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Arrue A, Olivas O, Erkoreka L, Alvarez FJ, Arnaiz A, Varela N, Bilbao A, Rodríguez JJ, Moreno-Calle MT, Gordo E, Marín E, Garcia-Cano J, Saez E, Gonzalez-Torres MÁ, Zumárraga M, Basterreche N. Multilocus Genetic Profile Reflecting Low Dopaminergic Signaling Is Directly Associated with Obesity and Cardiometabolic Disorders Due to Antipsychotic Treatment. Pharmaceutics 2023; 15:2134. [PMID: 37631349 PMCID: PMC10459305 DOI: 10.3390/pharmaceutics15082134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Treatment with second-generation antipsychotics (SGAs) can cause obesity and other cardiometabolic disorders linked to D2 receptor (DRD2) and to genotypes affecting dopaminergic (DA) activity, within reward circuits. We explored the relationship of cardiometabolic alterations with single genetic polymorphisms DRD2 rs1799732 (NG_008841.1:g.4750dup -> C), DRD2 rs6277 (NG_008841.1:g.67543C>T), COMT rs4680 (NG_011526.1:g.27009G>A), and VNTR in both DRD4 NC_000011.10 (637269-640706) and DAT1 NC_000005.10 (1392794-1445440), as well as with a multilocus genetic profile score (MLGP). A total of 285 psychiatric patients treated with SGAs for at least three months were selected. Cardiometabolic parameters were classified according to ATP-III and WHO criteria. Blood samples were taken for routinely biochemical assays and PCR genotyping. Obesity (BMI, waist (W)), high diastolic blood pressure (DBP), and hypertriglyceridemia (HTG) were present in those genetic variants related to low dopaminergic activity: InsIns genotype in rs1799732 (BMI: OR: 2.91 [1.42-5.94]), DRD4-VNTR-L allele (W: OR: 1.73 [1.04-2.87]) and 9R9R variant in DAT1-VNTR (W: OR: 2.73 [1.16-6.40]; high DBP: OR: 3.33 [1.54-7.31]; HTG: OR: 4.38 [1.85-10.36]). A low MLGP score indicated a higher risk of suffering cardiometabolic disorders (BMI: OR: 1.23 [1.05-1.45]; W: OR: 1.18 [1.03-1.34]; high DBP: OR: 1.22 [1.06-1.41]; HTG: OR: 1.20 [1.04-1.39]). The MLGP score was more sensitive for detecting the risk of suffering these alterations. Low dopaminergic system function would contribute to increased obesity, BDP, and HTG following long-term SGA treatment.
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Affiliation(s)
- Aurora Arrue
- Mental Health Network Group, BioCruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (O.O.); (L.E.)
- Neurochemical Research Unit, Bizkaia Mental Health Network, Osakidetza Basque Health Service, 48903 Barakaldo, Spain
| | - Olga Olivas
- Mental Health Network Group, BioCruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (O.O.); (L.E.)
- Bizkaia Mental Health Network, Zaldibar Hospital, Osakidetza Basque Health Service, 48250 Zaldibar, Spain
| | - Leire Erkoreka
- Mental Health Network Group, BioCruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (O.O.); (L.E.)
- Department of Psychiatry, Galdakao-Usánsolo University Hospital, Osakidetza Basque Health Service, 48960 Galdakao, Spain
- Department of Neurosciences, Faculty of Medicine and Dentistry, University of the Basque Country UPV/EHU, 48940 Leioa, Spain
| | - Francisco Jose Alvarez
- Research Unit, Cruces University Hospital, Osakidetza Basque Health Service, 48903 Barakaldo, Spain
| | - Ainara Arnaiz
- Mental Health Network Group, BioCruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (O.O.); (L.E.)
- Erandio Mental Health Center, Bizkaia Mental Health Network, Osakidetza Basque Health Service, 48950 Erandio, Spain
| | - Noemi Varela
- Mental Health Network Group, BioCruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (O.O.); (L.E.)
- Uribe Mental Health Center, Bizkaia Mental Health Network, Osakidetza Basque Health Service, 48990 Getxo, Spain
| | - Ainhoa Bilbao
- Animal Research Facility, BioCruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
| | - Jose-Julio Rodríguez
- Department of Neurosciences, Faculty of Medicine and Dentistry, University of the Basque Country UPV/EHU, 48940 Leioa, Spain
- Functional Neuroanatomy, BioCruces Bizkaia Health Research Institute, Ikerbasque Basque Foundation for Science, 48903 Barakaldo, Spain
| | - María Teresa Moreno-Calle
- Mental Health Network Group, BioCruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (O.O.); (L.E.)
- Department of Psychiatry, Galdakao-Usánsolo University Hospital, Osakidetza Basque Health Service, 48960 Galdakao, Spain
| | - Estibaliz Gordo
- Bizkaia Mental Health Network, Zamudio Hospital, Osakidetza Basque Health Service, 48170 Zamudio, Spain
| | - Elena Marín
- Mental Health Network Group, BioCruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (O.O.); (L.E.)
