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Yoong SL, Lum M, Wolfenden L, Jackson J, Barnes C, Hall AE, McCrabb S, Pearson N, Lane C, Jones JZ, Nolan E, Dinour L, McDonnell T, Booth D, Grady A. Healthy eating interventions delivered in early childhood education and care settings for improving the diet of children aged six months to six years. Cochrane Database Syst Rev 2023; 8:CD013862. [PMID: 37606067 PMCID: PMC10443896 DOI: 10.1002/14651858.cd013862.pub3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
BACKGROUND Dietary intake during early childhood can have implications on child health and developmental trajectories. Early childhood education and care (ECEC) services are recommended settings to deliver healthy eating interventions as they provide access to many children during this important period. Healthy eating interventions delivered in ECEC settings can include strategies targeting the curriculum (e.g. nutrition education), ethos and environment (e.g. menu modification) and partnerships (e.g. workshops for families). Despite guidelines supporting the delivery of healthy eating interventions in this setting, little is known about their impact on child health. OBJECTIVES To assess the effectiveness of healthy eating interventions delivered in ECEC settings for improving dietary intake in children aged six months to six years, relative to usual care, no intervention or an alternative, non-dietary intervention. Secondary objectives were to assess the impact of ECEC-based healthy eating interventions on physical outcomes (e.g. child body mass index (BMI), weight, waist circumference), language and cognitive outcomes, social/emotional and quality-of-life outcomes. We also report on cost and adverse consequences of ECEC-based healthy eating interventions. SEARCH METHODS We searched eight electronic databases including CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, ERIC, Scopus and SportDiscus on 24 February 2022. We searched reference lists of included studies, reference lists of relevant systematic reviews, the World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov and Google Scholar, and contacted authors of relevant papers. SELECTION CRITERIA We included randomised controlled trials (RCTs), including cluster-RCTs, stepped-wedge RCTs, factorial RCTs, multiple baseline RCTs and randomised cross-over trials, of healthy eating interventions targeting children aged six months to six years that were conducted within the ECEC setting. ECEC settings included preschools, nurseries, kindergartens, long day care and family day care. To be included, studies had to include at least one intervention component targeting child diet within the ECEC setting and measure child dietary or physical outcomes, or both. DATA COLLECTION AND ANALYSIS Pairs of review authors independently screened titles and abstracts and extracted study data. We assessed risk of bias for all studies against 12 criteria within RoB 1, which allows for consideration of how selection, performance, attrition, publication and reporting biases impact outcomes. We resolved discrepancies via consensus or by consulting a third review author. Where we identified studies with suitable data and homogeneity, we performed meta-analyses using a random-effects model; otherwise, we described findings using vote-counting approaches and via harvest plots. For measures with similar metrics, we calculated mean differences (MDs) for continuous outcomes and risk ratios (RRs) for dichotomous outcomes. We calculated standardised mean differences (SMDs) for primary and secondary outcomes where studies used different measures. We applied GRADE to assess certainty of evidence for dietary, cost and adverse outcomes. MAIN RESULTS We included 52 studies that investigated 58 interventions (described across 96 articles). All studies were cluster-RCTs. Twenty-nine studies were large (≥ 400 participants) and 23 were small (< 400 participants). Of the 58 interventions, 43 targeted curriculum, 56 targeted ethos and environment, and 50 targeted partnerships. Thirty-eight interventions incorporated all three components. For the primary outcomes (dietary outcomes), we assessed 19 studies as overall high risk of bias, with performance and detection bias being most commonly judged as high risk of bias. ECEC-based healthy eating interventions versus usual practice or no intervention may have a positive effect on child diet quality (SMD 0.34, 95% confidence interval (CI) 0.04 to 0.65; P = 0.03, I2 = 91%; 6 studies, 1973 children) but the evidence is very uncertain. There is moderate-certainty evidence that ECEC-based healthy eating interventions likely increase children's consumption of fruit (SMD 0.11, 95% CI 0.04 to 0.18; P < 0.01, I2 = 0%; 11 studies, 2901 children). The evidence is very uncertain about the effect of ECEC-based healthy eating interventions on children's consumption of vegetables (SMD 0.12, 95% CI -0.01 to 0.25; P =0.08, I2 = 70%; 13 studies, 3335 children). There is moderate-certainty evidence that ECEC-based healthy eating interventions likely result in little to no difference in children's consumption of non-core (i.e. less healthy/discretionary) foods (SMD -0.05, 95% CI -0.17 to 0.08; P = 