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Chen L, Thapaliya G, Papantoni A, Benson L, Carnell S. Neural correlates of appetite in adolescents. Appetite 2023; 191:107076. [PMID: 37806450 PMCID: PMC10997743 DOI: 10.1016/j.appet.2023.107076] [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: 05/02/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/10/2023]
Abstract
Appetitive characteristics are associated with child adiposity, but their biological underpinnings are unclear. We sought to investigate the neural correlates of psychometric and behavioral measures of appetitive characteristics in youth. Adolescents (14-18y; 39F, 37M) varying in familial obesity risk and body weight (20% with overweight, 24% with obesity) viewed pictures of high energy-density (ED) foods, low-ED foods and non-foods during fMRI scanning on two separate days. On one day participants consumed a 474 ml preload of water (0 kcal, fasted) and on another (counter-balanced) 474 ml milkshake (480 kcal, fed), before scanning. A multi-item ad libitum meal (ALM) followed scanning. Parents completed Child Eating Behavior Questionnaire (CEBQ) sub-scales assessing food approach and food self-regulation. Caloric compensation was calculated as the percentage of preload intake compensated for by down-regulation of ALM intake in the fed vs. fasted condition. Analyses correcting for multiple comparisons demonstrated that, for the fasted condition, higher CEBQ Food Responsiveness scores were associated with greater activation to high-ED (vs. low-ED) foods in regions implicated in food reward (insula, rolandic operculum, putamen). In addition, higher caloric compensation was associated with greater fed vs. fasted activations in response to foods (vs. non-foods) in thalamus and supramarginal gyrus. Uncorrected analyses provided further support for associations of different measures of appetitive characteristics with brain responses to food cues in each condition. Measures of appetitive characteristics demonstrated overlapping and distinct associations with patterns of brain activation elicited by food cues in fasted and fed states. Understanding the neural basis of appetitive characteristics could aid development of biobehaviorally-informed obesity interventions.
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Affiliation(s)
- L Chen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - G Thapaliya
- Division of Child & Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - A Papantoni
- Division of Child & Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - L Benson
- Division of Child & Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - S Carnell
- Division of Child & Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA.
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Reigh NA, Pearce AL, Rolls BJ, Kral TVE, Hetherington MM, Romano O, Keller KL. Inter-individual differences in children's short-term energy compensation: a systematic review and meta-analysis. Am J Clin Nutr 2023; 118:1202-1213. [PMID: 37758060 PMCID: PMC10739779 DOI: 10.1016/j.ajcnut.2023.09.013] [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: 01/09/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND The ability to regulate energy intake is often assessed using a preloading paradigm to measure short-term energy compensation. In children, large variability exists with this paradigm both within- and across- studies and is poorly understood. OBJECTIVES This systematic review and meta-analysis aimed to better understand factors contributing to variability in children's energy compensation. We tested 1) whether children demonstrated "good" energy compensation, defined as adjusting meal intake commensurate with preload intake and 2) differences in children's energy compensation by child age, sex, and weight status (assessed both continuously and categorically). METHODS Standard guidelines for systematic review were followed to search PubMed, PsychInfo, and Web of Science. Data on study design (preload form, preload-to-meal interval, preload energy difference, study setting) and participant characteristics (sex, age, weight status) were extracted from 29 experiments meeting inclusion criteria, and 13 were included in meta-analyses. COMPx (energy compensation index), a linear transformation comparing food intake following a high- vs. low-energy preload, was the outcome. Hedge's g was calculated, and random intercept-only models tested associations between COMPx and sex, age, and weight status. RESULTS The systematic review revealed mixed results regarding children's energy compensation and the role of inter-individual differences. Meta-analytic models revealed that children undercompensated (overate) for preload energy (β = -0.38; P = 0.008). Sex (β = 0.11; P = 0.76), age (β = 0.03; P = 0.75), and weight (assessed continuously; β = -0.07, P = 0.37) were not related to compensation. Children with overweight/obesity (assessed categorically) undercompensated more than children with healthy weight (β = 0.18; P = 0.04). CONCLUSIONS The systematic review highlighted wide variability across studies, while the meta-analysis demonstrated differences in COMPx by child weight status but not by age or sex. Standardizing protocols across studies is recommended, along with designing adequately powered studies aiming to test inter-individual differences a priori. Alternative approaches to the use of COMPx are recommended to allow better characterization of children's energy compensation ability. This study was registered at PROSPERO as CRD42020197748.