- Bizkaia Mental Health Network, Bermeo Hospital, Osakidetza Basque Health Service, 48370 Bermeo, Spain
| | - Javier Garcia-Cano
- Alternatives to Hospitalization in Bilbao, Bizkaia Mental Health Network, Osakidetza Basque Health Service, 48903 Bilbao, Spain
| | - Estela Saez
- Mental Health Network Group, BioCruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (O.O.); (L.E.)
- Department of Psychiatry, Galdakao-Usánsolo University Hospital, Osakidetza Basque Health Service, 48960 Galdakao, Spain
| | - Miguel Ángel Gonzalez-Torres
- Department of Neurosciences, Faculty of Medicine and Dentistry, University of the Basque Country UPV/EHU, 48940 Leioa, Spain
- Integrative Research Group in Mental Health, BioCruces Bizkaia Health Research Institute, 48013 Bilbao, Spain
- Department of Psychiatry, Basurto University Hospital, Osakidetza Basque Health Service, 48013 Bilbao, Spain
| | - Mercedes Zumárraga
- Mental Health Network Group, BioCruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (O.O.); (L.E.)
- Neurochemical Research Unit, Bizkaia Mental Health Network, Osakidetza Basque Health Service, 48903 Barakaldo, Spain
| | - Nieves Basterreche
- Functional Neuroanatomy, BioCruces Bizkaia Health Research Institute, Ikerbasque Basque Foundation for Science, 48903 Barakaldo, Spain
- Integrative Research Group in Mental Health, BioCruces Bizkaia Health Research Institute, 48013 Bilbao, Spain
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Davis AM, Befort CA, Lancaster BD, Tuck C, Polivka BJ, Carlson JA, Fleming K, Romine RS, Dean K, Murray M. Rationale and design of integrating a parents first obesity intervention with a pediatric weight management intervention for rural families - Evaluating the ripple effect. Contemp Clin Trials 2023; 128:107140. [PMID: 36893988 DOI: 10.1016/j.cct.2023.107140] [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: 11/23/2022] [Revised: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 03/09/2023]
Abstract
Rural families are disproportionately affected by obesity. Obesity often runs in families and is impacted by hereditary components, the shared home environment, and parent modeling/child observational learning. Moreover, parent changes in weight predict child changes in weight. Thus, targeting the family unit has the potential to enhance outcomes for adults and children simultaneously. Additionally, engaging rural nurses in medical clinics and schools may be important in determining whether rural telehealth programs are successfully implemented and sustained. This paper describes the rationale and design of a randomized control trial (RCT) evaluating the effectiveness of an integrated adult- and child-focused obesity treatment tailored for rural participants. Outcomes of this study include participant weight loss from baseline to 9-months, device-measured physical activity, and dietary intake. This project will additionally compare reach between clinic and school settings and evaluate the impact of nurse engagement. This study will include 240 participants from eight rural communities who will be randomized to either a Parent +Family-based group or a Newsletter +Family-based group. Parents in the Parent +Family-based group will receive a 3-month adult obesity treatment designed for adult behavior change as a first step. Then, parents and children together will enter the family-based program (iAmHealthy), allowing for potential enhancement of a theorized ripple effect. Parents in the Newsletter +Family-based group will receive 3 monthly newsletters and then participate in the 6-month family-based intervention designed for child behavior change. This study is the first RCT to examine the effectiveness of an integrated adult- and child-focused obesity treatment program. Registered with ClinicalTrials.gov NCT ID NCT05612971.
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Affiliation(s)
- Ann M Davis
- Center for Children's Healthy Lifestyles & Nutrition, 610 E 22nd St, Kansas City, MO 64108, United States; Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 4004, Kansas City, KS 66160, United States.