0.48, I2 = 16%; 7 studies, 1369 children) or consumption of sugar-sweetened beverages (SMD -0.10, 95% CI -0.34 to 0.14; P = 0.41, I2 = 45%; 3 studies, 522 children). Thirty-six studies measured BMI, BMI z-score, weight, overweight and obesity, or waist circumference, or a combination of some or all of these. ECEC-based healthy eating interventions may result in little to no difference in child BMI (MD -0.08, 95% CI -0.23 to 0.07; P = 0.30, I2 = 65%; 15 studies, 3932 children) or in child BMI z-score (MD -0.03, 95% CI -0.09 to 0.03; P = 0.36, I2 = 0%; 17 studies; 4766 children). ECEC-based healthy eating interventions may decrease child weight (MD -0.23, 95% CI -0.49 to 0.03; P = 0.09, I2 = 0%; 9 studies, 2071 children) and risk of overweight and obesity (RR 0.81, 95% CI 0.65 to 1.01; P = 0.07, I2 = 0%; 5 studies, 1070 children). ECEC-based healthy eating interventions may be cost-effective but the evidence is very uncertain (6 studies). ECEC-based healthy eating interventions may have little to no effect on adverse consequences but the evidence is very uncertain (3 studies). Few studies measured language and cognitive skills (n = 2), social/emotional outcomes (n = 2) and quality of life (n = 3). AUTHORS' CONCLUSIONS ECEC-based healthy eating interventions may improve child diet quality slightly, but the evidence is very uncertain, and likely increase child fruit consumption slightly. There is uncertainty about the effect of ECEC-based healthy eating interventions on vegetable consumption. ECEC-based healthy eating interventions may result in little to no difference in child consumption of non-core foods and sugar-sweetened beverages. Healthy eating interventions could have favourable effects on child weight and risk of overweight and obesity, although there was little to no difference in BMI and BMI z-scores. Future studies exploring the impact of specific intervention components, and describing cost-effectiveness and adverse outcomes are needed to better understand how to maximise the impact of ECEC-based healthy eating interventions.
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Affiliation(s)
- Sze Lin Yoong
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Victoria, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Melanie Lum
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Jacklyn Jackson
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Courtney Barnes
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Alix E Hall
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Sam McCrabb
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Nicole Pearson
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Cassandra Lane
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Jannah Z Jones
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Erin Nolan
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Lauren Dinour
- College of Education and Human Services, Montclair State University, Montclair, New Jersey, USA
| | - Therese McDonnell
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Debbie Booth
- Auchmuty Library, University of Newcastle, Callaghan, Australia
| | - Alice Grady
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
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Yoong SL, Lum M, Wolfenden L, Jackson J, Barnes C, Hall AE, McCrabb S, Pearson N, Lane C, Jones JZ, Dinour L, McDonnell T, Booth D, Grady A. Healthy eating interventions delivered in early childhood education and care settings for improving the diet of children aged six months to six years. Cochrane Database Syst Rev 2023; 6:CD013862. [PMID: 37306513 PMCID: PMC10259732 DOI: 10.1002/14651858.cd013862.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Dietary intake during early childhood can have implications on child health and developmental trajectories. Early childhood education and care (ECEC) services are recommended settings to deliver healthy eating interventions as they provide access to many children during this important period. Healthy eating interventions delivered in ECEC settings can include strategies targeting the curriculum (e.g. nutrition education), ethos and environment (e.g. menu modification) and partnerships (e.g. workshops for families). Despite guidelines supporting the delivery of healthy eating interventions in this setting, little is known about their impact on child health. OBJECTIVES To assess the effectiveness of healthy eating interventions delivered in ECEC settings for improving dietary intake in children aged six months to six years, relative to usual care, no intervention or an alternative, non-dietary intervention. Secondary objectives were to assess the impact of ECEC-based healthy eating interventions on physical outcomes (e.g. child body mass index (BMI), weight, waist circumference), language and cognitive outcomes, social/emotional and quality-of-life outcomes. We also report on cost and adverse consequences of ECEC-based healthy eating interventions. SEARCH METHODS We searched eight electronic databases including CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, ERIC, Scopus and SportDiscus on 24 February 2022. We searched reference lists of included studies, reference lists of relevant systematic reviews, the