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Affiliation(s)
- Nicole A Reigh
- The Pennsylvania State University, Department of Nutritional Sciences, University Park, Pennsylvania, United States
| | - Alaina L Pearce
- The Pennsylvania State University, Department of Nutritional Sciences, University Park, Pennsylvania, United States
| | - Barbara J Rolls
- The Pennsylvania State University, Department of Nutritional Sciences, University Park, Pennsylvania, United States
| | - Tanja V E Kral
- University of Pennsylvania, Department of Biobehavioral Health Sciences, Philadelphia, Pennsylvania, United States
| | | | - Olivia Romano
- The Pennsylvania State University, Department of Nutritional Sciences, University Park, Pennsylvania, United States
| | - Kathleen L Keller
- The Pennsylvania State University, Department of Nutritional Sciences, University Park, Pennsylvania, United States; The Pennsylvania State University, Department of Food Science, University Park, Pennsylvania, United States.
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Klos B, Cook J, Crepaz L, Weiland A, Zipfel S, Mack I. Impact of energy density on energy intake in children and adults: a systematic review and meta-analysis of randomized controlled trials. Eur J Nutr 2023; 62:1059-1076. [PMID: 36460778 PMCID: PMC10030411 DOI: 10.1007/s00394-022-03054-z] [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: 03/27/2022] [Accepted: 11/10/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE The energy density (ED) of a diet can be leveraged to prevent weight gain or treat overweight and obesity. By lowering the ED of the diet, energy intake can be reduced while maintaining portion size. However, a reliable meta-analysis of data from randomized controlled trials (RCTs) is missing. Therefore, this meta-analysis synthesized the evidence of ED manipulation on energy intake in RCTs. METHODS The systematic literature search of multiple databases according to PRISMA criteria considered RCTs investigating the objectively measured energy intake from meals with different ED (lower ED (median 1.1 kcal/g) versus higher ED (median 1.5 kcal/g)) under controlled conditions. Subgroup analyses for age (children versus adults), meal type (preload versus entrée design), and intervention length (1 meal versus > 1 meal) were performed to achieve the most homogeneous result. RESULTS The meta-analysis of 38 included studies demonstrated that lowering ED considerably reduced energy intake - 223 kcal (95% CI: - 259.7, - 186.0) in comparison to the higher ED interventions. As heterogeneity was high among studies, subgroup analyses were conducted. Heterogeneity decreased in subgroup analyses for age and meal type combined, strengthening the results. An extended analysis showed a positive linear relationship between ED and energy intake. Dietary ED did not affect the amount of food intake. CONCLUSION Manipulating ED substantially affects energy intake whereas food intake remains constant. Thus, this approach can be regarded as a powerful tool for weight management through nutrition therapy. Registration on 08/08/2021: CRD42021266653.
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Affiliation(s)
- Bea Klos
- Internal Medicine VI, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Jessica Cook
- Internal Medicine VI, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Letizia Crepaz
- Internal Medicine VI, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Alisa Weiland
- Internal Medicine VI, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Stephan Zipfel
- Internal Medicine VI, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Isabelle Mack
- Internal Medicine VI, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany.
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Hernandez E, Moore AM, Rollins BY, Tovar A, Savage JS. Sorry Parents, Children Consume High Amounts of Candy before and after a Meal: Within-Person Comparisons of Children's Candy Intake and Associations with Temperament and Appetite. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010052. [PMID: 36670603 PMCID: PMC9856888 DOI: 10.3390/children10010052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/09/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
Candy provides little nutritional value and contributes to children's energy intake from added sugars. Factors influencing children's candy intake remain largely unknown. This study describes children's total candy intake (kcal) before and after a meal and examines associations of candy intake in both conditions with children's temperament and appetite among a predominantly White, highly educated sample. Children (n = 38, age 5-8 years) were given free access to 11 candies (5 chocolate, 6 non-chocolate) and non-food alternatives during a pre-meal and a post-meal condition. Parents completed the Child Behavior Questionnaire and the Child Eating Behavior Questionnaire. Total candy intake was less when offered after a meal (209.3 kcal; SD = 111.25) than before a meal when still hungry (283.6 kcal; SD = 167.3), but not statistically different. Individual differences in candy intake between conditions was calculated to categorize children into three groups: "Better Regulators" consumed more candy before a meal (39%), "Consistent/Poorer Regulators" consumed similar amounts before and after a meal regardless of hunger (32%), and "Most Disinhibited" children consumed more candy after a meal when not hungry (29%). The "Better Regulators" group was lowest in negative affect and the "Consistent/Poorer Regulators" group was highest in food responsiveness. Children's candy intake was high relative to daily energy needs both before and after a meal. Child negative affect and food responsiveness appear to be child characteristics that predispose children to poor self-regulation of candy intake before and after a meal.