| | - Christie A Befort
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS 66160, United States
| | - Brittany D Lancaster
- Center for Children's Healthy Lifestyles & Nutrition, 610 E 22nd St, Kansas City, MO 64108, United States; Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 4004, Kansas City, KS 66160, United States
| | - Chris Tuck
- Center for Children's Healthy Lifestyles & Nutrition, 610 E 22nd St, Kansas City, MO 64108, United States
| | - Barbara J Polivka
- School of Nursing, University of Kansas Medical Center, Kansas City, KS 66160, United States
| | - Jordan A Carlson
- Center for Children's Healthy Lifestyles & Nutrition, 610 E 22nd St, Kansas City, MO 64108, United States; Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO 64108, United States
| | - Kandace Fleming
- Lifespan Institute, University of Kansas, Lawrence, KS 66045, United States
| | | | - Kelsey Dean
- Center for Children's Healthy Lifestyles & Nutrition, 610 E 22nd St, Kansas City, MO 64108, United States; Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO 64108, United States
| | - Megan Murray
- Center for Children's Healthy Lifestyles & Nutrition, 610 E 22nd St, Kansas City, MO 64108, United States; Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 4004, Kansas City, KS 66160, United States
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White O, Roeder N, Blum K, Eiden RD, Thanos PK. Prenatal Effects of Nicotine on Obesity Risks: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159477. [PMID: 35954830 PMCID: PMC9368674 DOI: 10.3390/ijerph19159477] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/25/2022] [Accepted: 07/29/2022] [Indexed: 11/16/2022]
Abstract
Nicotine usage by mothers throughout pregnancy has been observed to relate to numerous deleterious effects in children, especially relating to obesity. Children who have prenatally been exposed to nicotine tend to have lower birth weights, with an elevated risk of becoming overweight throughout development and into their adolescent and adult life. There are numerous theories as to how this occurs: catch-up growth theory, thrifty phenotype theory, neurotransmitter or endocrine imbalances theory, and a more recent examination on the genetic factors relating to obesity risk. In addition to the negative effect on bodyweight and BMI, individuals with obesity may also suffer from numerous comorbidities involving metabolic disease. These may include type 1 and 2 diabetes, high cholesterol levels, and liver disease. Predisposition for obesity with nicotine usage may also be associated with genetic risk alleles for obesity, such as the DRD2 A1 variant. This is important for prenatally nicotine-exposed individuals as an opportunity to provide early prevention and intervention of obesity-related risks.
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Affiliation(s)
- Olivia White
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA; (O.W.); (N.R.)
- Department of Psychology, University at Buffalo, Buffalo, NY 14203, USA
| | - Nicole Roeder
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA; (O.W.); (N.R.)
- Department of Psychology, University at Buffalo, Buffalo, NY 14203, USA
| | - Kenneth Blum
- Division of Addiction Research, Center for Psychiatry, Medicine & Primary Care (Office of Provost), Western University Health Sciences, Pomona, CA 91766, USA;
| | - Rina D. Eiden
- Department of Psychology, Social Science Research Institute, The Pennsylvania State University, University Park, PA 16801, USA;
| | - Panayotis K. Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA; (O.W.); (N.R.)
- Department of Psychology, University at Buffalo, Buffalo, NY 14203, USA
- Correspondence: ; Tel.: +1-(716)-881-7520
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Cardel MI, Lemas DJ, Lee AM, Miller DR, Huo T, Klimentidis YC, Fernandez JR. Taq1a polymorphism (rs1800497) is associated with obesity-related outcomes and dietary intake in a multi-ethnic sample of children. Pediatr Obes 2019; 14:e12470. [PMID: 30253082 PMCID: PMC6659394 DOI: 10.1111/ijpo.12470] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 04/18/2018] [Accepted: 05/26/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND In adults, the Taq1a polymorphism (rs1800497) near the D2 receptor (DRD2) gene is associated with body mass index and binge eating and is more prevalent among non-Hispanic Blacks (NHB) and Hispanic-Americans (HA) relative to non-Hispanic Whites (NHW). We hypothesize Taq1a polymorphism (rs1800497) risk alleles contribute to paediatric racial/ethnic differences in obesity phenotypes. OBJECTIVES This study aims to characterize the relationship between the Taq1a polymorphism (rs1800497), diet and adiposity in a multi-ethnic cohort of 286 children (98 NHB, 76 HA and 112 NHW), ages 7-12. METHODS Dual-energy X-ray absorptiometry, computed tomography scans and two 24-h dietary recalls assessed body composition, fat distribution and dietary intakes, respectively. RESULTS Children with two Taq1a risk alleles (NHB = 50.0%, HA = 43.3%, NHW = 6.7%) reported a 20% increase in total energy intake (P = 0.0034) and per cent of calories from sugar consumed (P = 0.0077) than did children with less than two risk alleles. Children with two Taq1a risk alleles demonstrated significantly higher total body fat (P = 0.0145), body fat percentage (P = 0.0377), intra-abdominal adiposity (P = 0.0459), subcutaneous abdominal adiposity (P = 0.0213) and total abdominal adiposity (P = 0.0209) than did children with one or no Taq1a risk alleles. CONCLUSIONS Our results suggest that having two Taq1a risk alleles is associated with an increase in reported calorie and sugar consumption and is a potential risk factor for early development of excess adiposity in multi-ethnic children. These results need to be confirmed in a larger sample.