World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov and Google Scholar, and contacted authors of relevant papers. SELECTION CRITERIA We included randomised controlled trials (RCTs), including cluster-RCTs, stepped-wedge RCTs, factorial RCTs, multiple baseline RCTs and randomised cross-over trials, of healthy eating interventions targeting children aged six months to six years that were conducted within the ECEC setting. ECEC settings included preschools, nurseries, kindergartens, long day care and family day care. To be included, studies had to include at least one intervention component targeting child diet within the ECEC setting and measure child dietary or physical outcomes, or both. DATA COLLECTION AND ANALYSIS Pairs of review authors independently screened titles and abstracts and extracted study data. We assessed risk of bias for all studies against 12 criteria within RoB 1, which allows for consideration of how selection, performance, attrition, publication and reporting biases impact outcomes. We resolved discrepancies via consensus or by consulting a third review author. Where we identified studies with suitable data and homogeneity, we performed meta-analyses using a random-effects model; otherwise, we described findings using vote-counting approaches and via harvest plots. For measures with similar metrics, we calculated mean differences (MDs) for continuous outcomes and risk ratios (RRs) for dichotomous outcomes. We calculated standardised mean differences (SMDs) for primary and secondary outcomes where studies used different measures. We applied GRADE to assess certainty of evidence for dietary, cost and adverse outcomes. MAIN RESULTS: We included 52 studies that investigated 58 interventions (described across 96 articles). All studies were cluster-RCTs. Twenty-nine studies were large (≥ 400 participants) and 23 were small (< 400 participants). Of the 58 interventions, 43 targeted curriculum, 56 targeted ethos and environment, and 50 targeted partnerships. Thirty-eight interventions incorporated all three components. For the primary outcomes (dietary outcomes), we assessed 19 studies as overall high risk of bias, with performance and detection bias being most commonly judged as high risk of bias. ECEC-based healthy eating interventions versus usual practice or no intervention may have a positive effect on child diet quality (SMD 0.34, 95% confidence interval (CI) 0.04 to 0.65; P = 0.03, I2 = 91%; 6 studies, 1973 children) but the evidence is very uncertain. There is moderate-certainty evidence that ECEC-based healthy eating interventions likely increase children's consumption of fruit (SMD 0.11, 95% CI 0.04 to 0.18; P < 0.01, I2 = 0%; 11 studies, 2901 children). The evidence is very uncertain about the effect of ECEC-based healthy eating interventions on children's consumption of vegetables (SMD 0.12, 95% CI -0.01 to 0.25; P =0.08, I2 = 70%; 13 studies, 3335 children). There is moderate-certainty evidence that ECEC-based healthy eating interventions likely result in little to no difference in children's consumption of non-core (i.e. less healthy/discretionary) foods (SMD -0.05, 95% CI -0.17 to 0.08; P = 0.48, I2 = 16%; 7 studies, 1369 children) or consumption of sugar-sweetened beverages (SMD -0.10, 95% CI -0.34 to 0.14; P = 0.41, I2 = 45%; 3 studies, 522 children). Thirty-six studies measured BMI, BMI z-score, weight, overweight and obesity, or waist circumference, or a combination of some or all of these. ECEC-based healthy eating interventions may result in little to no difference in child BMI (MD -0.08, 95% CI -0.23 to 0.07; P = 0.30, I2 = 65%; 15 studies, 3932 children) or in child BMI z-score (MD -0.03, 95% CI -0.09 to 0.03; P = 0.36, I2 = 0%; 17 studies; 4766 children). ECEC-based healthy eating interventions may decrease child weight (MD -0.23, 95% CI -0.49 to 0.03; P = 0.09, I2 = 0%; 9 studies, 2071 children) and risk of overweight and obesity (RR 0.81, 95% CI 0.65 to 1.01; P = 0.07, I2 = 0%; 5 studies, 1070 children). ECEC-based healthy eating interventions may be cost-effective but the evidence is very uncertain (6 studies). ECEC-based healthy eating interventions may have little to no effect on adverse consequences but the evidence is very uncertain (3 studies). Few studies measured language and cognitive skills (n = 2), social/emotional outcomes (n = 2) and quality of life (n = 3). AUTHORS' CONCLUSIONS ECEC-based healthy eating interventions may improve child diet quality slightly, but the evidence is very uncertain, and likely increase child fruit consumption slightly. There is uncertainty about the effect of ECEC-based healthy eating interventions on vegetable consumption. ECEC-based healthy eating interventions may result in little to no difference in child consumption of non-core foods and sugar-sweetened beverages. Healthy eating interventions could have favourable effects on child weight and risk of overweight and obesity, although there was little to no difference in BMI and BMI z-scores. Future studies exploring the impact of specific intervention components, and describing cost-effectiveness and adverse outcomes are needed to better understand how to maximise the impact of ECEC-based healthy eating interventions.