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Affiliation(s)
- Erika Hernandez
- Center for Childhood Obesity Research, 129 Noll Laboratory, The Pennsylvania State University, University Park, PA 16802, USA
- Correspondence: ; Tel.: +1-(814)-865-5246
| | - Amy M. Moore
- Center for Childhood Obesity Research, 129 Noll Laboratory, The Pennsylvania State University, University Park, PA 16802, USA
| | - Brandi Y. Rollins
- Biobehavioral Health, The Pennsylvania State University, 118 Henderson Building, University Park, PA 16802, USA
| | - Alison Tovar
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Box G-S121-4, Providence, RI 02912, USA
| | - Jennifer S. Savage
- Center for Childhood Obesity Research, 129 Noll Laboratory, The Pennsylvania State University, University Park, PA 16802, USA
- Department of Nutritional Sciences, 110 Chandlee Laboratory, The Pennsylvania State University, University Park, PA 16802, USA
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Robinson E, Khuttan M, McFarland-Lesser I, Patel Z, Jones A. Calorie reformulation: a systematic review and meta-analysis examining the effect of manipulating food energy density on daily energy intake. Int J Behav Nutr Phys Act 2022; 19:48. [PMID: 35459185 PMCID: PMC9026919 DOI: 10.1186/s12966-022-01287-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/25/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Dietary energy density is thought to be a contributor to obesity, but the extent to which different magnitudes and types of reductions to food energy density decreases daily energy intake is unclear. The primary objective was to systematically review and meta-analyse experimental studies that have examined the effect that manipulating energy density of food has on total daily energy intake. Secondary objectives were to examine moderators of the effect that altering energy density has on daily energy intake and effects on body weight. METHODS A systematic review and multi-level meta-analysis of studies on human participants that used an experimental design to manipulate the energy density of foods served and measured energy intake for a minimum of 1 day. RESULTS Thirty-one eligible studies sampling both children (n = 4) and adults (n = 27) contributed 90 effects comparing the effect of higher vs. lower energy density of served food on daily energy intake to the primary meta-analysis. Lower energy density of food was associated with a large decrease in daily energy intake (SMD = - 1.002 [95% CI: - 0.745 to - 1.266]). Findings were consistent across studies that did vs. did not manipulate macronutrient content to vary energy density. The relation between decreasing energy density and daily energy intake tended to be strong and linear, whereby compensation for decreases to energy density of foods (i.e. by eating more at other meals) was minimal. Meta-analysis of (n = 5) studies indicated that serving lower energy dense food tended to be associated with greater weight loss than serving higher energy dense food, but this difference was not significant (- 0.7 kg difference in weight change, 95% CIs: - 1.34, 0.04). CONCLUSIONS Decreasing the energy density of food can substantially reduce daily energy intake and may therefore be an effective public health approach to reducing population level energy intake. TRIAL REGISTRATION Registered on PROSPERO ( CRD42020223973 ).