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Affiliation(s)
- M. I. Cardel
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - D. J. Lemas
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - A. M. Lee
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - D. R. Miller
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - T. Huo
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Y. C. Klimentidis
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - J. R. Fernandez
- Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, USA,Department of Nutrition Sciences, School of Public Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
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Cameron JD, Chaput JP, Sjödin AM, Goldfield GS. Brain on Fire: Incentive Salience, Hedonic Hot Spots, Dopamine, Obesity, and Other Hunger Games. Annu Rev Nutr 2017; 37:183-205. [PMID: 28564556 DOI: 10.1146/annurev-nutr-071816-064855] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This review examines human feeding behavior in light of psychological motivational theory and highlights the importance of midbrain dopamine (DA). Prospective evidence of both reward surfeit and reward deficit pathways to increased body weight are evaluated, and we argue that it is more complex than an either/or scenario when examining DA's role in reward sensitivity, eating, and obesity. The Taq1A genotype is a common thread that ties the contrasting models of DA reward and obesity; this genotype related to striatal DA is not associated with obesity class per se but may nevertheless confer an increased risk of weight gain. We also critically examine the concept of so-called food addiction, and despite growing evidence, we argue that there is currently insufficient human data to warrant this diagnostic label. The surgical and pharmacological treatments of obesity are discussed, and evidence is presented for the selective use of DA-class drugs in obesity treatment.
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Affiliation(s)
- Jameason D Cameron
- Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario K1H 5B2, Canada; , ,
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario K1H 5B2, Canada; , ,
| | - Anders M Sjödin
- Department of Nutrition, Exercise and Sports, Faculty of Sciences, University of Copenhagen, 1165 Copenhagen, Denmark;
| | - Gary S Goldfield
- Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario K1H 5B2, Canada; , ,
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A meta-analysis of the relationship between brain dopamine receptors and obesity: a matter of changes in behavior rather than food addiction? Int J Obes (Lond) 2016; 40 Suppl 1:S12-21. [PMID: 27001642 PMCID: PMC4819757 DOI: 10.1038/ijo.2016.9] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Addiction to a wide range of substances of abuse has been suggested to reflect a ‘Reward Deficiency Syndrome'. That is, drugs are said to stimulate the reward mechanisms so intensely that, to compensate, the population of dopamine D2 receptors (DD2R) declines. The result is that an increased intake is necessary to experience the same degree of reward. Without an additional intake, cravings and withdrawal symptoms result. A suggestion is that food addiction, in a similar manner to drugs of abuse, decrease DD2R. The role of DD2R in obesity was therefore examined by examining the association between body mass index (BMI) and the Taq1A polymorphism, as the A1 allele is associated with a 30–40% lower number of DD2R, and is a risk factor for drug addiction. If a lower density of DD2R is indicative of physical addiction, it was argued that if food addiction occurs, those with the A1 allele should have a higher BMI. A systematic review found 33 studies that compared the BMI of those who did and did not have the A1 allele. A meta-analysis of the studies compared those with (A1/A1 and A1/A2) or without (A2/A2) the A1 allele; no difference in BMI was found (standardized mean difference 0.004 (s.e. 0.021), variance 0.000, Z=0.196, P<0.845). It was concluded that there was no support for a reward deficiency theory of food addiction. In contrast, there are several reports that those with the A1 allele are less able to benefit from an intervention that aimed to reduce weight, possibly a reflection of increased impulsivity.
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Kong KL, Epstein LH. Food reinforcement during infancy. Prev Med 2016; 92:100-105. [PMID: 27373207 PMCID: PMC5361189 DOI: 10.1016/j.ypmed.2016.06.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 06/24/2016] [Accepted: 06/27/2016] [Indexed: 11/26/2022]
Abstract
The motivation to eat, as operationalized by measuring how hard someone will work for food, is cross-sectionally and prospectively related to obesity. Persons high in food reinforcement consume more calories, and energy intake mediates the relationship between food reinforcement and obesity. Research has shown avid sucking for milk in early infancy predicts later adiposity, and the relationship between food reinforcement and excess body weight has been observed in infants as young as 9months of age. New methodological developments in studying food reinforcement in infants and young children provide the first opportunity to study the origin of food reinforcement. This review seeks to provide background on the measurement of food reinforcement, and to present, for the first time, prenatal and postnatal predictors of infant food reinforcement. Lastly, potential mechanisms for an increasing trajectory of food reinforcement throughout development are proposed.
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Affiliation(s)
- Kai Ling Kong
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, 3435 Main Street, Buffalo, NY, 14214-3000, United States.
| | - Leonard H Epstein
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, 3435 Main Street, Buffalo, NY, 14214-3000, United States.