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Affiliation(s)
- Sze Lin Yoong
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Victoria, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Melanie Lum
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Jacklyn Jackson
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Courtney Barnes
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Alix E Hall
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Sam McCrabb
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Nicole Pearson
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Cassandra Lane
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Jannah Z Jones
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Lauren Dinour
- College of Education and Human Services, Montclair State University, Montclair, New Jersey, USA
| | - Therese McDonnell
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Debbie Booth
- Auchmuty Library, University of Newcastle, Callaghan, Australia
| | - Alice Grady
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
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Tauriello S, Moding K, Aronoff N, Kubiniec E, Anzman-Frasca S. Examining links between child temperament and feeding, eating, and weight outcomes: An updated systematic review of the literature. Eat Behav 2023; 49:101739. [PMID: 37209569 DOI: 10.1016/j.eatbeh.2023.101739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Weight outcomes have been associated with child temperament, defined as individual differences in reactivity and self-regulation. The current systematic review aims to provide an updated summary of the evidence linking temperamental negative reactivity, surgency, and regulation superfactors to early childhood feeding, eating, and weight outcomes. METHODS PubMed, PsycINFO and Embase databases, as well as scientific meeting programs, were searched using keywords and subject headings. Publication dates were limited to 2012-2019 as prior reviews were published in 2012 and 2014. Identified studies were eligible if they included children ages 0-5 years, a measure of child temperament, and a measure of parent/caregiver feeding, child eating, or child weight. 7113 studies were identified and 121 met inclusion criteria. RESULTS Feeding, eating, and weight outcomes were largely unrelated to overarching negative reactivity, surgency, and effortful control superfactors. Examination of individual temperament dimensions suggested difficult temperament was frequently linked to non-responsive feeding practices, whereas elevated emotionality and decreased self-regulation were linked to maladaptive eating behaviors, and lower inhibitory control to adiposity. Analyses with infants reported greater percentages of significant associations compared to children, and cross-sectional studies generally reported fewer significant associations than other study designs. CONCLUSIONS Difficult temperament, greater emotionality and lower self-regulation and inhibitory control were the aspects of temperament most consistently related to poorer early childhood feeding, eating, and weight outcomes. Associations tended to be stronger in infancy, and when examined within a non-cross-sectional study design. Findings can inform the development of tailored efforts to promote healthy eating and growth throughout childhood.
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Affiliation(s)
- Sara Tauriello
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States of America
| | - Kameron Moding
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, United States of America
| | - Nell Aronoff
- University Libraries, University at Buffalo, Buffalo, NY, United States of America
| | - Elizabeth Kubiniec
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States of America
| | - Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States of America; Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY, United States of America.
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Manzano MA, Strong DR, Rhee KE, Liang J, Boutelle KN. Discordance between assessments of food cue responsiveness: Implications for assessment in youth with overweight/obesity. Appetite 2023; 186:106575. [PMID: 37100119 DOI: 10.1016/j.appet.2023.106575] [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: 06/24/2022] [Revised: 04/20/2023] [Accepted: 04/22/2023] [Indexed: 04/28/2023]
Abstract
Food cue responsiveness (FCR), broadly defined as behavioral, cognitive, emotional and/or physiological responses to external appetitive cues outside of physiological need, contributes to overeating and obesity among youth and adults. A variety of measures purportedly assess this construct, ranging from youth- or parent-report surveys to objective eating tasks. However, little research has assessed their convergence. It is especially important to evaluate this in children with overweight/obesity (OW/OB), as reliable and valid assessments of FCR are essential to better understand the role of this critical mechanism in behavioral interventions. The present study examined the relationship between five measures of FCR in a sample of 111 children with OW/OB (mean age = 10.6, mean BMI percentile = 96.4; 70% female; 68% white; 23% Latinx). Assessments included: objectively measured eating in the absence of hunger (EAH), parasympathetic activity when exposed to food, parent reported food responsiveness subscale from the Child Eating Behavior Questionnaire (CEBQ-FR), child self-reported Power of Food total score (C-PFS), and child self-reported Food Cravings Questionnaire total score (FCQ-T). Statistically significant spearman correlations were found between EAH and CEBQ-FR (ρ = 0.19, p < 0.05) and parasympathetic reactivity to food cues with both C-PFS (ρ = -0.32, p = 0.002) and FCQ-T (ρ = -0.34, p < 0.001). No other associations were statistically significant. These relationships remained significant in subsequent linear regression models controlling for child age and gender. The lack of concordance between measures assessing highly conceptually related constructs is of concern. Future studies should seek to elucidate a clear operationalization of FCR, examine the associations between FCR assessments in children and adolescents with a range of weight statuses, and evaluate how to best revise these measures to accurately reflect the latent construct being assessed.
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Affiliation(s)
- Michael A Manzano
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, United States; University of California San Diego, Department of Pediatrics, United States.