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Affiliation(s)
- Eric Robinson
- Department of Psychology, Eleanor Rathbone Building, University of Liverpool, Liverpool, L69 7ZA, UK.
| | - Mercedes Khuttan
- Department of Psychology, Eleanor Rathbone Building, University of Liverpool, Liverpool, L69 7ZA, UK
| | - India McFarland-Lesser
- Department of Psychology, Eleanor Rathbone Building, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Zina Patel
- Department of Psychology, Eleanor Rathbone Building, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Andrew Jones
- Department of Psychology, Eleanor Rathbone Building, University of Liverpool, Liverpool, L69 7ZA, UK
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Perrar I, Alexy U, Jankovic N. Changes in Total Energy, Nutrients and Food Group Intake among Children and Adolescents during the COVID-19 Pandemic-Results of the DONALD Study. Nutrients 2022; 14:nu14020297. [PMID: 35057478 PMCID: PMC8778042 DOI: 10.3390/nu14020297] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/03/2022] [Accepted: 01/07/2022] [Indexed: 02/01/2023] Open
Abstract
The COVID-19 pandemic may have changed the habitual lifestyles of children and adolescents, in particular, due to the closure of kindergartens and schools. To investigate the impact of the pandemic on nutrients and food intake of children and adolescents in Germany, we analyzed repeated 3-day weighed dietary records from 108 participants (3–18 years; females: n = 45, males: n = 63) of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study. Polynomial mixed-effects regression models were used to identify prospective changes in dietary intake (total energy (TEI), carbohydrates, fat, protein, free sugar, ultra-processed foods, fruits and vegetables, sugar sweetened beverages and juices) before and during the first months of the COVID-19 pandemic. For the current analysis, we have chosen the first months of the pandemic (March 2020–August 2020), as this was the period with the most restrictions in Germany so far (kindergarten, school and restaurant closures; contact and outdoor activity restrictions). No significant changes in either the selected nutrients or food groups were observed. However, children and adolescents recorded a significantly lower TEI during the pandemic (β = −109.65, p = 0.0062). Results remained significant after the exclusion of participants with under-reported records (β = −95.77, p = 0.0063). While macronutrient intake did not change, descriptive data indicate a non-significant decrease in sugar sweetened beverages and ultra-processed foods intake. We suggest that children and adolescents from high socioeconomic families may have adapted lifestyle changes during the pandemic.
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Affiliation(s)
- Ines Perrar
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Friedrich-Hirzebruch-Allee 7, 53115 Bonn, Germany
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany; (U.A.); (N.J.)
- Correspondence:
| | - Ute Alexy
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany; (U.A.); (N.J.)
| | - Nicole Jankovic
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany; (U.A.); (N.J.)
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Appetite self-regulation declines across childhood while general self-regulation improves: A narrative review of the origins and development of appetite self-regulation. Appetite 2021; 162:105178. [PMID: 33639246 DOI: 10.1016/j.appet.2021.105178] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/18/2021] [Accepted: 02/21/2021] [Indexed: 02/07/2023]
Abstract
This narrative review discusses the origins and development of appetite self-regulation (ASR) in childhood (from infancy to age 6 or 7 years). The origins, or foundations, are the biological infrastructure associated with appetite regulation and appetite self-regulation. Homeostatic regulation in infancy is examined and then evidence about developmental change in components of ASR. The main ASR-related components covered are: delay-of-gratification, caloric compensation, eating in the absence of hunger, food responsiveness/hedonics and fussy eating. The research included behavioral measures, parent-reports of appetitive traits and fMRI studies. There were two main trends in the evidence: a decline across childhood in the components of ASR associated with food approach (and therefore an increase in disinhibited eating), and wide individual differences. The decline in ASR contrasts with general self-regulation (GSR) where the evidence is of an improvement across childhood. For many children, bottom-up automatic reactive processes via food reward/hedonics or food avoidance as in fussy eating, appear not to be matched by improvements in top-down regulatory capacities. The prominence of bottom-up processes in ASR could be the main factor in possible differences in developmental paths for GSR and ASR. GSR research is situated in developmental science with its focus on developmental processes, theory and methodology. In contrast, the development of ASR at present does not have a strong developmental tradition to access and there is no unifying model of ASR and its development. We concluded (1) outside of mean-level or normative changes in the components of ASR, individual differences are prominent, and (2) there is a need to formulate models of developmental change in ASR together with appropriate measurement, research designs and data analysis strategies.