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Maximova K, Ambler KA, Rudko JN, Chui N, Ball GDC. Ready, set, go! Motivation and lifestyle habits in parents of children referred for obesity management. Pediatr Obes 2015; 10:353-60. [PMID: 25394883 DOI: 10.1111/ijpo.272] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 07/29/2014] [Accepted: 09/26/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Parents play a fundamental role in helping children with obesity to make and maintain healthy lifestyle changes. OBJECTIVE This study aimed to characterize stages of engagement to change nutrition and physical activity habits among parents whose children with obesity were enrolled in obesity management and examine differences in parents' own nutrition and physical activity habits according to their stage of engagement. METHODS Medical records of 113 children (body mass index [BMI] ≥95th percentile) enrolled in an outpatient weight management clinic were reviewed for baseline (cross-sectional) data. Parents completed the Weight Loss Behavior-Stage of Change Scale to assess the degree of engagement in making healthy changes to their lifestyle behaviours. Latent class analysis was used to classify parents into distinct clusters by grouping individuals with similar ratings of stages of engagement regarding nutrition- and physical activity-related behaviours. RESULTS Parents' engagement in healthy lifestyle behaviours varied (more engaged [n = 43]; less engaged [n = 70]). A greater proportion of parents in the more engaged group was in action and/or maintenance stages of changing their lifestyle habits. The more engaged group was less overweight than the less engaged group (BMI = 28.5 vs. 33.3 kg m(-2); P < 0.05). Further, the more engaged group consumed fewer total calories, calories from fat, trans fat and carbohydrates vs. their less engaged peers (P < 0.05). Compared with the less engaged group, the more engaged group consumed more daily servings of vegetables and fruits (4.9 vs. 3.9, P < 0.05) and accumulated more steps per day (9130 vs. 7225; P < 0.05). The more engaged group was also more likely to meet daily recommendations for vegetable and fruit intake (48.8 vs. 24.3%; P < 0.05) and physical activity (42.9 vs. 22.9%, P < 0.05). CONCLUSIONS Parents of children with obesity varied in their degree of engagement in making healthy changes to their lifestyle behaviours, and those categorized as more engaged already demonstrated positive lifestyle behaviours. Information regarding parents' degree of engagement in healthy behaviours can inform clinical recommendations, especially when parents represent the primary agents of change in families trying to manage paediatric obesity.
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Affiliation(s)
- K Maximova
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - K A Ambler
- Pediatric Centre for Weight and Health, Stollery Children's Hospital, Alberta Health Services, Edmonton, Alberta, Canada.,Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - J N Rudko
- Pediatric Centre for Weight and Health, Stollery Children's Hospital, Alberta Health Services, Edmonton, Alberta, Canada
| | - N Chui
- Pediatric Centre for Weight and Health, Stollery Children's Hospital, Alberta Health Services, Edmonton, Alberta, Canada
| | - G D C Ball
- Pediatric Centre for Weight and Health, Stollery Children's Hospital, Alberta Health Services, Edmonton, Alberta, Canada.,Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Best JR, Goldschmidt AB, Mockus-Valenzuela DS, Stein RI, Epstein LH, Wilfley DE. Shared weight and dietary changes in parent-child dyads following family-based obesity treatment. Health Psychol 2015; 35:92-5. [PMID: 26192385 DOI: 10.1037/hea0000247] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The primary objective was to determine whether children and their participating parents undergoing family-based behavioral treatment (FBT) for obesity show similar dietary changes following treatment, and if so, whether these shared dietary changes explain the similarity in weight change within the parent-child dyad. METHOD Data come from a randomized controlled trial of 148 parent-child dyads who completed FBT and were followed over a 2-year maintenance phase. Energy-dense, nutrient-poor foods ("RED" foods) and fruit and vegetable intake were assessed across time. RESULTS Maintenance of lower RED food intake following FBT predicted weight maintenance in children and in parents (ps < .01), and dietary and weight changes were correlated within parent-child dyads (ps < .01). Most interesting, the similarity in long-term weight maintenance between children and their parents was predicted by the similarity in long-term changes in RED food intake between children and their parents (p < .001). CONCLUSIONS These findings point to the important role of maintaining low energy-dense, nutrient-poor food intake for long-term weight maintenance in children and parents. Furthermore, these results suggest that the correlation between parent and child weight maintenance can be explained in part by similar long-term changes in energy-dense, nutrient-poor food intake.