| | - David R Strong
- University of California San Diego, Herbert Wertheim School of Public Health and Human Longevity Science, United States
| | - Kyung E Rhee
- University of California San Diego, Department of Pediatrics, United States
| | - June Liang
- University of California San Diego, Department of Pediatrics, United States
| | - Kerri N Boutelle
- University of California San Diego, Department of Pediatrics, United States; University of California San Diego, Herbert Wertheim School of Public Health and Human Longevity Science, United States; University of California San Diego, Department of Psychiatry, United States
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Factors Associated with Eating in the Absence of Hunger among Children and Adolescents: A Systematic Review. Nutrients 2022; 14:nu14224715. [PMID: 36432407 PMCID: PMC9699171 DOI: 10.3390/nu14224715] [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: 09/23/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/10/2022] Open
Abstract
Eating in the absence of hunger (EAH) has been extensively studied over the past two decades and has been associated with excess body weight and the development of obesity. However, determinants of EAH remain uncertain. This systematic review aims to identify individual, familial, and environmental factors associated with EAH among children and adolescents. We included studies with a measure of EAH in participants aged 3-17 years old and including ≥1 factor associated with EAH. Our search identified 1494 articles. Of these, we included 81 studies: 53 cross-sectional, 19 longitudinal and nine intervention studies. In childhood (≤12 years old), EAH increases with age, it is greater in boys compared to girls, and it is positively associated with adiposity. Moreover, EAH development seems to be influenced by genetics. In adolescence, the number of studies is limited; yet, studies show that EAH slightly increases or remains stable with age, is not clearly different between sexes, and findings for overweight or obesity are less consistent across studies in adolescence. For familial factors, parental restrictive feeding practices are positively associated with EAH during childhood, mostly for girls. Studies assessing environmental factors are lacking and robust longitudinal studies spanning from early childhood to adolescence are needed.
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Rollins BY, Francis LA, Riggs NR. Family Psychosocial Assets, Child Behavioral Regulation, and Obesity. Pediatrics 2022; 149:184741. [PMID: 35128559 DOI: 10.1542/peds.2021-052918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/10/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Little attention has been given to the study of early childhood factors that protect against the development of obesity and severe obesity. We investigated whether exposure to familial psychosocial assets and risks in infancy (1-15 months) and early childhood (24-54 months) and child behavioral regulation in early childhood predict longitudinal change in BMI (2 to 15 years). METHODS Participants included 1077 predominantly non-Hispanic, White, English-speaking mother-child dyads from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development dataset. Cumulative familial asset and risk indices were created using measures (eg, maternal parenting sensitivity, poverty) from 2 developmental periods (1-15 months, 24-54 months). A child behavioral regulation index was created on the basis of behavioral tasks and parent reports. Previously published BMI trajectories (nonoverweight [40th percentile], nonoverweight [70th percentile], overweight/obese, severely obese) were used as the outcome. RESULTS All indices predicted membership in the overweight/obese trajectory; however, when entered into the same model, only familial assets continued to reduce the odds of membership in this trajectory. Familial assets and child behavioral regulation independently reduced the odds of membership in the severely obese trajectory. Furthermore, child behavioral regulation and familial assets buffered the negative effects of familial risk on BMI trajectory membership. CONCLUSIONS Early exposure to familial assets and child behavioral regulation may have long-term protective effects on weight gain over early exposure to some familial risk factors (eg, poverty); thus, these indices may help foster obesity resilience.
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Affiliation(s)
- Brandi Y Rollins
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania
| | - Lori A Francis
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania
| | - Nathaniel R Riggs
- Human Development and Family Studies, Colorado State University, Fort Collins, Colorado
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Saelens BE, Melhorn SJ, Rowland MG, Scholz K, De Leon MRB, Elfers CT, Schur EA, Roth CL. General and Food-Specific Impulsivity and Inhibition Related to Weight Management. Child Obes 2022; 18:84-91. [PMID: 34357785 PMCID: PMC8892982 DOI: 10.1089/chi.2021.0080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: Understanding child characteristics that relate to weight management treatment outcome could help identify opportunities for intervention innovation or tailoring. The limited evidence available is inconsistent regarding whether and which aspects of children's general or food-specific impulsivity and inhibition relate to treatment outcomes. Methods: Children with (n = 54) and without obesity (n = 22) were compared on various measures of impulsivity and inhibition. Children with obesity (n = 40) then completed family-based treatment for weight management. Analyses examined associations between baseline children's impulsivity and inhibition and child weight status change (BMI z-score) and between treatment-based changes in impulsivity and inhibition and weight status change, with and without adjustment by baseline functional magnetic resonance imaging-measured appetitive drive. Results: Children with obesity scored more poorly on some, but not all, measures of impulsivity and inhibition than children without obesity. Lower baseline general inhibition and greater parent-report of child impulsivity were associated (independently) with greater improvements in child weight status, with modest attenuation after appetite drive adjustment. Children improved task-based general inhibition during treatment. Improvements in general inhibition and snack food discounting were associated with better child weight outcomes, although adjusting for baseline values attenuated these associations. Conclusions: Children with obesity having greater initial impulsivity had better weight outcomes in treatment even after adjusting for initial appetitive drive. In contrast, improvements in task-based inhibition and food-related discounting during treatment were also related to better outcomes. Research is needed on innovative approaches to better address impulsivity and inhibition in children's weight management. Clinical Trial Registration number: NCT02484976.