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Schiano C, Grimaldi V, Scognamiglio M, Costa D, Soricelli A, Nicoletti GF, Napoli C. Soft drinks and sweeteners intake: Possible contribution to the development of metabolic syndrome and cardiovascular diseases. Beneficial or detrimental action of alternative sweeteners? Food Res Int 2021; 142:110220. [PMID: 33773688 DOI: 10.1016/j.foodres.2021.110220] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 01/04/2023]
Abstract
The rapid increase in obesity, metabolic syndrome, and cardiovascular diseases (CVDs) has been related to the rise in sugar-added foods and sweetened beverages consumption. An interesting approach has been to replace sugar with alternative sweeteners (AS), due to their impact on public health. Preclinical and clinical studies, which analyze the safety of AS intake, are still limited. Major pathogenic mechanisms of these substances include ROS and AGEs formation. Indeed, endothelial dysfunction involving in the pathogenesis of micro- and macro-vascular diseases is mitochondrial dysfunction dependent. Hyperglycemia and endoplasmic reticulum stress together produce ROS, contributing to the development and progression of cardiovascular complications during type 2 diabetes (T2D), thus causing oxidative changes and direct damage of lipids, proteins, and DNA. Epidemiological studies in healthy subjects have suggested that the consumption of artificial AS can promote CV complications, such as glucose intolerance and predisposition to the onset of T2D, whereas natural AS could reduce hyperglycemia, improve lipid metabolism and have antioxidant effects. Long-term prospective clinical randomized studies are needed to evaluate precisely whether exposure to alternative sugars can have clinical implications on natural history and clinical outcomes, especially in children or during the gestational period through breast milk.
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Affiliation(s)
- Concetta Schiano
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania "L. Vanvitelli", Naples, Italy.
| | | | - Michele Scognamiglio
- Clinical Department of Internal Medicine and Specialistic Units, Division of Clinical Immunology and Immunohematology, Transfusion Medicine, and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Azienda Universitaria Policlinico (AOU), Naples, Italy
| | - Dario Costa
- Clinical Department of Internal Medicine and Specialistic Units, Division of Clinical Immunology and Immunohematology, Transfusion Medicine, and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Azienda Universitaria Policlinico (AOU), Naples, Italy
| | - Andrea Soricelli
- IRCCS SDN, Naples, Italy; Department of Exercise and Wellness Sciences, University of Naples Parthenope, Naples, Italy
| | - Giovanni Francesco Nicoletti
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Plastic Surgery Unit, University of Campania "L. Vanvitelli", Naples, Italy
| | - Claudio Napoli
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania "L. Vanvitelli", Naples, Italy; IRCCS SDN, Naples, Italy; Clinical Department of Internal Medicine and Specialistic Units, Division of Clinical Immunology and Immunohematology, Transfusion Medicine, and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Azienda Universitaria Policlinico (AOU), Naples, Italy
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Kral TVE, Moore RH, Chittams J, O'Malley L, Jones E, Quinn RJ, Fisher JO. Does eating in the absence of hunger extend to healthy snacks in children? Pediatr Obes 2020; 15:e12659. [PMID: 32548966 DOI: 10.1111/ijpo.12659] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 04/24/2020] [Accepted: 05/04/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To assess if eating in the absence of hunger (EAH) extends to healthier snacks and examine the relationship between the home food environment and EAH in children with normal weight (NW) or overweight/obesity (OB) who are at low risk (LR) or high risk (HR) for obesity based on maternal obesity. METHODS EAH was assessed after lunch and dinner when children received either low energy dense fruit snacks or high energy dense sweet/savoury snacks. The availability of obesogenic foods in the home was assessed by the Home Food Inventory. RESULTS Data showed significant main effects of risk group (P=.0003) and snack type (P < .001). EAH was significantly greater in HR-OB (284±8 kcal) than LR-NW (249±9 kcal) or HR-NW (251±8 kcal) children. Serving fruit rather than sweet/savoury snacks reduced energy intake, on average, by 60% (223 kcal) across risk groups. For each unit increase in the obesogenic home food environment, EAH of sweet/savoury snacks decreased by 1.83 calories. CONCLUSIONS Offering low energy dense snacks after a meal can moderate EAH and increase children's intake of healthy foods. Increased access to obesogenic foods in the home may reduce the salience of high energy dense snacks when they become available in other settings.
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Affiliation(s)
- Tanja V E Kral
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Reneé H Moore
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Jesse Chittams
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lauren O'Malley
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Elizabeth Jones
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ryan J Quinn
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jennifer O Fisher
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
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