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Affiliation(s)
- John R Best
- Department of Psychiatry, Washington University School of Medicine
| | | | | | | | | | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine
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Blum K, Thanos PK, Gold MS. Dopamine and glucose, obesity, and reward deficiency syndrome. Front Psychol 2014; 5:919. [PMID: 25278909 PMCID: PMC4166230 DOI: 10.3389/fpsyg.2014.00919] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 08/01/2014] [Indexed: 01/08/2023] Open
Abstract
Obesity as a result of overeating as well as a number of well described eating disorders has been accurately considered to be a world-wide epidemic. Recently a number of theories backed by a plethora of scientifically sound neurochemical and genetic studies provide strong evidence that food addiction is similar to psychoactive drug addiction. Our laboratory has published on the concept known as Reward Deficiency Syndrome (RDS) which is a genetic and epigenetic phenomena leading to impairment of the brain reward circuitry resulting in a hypo-dopaminergic function. RDS involves the interactions of powerful neurotransmitters and results in abnormal craving behavior. A number of important facts which could help translate to potential therapeutic targets espoused in this focused review include: (1) consumption of alcohol in large quantities or carbohydrates binging stimulates the brain’s production of and utilization of dopamine; (2) in the meso-limbic system the enkephalinergic neurons are in close proximity, to glucose receptors; (3) highly concentrated glucose activates the calcium channel to stimulate dopamine release from P12 cells; (4) a significant correlation between blood glucose and cerebrospinal fluid concentrations of homovanillic acid the dopamine metabolite; (5) 2-deoxyglucose (2DG), the glucose analog, in pharmacological doses is associated with enhanced dopamine turnover and causes acute glucoprivation. Evidence from animal studies and fMRI in humans support the hypothesis that multiple, but similar brain circuits are disrupted in obesity and drug dependence and for the most part, implicate the involvement of DA-modulated reward circuits in pathologic eating behaviors. Based on a consensus of neuroscience research treatment of both glucose and drug like cocaine, opiates should incorporate dopamine agonist therapy in contrast to current theories and practices that utilizes dopamine antagonistic therapy. Considering that up until now clinical utilization of powerful dopamine D2 agonists have failed due to chronic down regulation of D2 receptors newer targets based on novel less powerful D2 agonists that up-regulate D2 receptors seems prudent. We encourage new strategies targeted at improving DA function in the treatment and prevention of obesity a subtype of reward deficiency.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville FL, USA ; Department of Addiction Research & Therapy, Malibu Beach Recovery Center Malibu Beach, CA, USA
| | - Panayotis K Thanos
- Behavior Neuropharmacology and Neuroimaging Lab, Department of Psychology, State University of New York Stony Brook, NY, USA
| | - Mark S Gold
- Department of Psychiatry, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville FL, USA ; Department of Addiction Research & Therapy, Malibu Beach Recovery Center Malibu Beach, CA, USA
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Epstein LH, Yokum S, Feda DM, Stice E. Food reinforcement and parental obesity predict future weight gain in non-obese adolescents. Appetite 2014; 82:138-42. [PMID: 25045864 DOI: 10.1016/j.appet.2014.07.018] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 07/01/2014] [Accepted: 07/16/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Food reinforcement, the extent to which people are willing to work to earn a preferred snack food, and parental obesity are risk factors for weight gain, but there is no research comparing the predictive effects of these factors for adolescent weight gain. METHODS 130 non-obese adolescents (M age=15.2 ± 1.0; M BMI=20.7 ± 2.0; M zBMI=0.16 ± 0.64) at differential risk for weight gain based on parental obesity completed baseline food and money reinforcement tasks, and provided zBMI data over a 2-year follow-up. RESULTS The number of obese (BMI ≥ 30) parents (p=0.007) and high food reinforcement (p=0.046) were both significant independent predictors of greater zBMI increases, controlling for age, sex, parent education and minority status. Having no obese parents or being low or average in food reinforcement was associated with reductions in zBMI, but those high in food reinforcement showed larger zBMI increases (0.102) than having one obese parent (0.025) but less than having two obese parents (0.177). DISCUSSION Food reinforcement and parental obesity independently predict future weight gain among adolescents. It might be fruitful for obesity prevention programs to target both high risk groups.
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Affiliation(s)
- Leonard H Epstein
- Department of Pediatrics, University at Buffalo School of Medicine and Biomedical Sciences, 3435 Main Street, Buffalo, NY 14214 USA.
| | - Sonja Yokum
- Oregon Research Institute, 1776 Millrace Dr., Eugene, OR 97403 USA
| | - Denise M Feda
- Department of Pediatrics, University at Buffalo School of Medicine and Biomedical Sciences, 3435 Main Street, Buffalo, NY 14214 USA
| | - Eric Stice
- Oregon Research Institute, 1776 Millrace Dr., Eugene, OR 97403 USA
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Salvy SJ, Bowker JC. Peers and Obesity during Childhood and Adolescence: A Review of the Empirical Research on Peers, Eating, and Physical Activity. ACTA ACUST UNITED AC 2014; 4. [PMID: 28090396 PMCID: PMC5228616 DOI: 10.4172/2165-7904.1000207] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Obesity during childhood and adolescence is a growing problem in the United States, Canada, and around the world that leads to significant physical, psychological, and social impairment. In recent years, empirical research on factors that contribute to the development and maintenance of obesity has begun to consider peer experiences, such as peer rejection, peer victimization, and friendship. Peer experiences have been theoretically and empirically related to the “Big Two” contributors to the obesity epidemic, eating and physical activity, but there has not been a comprehensive review of the extant empirical literature. In this article, we review and synthesize the emerging theoretical and empirical literatures on peer experiences in relation to: (a) eating (food consumption and food selection); and (b) physical activity, during childhood and adolescence. A number of limitations and issues in the theoretical and empirical literatures are also discussed, along with future research directions. In conclusion, we argue that the involvement of children and adolescents’ peer networks in prevention and intervention efforts may be critical for promoting and maintaining positive behavioral health trajectories.