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Affiliation(s)
- Brian E. Saelens
- Department of Pediatrics, University of Washington, Seattle, WA, USA.,Seattle Children's Research Institute, Seattle, WA, USA.,Address correspondence to: Brian E. Saelens, PhD, Seattle Children's Research Institute, 1920 Terry Avenue, Seattle, WA 98101, USA
| | - Susan J. Melhorn
- Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - Kelley Scholz
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Mary Rosalynn B. De Leon
- Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - Ellen A. Schur
- Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Christian L. Roth
- Department of Pediatrics, University of Washington, Seattle, WA, USA.,Seattle Children's Research Institute, Seattle, WA, USA
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8
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Morrison S, Galland BC, Haszard JJ, Jackson R, McIntosh DR, Beebe DW, Elder DE, Ward AL, Meredith-Jones K, Taylor RW. Eating in the absence of hunger in children with mild sleep loss: a randomized crossover trial with learning effects. Am J Clin Nutr 2021; 114:1428-1437. [PMID: 34192297 DOI: 10.1093/ajcn/nqab203] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/27/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND While insufficient sleep duration has emerged as a strong, independent risk factor for obesity, the mechanisms remain unclear. One possibility is greater "eating in the absence of hunger" (EAH) or energy intake beyond the point of satiety, when tired. OBJECTIVE The aim was to determine whether mild sleep loss increases EAH in children. METHODS A crossover study was undertaken in 105 healthy children (8-12 y) with normal sleep (∼8-11 h/night). After randomization, children went to bed 1 h earlier (sleep extension) or 1 h later (sleep restriction) than their usual bedtime, over 2 intervention weeks separated by a 1-wk washout. At the end of each intervention week, children underwent an EAH feeding experiment involving a preloading meal until satiation, followed by an ad libitum buffet (of highly palatable snacks) to measure EAH, with each food item weighed before and after consumption. RESULTS Ninety-three children completed the EAH experiment. There was no evidence of a difference in energy intake from EAH between sleep restriction and extension conditions when analyzed as a crossover design. However, a learning effect was found, with children eating significantly less (-239 kJ; 95% CI: -437, -41 kJ; P = 0.018) during the preload phase and significantly more (181 kJ; 95% CI: 38, 322 kJ; P = 0.013) in the ad libitum phase in the second week. No significant differences were seen using an underpowered parallel analysis for energy intake during the ad libitum phase when sleep deprived (106 kJ; 95% CI: -217, 431 kJ; P = 0.514). CONCLUSIONS Our findings suggest that measuring a difference in eating behavior in relation to sleep proved unsuitable using the EAH experiment in a crossover design in children, due to a learning effect. This trial was registered at the Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367587&isReview=true) as ACTRN12618001671257 .
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Affiliation(s)
- Silke Morrison
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Barbara C Galland
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | | | - Rosie Jackson
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Dean W Beebe
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Dawn E Elder
- Department of Pediatrics and Child Health, University of Otago, Wellington, New Zealand
| | - Aimee L Ward
- Department of Medicine, University of Otago, Dunedin, New Zealand.,Department of Geography, Kent State University, Kent, OH, USA
| | | | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
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9
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Manzano MA, Strong DR, Kang Sim DE, Rhee KE, Boutelle KN. Psychometric properties of the Child Eating Behavior Questionnaire (CEBQ) in school age children with overweight and obesity: A proposed three-factor structure. Pediatr Obes 2021; 16:e12795. [PMID: 33945226 DOI: 10.1111/ijpo.12795] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/13/2021] [Accepted: 04/07/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Obesity in youth is a significant public health concern, with eating behaviors being a major contributor. The Child Eating Behavior Questionnaire (CEBQ) was developed to evaluate the appetitive characteristics of young children, across a myriad of eating domains. Despite the breadth of its use, the psychometric properties of the measure in children with overweight/obesity (OW/OB), particularly treatment seeking youth, remains largely unexplored. METHODS The psychometric properties of the CEBQ were examined in a sample of school age children (8-12) with OW/OB. Parent-child dyads (N = 148) completed assessments prior to beginning a family weight management program. Exploratory factor analysis (EFA) was performed utilizing polychoric correlations, and emerging subscales were assessed to ensure that the range of response scores demonstrated adequate variability. Indices of the number of factors to be retained included acceleration factor (2), optimal coordinates (4), Velicer's MAP (5) and parallel analysis (11). These indices were used in combination with clinical utility to determine the final factor structure. RESULTS A three-factor structure emerged. The first factor combined many food responsiveness, enjoyment of food, satiety responsiveness and slowness in eating items, with the latter two domains loading negatively. The second factor retained the food fussiness subscale, and the third factor included items from the emotional over- and under-eating subscales. CONCLUSIONS These results suggest that in children with OW/OB, eating behaviors may be optimally assessed using three domains: reward-based eating, emotional eating and picky eating. Future research should explore how this structure holds in non-treatment-seeking samples and across wider socio-demographic profiles.
