS and brain volumes, and no associations between RE and brain volumes.

DISCUSSION

Associations between BMI and brain volumes exist in typically developing children, but there are significant sex differences in the magnitude and shape of the associations. RE is associated with some differences in brain volumes in girls only. Longitudinal studies are needed to assess these associations over a longer period of time.

The role of dietary modification in the prevention and management of metabolic dysfunction-associated fatty liver disease: An international multidisciplinary expert consensus

Metabolic dysfunction-associated fatty liver disease (MAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD), has become the leading cause of chronic liver disease worldwide. Optimal dietary intervention strategies for MAFLD are not standardized. This study aimed to achieve consensus on prevention of MAFLD through dietary modification. A multidisciplinary panel of 55 international experts, including specialists in hepatology, gastroenterology, dietetics, endocrinology and other medical specialties from six continents collaborated in a Delphi-based consensus development process. The consensus statements covered aspects ranging from epidemiology to mechanisms, management, and dietary recommendations for MAFLD. The recommended dietary strategies emphasize adherence to a balanced diet with controlled energy intake and personalized nutritional interventions, such as calorie restriction, high-protein, or low-carbohydrate diets. Specific dietary advice encouraged increasing the consumption of whole grains, plant-based proteins, fish, seafood, low-fat or fat-free dairy products, liquid plant oils, and deeply colored fruits and vegetables. Concurrently, it advised reducing the intake of red and processed meats, saturated and trans fats, ultra-processed foods, added sugars, and alcohol. Additionally, maintaining the Mediterranean or DASH diet, minimizing sedentary behavior, and engaging in regular physical activity are recommended. These consensus statements lay the foundation for customized dietary guidelines and proposing avenues for further research on nutrition and MAFLD.

Cortical thickness and childhood eating behaviors: differences according to sex and age, and relevance for eating disorders

PURPOSE

This study investigated the association between childhood eating behaviors and cortical morphology, in relation to sex and age, in a community sample.

METHODS

Neuroimaging data of 71 children (mean age = 9.9 ± 1.4 years; 39 boys/32 girls) were obtained from the Nathan Kline Institute-Rockland Sample. Emotional overeating, food fussiness, and emotional undereating were assessed using the Children's Eating Behavior Questionnaire. Cortical thickness was obtained at 81,924 vertices covering the entire cortex. Generalized Linear Mixed Models were used for statistical analysis.

RESULTS

There was a significant effect of sex in the association between cortical thickness and emotional overeating (localized at the right postcentral and bilateral superior parietal gyri). Boys with more emotional overeating presented cortical thickening, whereas the opposite was observed in girls (p < 0.05). Different patterns of association were identified between food fussiness and cortical thickness (p < 0.05). The left rostral middle frontal gyrus displayed a positive correlation with food fussiness from 6 to 8 years, but a negative correlation from 12 to 14 years. Emotional undereating was associated with cortical thickening at the left precuneus, left middle temporal gyrus, and left insula (p < 0.05) with no effect of sex or age.

CONCLUSIONS

Leveraging on a community sample, findings support distinct patterns of associations between eating behaviors and cortical thickness, depending on sex and age.

Food parenting and Children's eating behaviour: Exploring the role of coparenting

Parents have primary influence over the development of their children's eating behaviours, however less attention has been given to whether or how their coparenting plays a role in this association. The aim of this study was to investigate the cross-sectional associations between mothers' and fathers' food parenting practices and children's eating behaviour and examine whether coparenting quality moderates or confounds these associations. Parents (222 mothers and 167 fathers) with children 18 months to 5 years completed an online survey that assessed their food parenting practices and coparenting quality. One parent per family (91% mothers) also reported their children's food approach behaviours. We used linear regressions with generalized estimating equations to examine the associations between food parenting practices and children's eating behaviours. To explore moderation by coparenting quality, we included an interaction term in each model (coparenting quality x food parenting practice). To explore confounding, models were adjusted for coparenting quality. All models were stratified by parent gender and included parent educational attainment, child age, and child BMI z-scores as covariates. Among both mothers and fathers, we found that structure and autonomy support food parenting practices were inversely associated with children's food responsiveness, and desire to drink, while coercive control practices were positively associated with these food approach behaviours. We found the opposite direction of association between these food parenting practices and children's enjoyment of food. Among mothers, autonomy support was inversely associated with children's emotional overeating, while coercive control was positively associated with this eating behaviour. Coparenting quality did not moderate or confound the associations. Future studies should continue to explore these associations among families with young children and consider feeding coparenting in the association.

Biobehavioral susceptibility for obesity in childhood: Behavioral, genetic and neuroimaging studies of appetite

Modern food environments are conducive to overeating and weight gain, but not everyone develops obesity. One reason for this may be that individuals differ in appetitive characteristics, or traits, that manifest early in life and go on to influence their behavioral susceptibility to gain and maintain excess weight. Classic studies showing that eating behavior in children can be measured by behavioral paradigms such as tests of caloric compensation and eating in the absence of hunger inspired the development and validation of psychometric instruments to assess appetitive characteristics in children and infants. A large body of evidence now suggests that food approach traits increase obesity risk, while food avoidant traits, such as satiety responsiveness, decrease obesity risk. Twin studies and genetic association studies have demonstrated that appetitive characteristics are heritable, consistent with a biological etiology. However, family environment factors are also influential, with mounting evidence suggesting that genetic and environmental risk factors interact and correlate with consequences for child eating behavior and weight. Further, neuroimaging studies are revealing that individual differences in responses to visual food cues, as well as to small tastes and larger amounts of food, across a number of brain regions involved in reward/motivation, cognitive control and other functions, may contribute to individual variation in appetitive behavior. Growing evidence also suggests that variation on psychometric measures of appetite is associated with regional differences in brain structure, and differential patterns of resting state functional connectivity. Large prospective studies beginning in infancy promise to enrich our understanding of neural and other biological underpinnings of appetite and obesity development in early life, and how the interplay between genetic and environmental factors affects appetitive systems. The biobehavioral susceptibility model of obesity development and maintenance outlined in this narrative review has implications for prevention and treatment of obesity in childhood.