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Affiliation(s)
| | - Julie C Bowker
- Department of Psychology, State University of New York at Buffalo, Buffalo, NY, USA
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Carr KA, Lin H, Fletcher KD, Sucheston L, Singh PK, Salis RJ, Erbe RW, Faith MS, Allison DB, Stice E, Epstein LH. Two functional serotonin polymorphisms moderate the effect of food reinforcement on BMI. Behav Neurosci 2013; 127:387-99. [PMID: 23544600 DOI: 10.1037/a0032026] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Food reinforcement, or the motivation to eat, has been associated with increased energy intake, greater body weight, and prospective weight gain. Much of the previous research on the reinforcing value of food has focused on the role of dopamine, but it may be worthwhile to examine genetic polymorphisms in the serotonin and opioid systems as these neurotransmitters have been shown to be related to reinforcement processes and to influence energy intake. We examined the relationship among 44 candidate genetic polymorphisms in the dopamine, serotonin, and opioid systems, as well as food reinforcement and body mass index (BMI) in a sample of 245 individuals. Polymorphisms in the monoamine oxidase A (MAOA-LPR) and serotonin receptor 2A genes (rs6314) moderated the effect of food reinforcement on BMI, accounting for an additional 5-10% variance and revealed a potential role of the single nucleotide polymorphism, rs6314, in the serotonin 2A receptor as a differential susceptibility factor for obesity. Differential susceptibility describes a factor that can confer either risk or protection depending on a second variable, such that rs6314 is predictive of both high and low BMI based on the level of food reinforcement, while the diathesis stress or dual-gain model only influences one end of the outcome measure. The interaction with MAOA-LPR better fits the diathesis stress model, with the 3.5R/4R allele conferring protection for individuals low in food reinforcement. These results provide new insight into genes theoretically involved in obesity, and support the hypothesis that genetics moderate the association between food reinforcement and BMI.
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Affiliation(s)
- Katelyn A Carr
- Department of Pediatrics, University at Buffalo, School of Medicine and Biomedical Sciences, Buffalo, NY 14214-3000, USA
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Cameron JD, Riou MÈ, Tesson F, Goldfield GS, Rabasa-Lhoret R, Brochu M, Doucet É. The TaqIA RFLP is associated with attenuated intervention-induced body weight loss and increased carbohydrate intake in post-menopausal obese women. Appetite 2012; 60:111-116. [PMID: 23032305 DOI: 10.1016/j.appet.2012.09.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Revised: 08/15/2012] [Accepted: 09/15/2012] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Polymorphisms of the dopamine receptor D2 (DRD2) gene have been associated with obesity phenotypes. Our aim was to examine if the genotype of TaqIA Restriction Fragment Length Polymorphism (RFPL) was related to an attenuated weight loss response or to changes in energy expenditure (EE) and food preference before and after weight loss. methods: Obese post-menopausal women (age=57.1 ± 4.6 yr, weight=85.4 ± 15.4 kg and BMI=32.8 ± 4.5 kg/m(2)) were genotyped for TaqIA (n=127) by using PCR-RFLP analysis and categorized as possessing at least one copy of the A1 allele (A1(+)) or no copy (A1(-)). Women were randomized into two groups, caloric restriction (CR) and caloric restriction+resistance training (CRRT) and in this study were further classified as follows: A1(+)CR, A1(+)CRRT, A1-(-)CR and (-)A1(-)CRRT. Body composition, total daily EE, physical activity EE, Resting EE (REE), and energy intake were obtained at baseline and post-intervention using DXA, doubly-labeled water, indirect calorimetry, and 3-day dietary records, respectively. RESULTS Overall, all of the anthropometric variables and REE significantly decreased post-intervention (p<0.001). Women in the CRRT group lost significantly more fat mass (FM) than the CR women (p<0.05). There were significant time by group by allele interactions for attenuated body weight (BW), BMI, and FM loss for A1(+) (vs. A1(-)) in CRRT (p<0.05) and for increased % carbohydrate intake (p<0.01). CONCLUSION TaqIA genotype was associated with body weight loss post-intervention; more specifically, carriers of the A1 allele lost significantly less BW and FM than the A1(-) and had increased carbohydrate intake in the CRRT group.
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Affiliation(s)
| | - Marie-Ève Riou
- School of Human Kinetics, University of Ottawa, Ontario, Canada K1N 6N5
| | - Frédérique Tesson
- Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Canada
| | - Gary S Goldfield
- School of Human Kinetics, University of Ottawa, Ontario, Canada K1N 6N5; Children's Hospital of Eastern Research Institute, Ottawa, Ontario, Canada
| | - Rémi Rabasa-Lhoret
- Department of Nutrition, Université de Montréal, Montréal, Canada; Montreal Institute for Clinical Research (IRCM), Montréal, Canada; Montreal Diabetes Research Center (MDRC) of Centre de Recherche du centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Canada
| | - Martin Brochu
- Faculty of Physical Education and Sports, University of Sherbrooke, Sherbrooke, QC, Canada; Research Centre on Aging, Social Services and Health Centre, University Institute of Geriatrics of Sherbrooke, QC, Canada
| | - Éric Doucet
- School of Human Kinetics, University of Ottawa, Ontario, Canada K1N 6N5.