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Affiliation(s)
- Michael A Manzano
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA.,San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - David R Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - D Eastern Kang Sim
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Kyung E Rhee
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Kerri N Boutelle
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA.,San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA.,Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA.,Department of Psychiatry, University of California San Diego, La Jolla, California, USA
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10
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Rhee KE, Manzano M, Goffin S, Strong D, Boutelle KN. Exploring the relationship between appetitive behaviours, executive function, and weight status among preschool children. Pediatr Obes 2021; 16:e12774. [PMID: 33530135 PMCID: PMC9186098 DOI: 10.1111/ijpo.12774] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 12/15/2020] [Accepted: 01/15/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The goal was to conduct exploratory analysis to determine if executive functions (EFs) and food responsiveness/satiety responsiveness (appetitive behaviours that describe one's tendency to eat in the presence of food or food cues) interact to influence weight status among preschool children participating in a trial promoting self-regulation around energy-dense foods. METHODS At baseline, parents completed the Behaviour Rating Inventory of Executive Function-Preschool and the Child Eating Behaviour Questionnaire. Children completed anthropometric measurements at the preschool. Spearman's correlation, linear regression, and tests of interaction were conducted. The relationship between weight status and EFs among those who were high vs low in food responsiveness and satiety responsiveness was examined. RESULTS Children (n = 92) had a mean age of 5.1 years and body mass index (BMI) percentile of 57.6; half (54%) were male. There were significant correlations between food responsiveness and several EFs (emotional control, inhibitory control, working memory, and plan/organize). In the stratified analysis, children with high food responsiveness or low satiety responsiveness had higher BMI percentiles as emotional control skills worsened. BMI percentiles were not elevated among children with low food responsiveness and poor emotional control. CONCLUSION These results suggest that EFs may be more relevant to weight status if preschool children had high levels of food responsiveness or low levels of satiety responsiveness (ie, increased tendency to be influenced by environmental food cues). This analysis should be replicated with direct measures of executive function and appetitive behaviours in larger samples of young children to examine longitudinal impact on weight status.
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Affiliation(s)
- Kyung E. Rhee
- Department of Pediatrics, University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093. USA
| | - Michael Manzano
- Department of Pediatrics, University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093. USA.,San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA 92120. USA
| | - Stanny Goffin
- Department of Pediatrics, University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093. USA
| | - David Strong
- Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093. USA
| | - Kerri N. Boutelle
- Department of Pediatrics, University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093. USA.,Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093. USA.,Department of Psychiatry, University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093. USA
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11
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Hughes SO, Power TG, Beck A, Betz D, Goodell LS, Hopwood V, Jaramillo JA, Lanigan J, Martinez AD, Micheli N, Olivera Y, Overath I, Parker L, Ramos G, Thompson YP, Johnson SL. Short-Term Effects of an Obesity Prevention Program Among Low-Income Hispanic Families With Preschoolers. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:224-239. [PMID: 31917129 DOI: 10.1016/j.jneb.2019.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 11/25/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To assess the short-term effects of an obesity prevention program promoting eating self-regulation and healthy food preferences in low-income Hispanic children. DESIGN Randomized controlled trial with pretest, posttest, and 6- and 12-month assessments. SETTING AND PARTICIPANTS Head Start and similar early learning institutions in Houston, TX, and Pasco, WA. A total of 255 families with preschoolers randomized into prevention (n = 136) and control (n = 119) groups. INTERVENTION Multicomponent family-based prevention program. Fourteen waves lasted 7 weeks each with 8-10 mother-child dyads in each group. MAIN OUTCOME MEASURES Parent assessments included feeding practices, styles, and knowledge. Child assessments included child eating self-regulation, willingness to try new foods, and parent report of child fruit and vegetable preferences. Parent and child heights and weights were measured. ANALYSIS Multilevel analyses were employed to consider the nested nature of the data: time points within families within waves. RESULTS The program had predicted effects on parental feeding practices, styles, and knowledge in the pre- to post-comparisons. Effects on child eating behavior were minimal; only the number of different vegetables tried showed significant pre-post differences. CONCLUSIONS AND IMPLICATIONS Short-term effects of this prevention program highlight the importance of family-focused feeding approaches to combating child overweight and obesity.
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Affiliation(s)
- Sheryl O Hughes
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX.