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Cecil J, Dalton M, Finlayson G, Blundell J, Hetherington M, Palmer C. Obesity and eating behaviour in children and adolescents: contribution of common gene polymorphisms. Int Rev Psychiatry 2012; 24:200-10. [PMID: 22724641 DOI: 10.3109/09540261.2012.685056] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The prevalence of childhood obesity is increasing in many countries and confers risks for early type 2 diabetes, cardiovascular disease and metabolic syndrome. In the presence of potent 'obesogenic' environments not all children become obese, indicating the presence of susceptibility and resistance. Taking an energy balance approach, susceptibility could be mediated through a failure of appetite regulation leading to increased energy intake or via diminished energy expenditure. Evidence shows that heritability estimates for BMI and body fat are paralleled by similar coefficients for energy intake and preferences for dietary fat. Twin studies implicate weak satiety and enhanced food responsiveness as factors determining an increase in BMI. Single gene mutations, for example in the leptin receptor gene, that lead to extreme obesity appear to operate through appetite regulating mechanisms and the phenotypic response involves overconsumption and a failure to inhibit eating. Investigations of robustly characterized common gene variants of fat mass and obesity associated (FTO), peroxisome proliferator-activated receptor (PPARG) and melanocortin 4 receptor (MC4R) which contribute to variance in BMI also influence the variance in appetite factors such as measured energy intake, satiety responsiveness and the intake of palatable energy-dense food. A review of the evidence suggests that susceptibility to childhood obesity involving specific allelic variants of certain genes is mediated primarily through food consumption (appetite regulation) rather than through a decrease in activity-related energy expenditure. This conclusion has implications for early detection of susceptibility, and for prevention and management of childhood obesity.
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Affiliation(s)
- Joanne Cecil
- School of Medicine, University of St Andrews, UK.
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Faith MS, Van Horn L, Appel LJ, Burke LE, Carson JAS, Franch HA, Jakicic JM, Kral TV, Odoms-Young A, Wansink B, Wylie-Rosett J. Evaluating Parents and Adult Caregivers as “Agents of Change” for Treating Obese Children: Evidence for Parent Behavior Change Strategies and Research Gaps. Circulation 2012; 125:1186-207. [DOI: 10.1161/cir.0b013e31824607ee] [Citation(s) in RCA: 187] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This scientific statement addresses parents and adult caregivers (PACs) as “agents of change” for obese children, evaluating the strength of evidence that particular parenting strategies can leverage behavior change and reduce positive energy balance in obese youth. The statement has 3 specific aims. The first is to review core behavior change strategies for PACs as used in family-based treatment programs and to provide a resource list. The second is to evaluate the strength of evidence that greater parental “involvement” in treatment is associated with better reductions in child overweight. The third is to identify research gaps and new opportunities for the field. This review yielded limited and inconsistent evidence from randomized controlled clinical trials that greater PAC involvement necessarily is associated with better child outcomes. For example, only 17% of the intervention studies reported differential improvements in child overweight as a function of parental involvement in treatment. On the other hand, greater parental adherence with core behavior change strategies predicted better child weight outcomes after 2 and 5 years in some studies. Thus, the literature lacks conclusive evidence that one particular parenting strategy or approach causally is superior to others in which children have a greater focus in treatment. A number of research gaps were identified, including the assessment of refined parenting phenotypes, cultural tailoring of interventions, examination of family relationships, and incorporation of new technologies. A conceptual model is proposed to stimulate research identifying the determinants of PAC feeding and physical activity parenting practices, the results of which may inform new treatments. The statement addresses the need for innovative research to advance the scope and potency of PAC treatments for childhood obesity.
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Chen ALC, Blum K, Chen TJH, Giordano J, Downs BW, Han D, Barh D, Braverman ER. Correlation of the Taq1 dopamine D2 receptor gene and percent body fat in obese and screened control subjects: A preliminary report. Food Funct 2012; 3:40-8. [DOI: 10.1039/c1fo10089k] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Watson PM, Dugdill L, Pickering K, Bostock S, Hargreaves J, Staniford L, Cable NT. A whole family approach to childhood obesity management (GOALS): Relationship between adult and child BMI change. Ann Hum Biol 2011; 38:445-52. [DOI: 10.3109/03014460.2011.590531] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Paula M. Watson
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Lindsey Dugdill
- College of Health and Social Care, University of Salford, Salford, UK
| | - Katie Pickering
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Stephanie Bostock
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Jackie Hargreaves
- Physical Activity, Sport and Exercise Sciences, Leeds Metropolitan University, Leeds, UK
| | - Leanne Staniford
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Nigel T. Cable
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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