| | - Thomas G Power
- Department of Human Development, Washington State University, Pullman, WA
| | - Ashley Beck
- Department of Human Development, Washington State University, Pullman, WA
| | - Drew Betz
- Department of Human Development, Washington State University, Pullman, WA
| | - L Suzanne Goodell
- Department of Food, Bioprocessing, and Nutritional Sciences, North Carolina State University, Raleigh, NC
| | - Veronica Hopwood
- Department of Human Development, Washington State University, Pullman, WA
| | - J Andrea Jaramillo
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Jane Lanigan
- Department of Human Development, Washington State University, Pullman, WA
| | | | - Nilda Micheli
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Yadira Olivera
- Department of Human Development, Washington State University, Pullman, WA
| | - Irene Overath
- Department of Human Development, Washington State University, Pullman, WA
| | - Louise Parker
- Department of Human Development, Washington State University, Pullman, WA
| | - Guadalupe Ramos
- Department of Human Development, Washington State University, Pullman, WA
| | - Yuri Peralta Thompson
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX
| | - Susan L Johnson
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, CO
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12
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Sylvetsky AC, Parnarouskis L, Merkel PE, Gearhardt AN. Children's Sugar-Sweetened Beverage Consumption: Striking Parallels With Substance Use Disorder Symptoms. Front Pediatr 2020; 8:594513. [PMID: 33282802 PMCID: PMC7689136 DOI: 10.3389/fped.2020.594513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/02/2020] [Indexed: 12/16/2022] Open
Affiliation(s)
- Allison C Sylvetsky
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | | | - Patrick E Merkel
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States
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13
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Jirout J, LoCasale-Crouch J, Turnbull K, Gu Y, Cubides M, Garzione S, Evans TM, Weltman AL, Kranz S. How Lifestyle Factors Affect Cognitive and Executive Function and the Ability to Learn in Children. Nutrients 2019; 11:E1953. [PMID: 31434251 PMCID: PMC6723730 DOI: 10.3390/nu11081953] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 08/08/2019] [Accepted: 08/14/2019] [Indexed: 12/13/2022] Open
Abstract
In today's research environment, children's diet, physical activity, and other lifestyle factors are commonly studied in the context of health, independent of their effect on cognition and learning. Moreover, there is little overlap between the two literatures, although it is reasonable to expect that the lifestyle factors explored in the health-focused research are intertwined with cognition and learning processes. This thematic review provides an overview of knowledge connecting the selected lifestyle factors of diet, physical activity, and sleep hygiene to children's cognition and learning. Research from studies of diet and nutrition, physical activity and fitness, sleep, and broader influences of cultural and socioeconomic factors related to health and learning, were summarized to offer examples of research that integrate lifestyle factors and cognition with learning. The literature review demonstrates that the associations and causal relationships between these factors are vastly understudied. As a result, current knowledge on predictors of optimal cognition and learning is incomplete, and likely lacks understanding of many critical facts and relationships, their interactions, and the nature of their relationships, such as there being mediating or confounding factors that could provide important knowledge to increase the efficacy of learning-focused interventions. This review provides information focused on studies in children. Although basic research in cells or animal studies are available and indicate a number of possible physiological pathways, inclusion of those data would distract from the fact that there is a significant gap in knowledge on lifestyle factors and optimal learning in children. In a climate where childcare and school feeding policies are continuously discussed, this thematic review aims to provide an impulse for discussion and a call for more holistic approaches to support child development.
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Affiliation(s)
- Jamie Jirout
- Center for Advanced Study of Teaching and Learning, Charlottesville, VA 22903, USA
| | | | - Khara Turnbull
- Center for Advanced Study of Teaching and Learning, Charlottesville, VA 22903, USA
| | - Yin Gu
- Center for Advanced Study of Teaching and Learning, Charlottesville, VA 22903, USA
| | - Mayaris Cubides
- Center for Advanced Study of Teaching and Learning, Charlottesville, VA 22903, USA
| | - Sarah Garzione
- Department of Kinesiology, Curry School of Education and Human Development, University of Virginia, Charlottesville, VA 22903, USA
| | - Tanya M Evans
- Center for Advanced Study of Teaching and Learning, Charlottesville, VA 22903, USA
| | - Arthur L Weltman
- Department of Kinesiology, Curry School of Education and Human Development, University of Virginia, Charlottesville, VA 22903, USA
| | - Sibylle Kranz
- Department of Kinesiology, Curry School of Education and Human Development, University of Virginia, Charlottesville, VA 22903, USA.
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14
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Abstract
PURPOSE OF REVIEW This review summarizes findings on pediatric loss-of-control (LOC) eating and obesity published since 2013 in relation to physiological, socioenvironmental, and psychological factors. RECENT FINDINGS LOC eating and obesity are highly comorbid in youth. Genetic and physiological risk factors are associated with the development of LOC eating. Adverse physiological outcomes of LOC eating include increased risk for overweight and obesity and greater dysfunction in components of metabolic syndrome. Socioenvironmental, psychological, and behavioral factors, such as weight-based teasing, dieting, negative affect, emotion dysregulation, and aspects of cognitive functioning, are consistently related to LOC eating in youth, independent of weight. Prospectively, LOC eating may predict the onset of anxiety disorders, depression, and more severe eating psychopathology later in life. Updates on interventions and future directions are discussed. LOC eating may be a key symptom to target adverse physiological and psychological outcomes; however, treatments are limited and require further examination.
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Affiliation(s)
- Meghan E Byrne
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814-4799, USA
| | - Sarah LeMay-Russell
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814-4799, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814-4799, USA.
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