Definitions of hunger and fullness among youth enrolled in a pediatric weight management program

Caregivers' Attention Toward, and Response to, Their Child's Interoceptive Hunger and Thirst Cues

People can use their internal state to determine if they are hungry or thirsty. Although the meaning of some interoceptive cues may be innate (e.g., pain), it is possible that others-including those for hunger and thirst-are acquired. There has been little exploration of this idea in humans. Consequently, we conducted a survey among child caregivers to determine if the basic conditions necessary for interoceptive learning were present. Two-hundred and thirty-five caregivers of children aged 1-12 years were asked if they had recently noticed stomach rumbling, hunger-related irritability, and a dry mouth in their child. They were also asked how they would respond. The impact of several moderating variables, especially caregiver beliefs about the causes of hunger, fullness, and thirst, was also explored. Fifteen percent of caregivers had recently noticed stomach rumbling in their child, 28% hunger-related irritability, and 14% a dry mouth. Forty-four percent of caregivers had noticed at least one of these three cues. Noticing hunger cues was significantly moderated by caregiver beliefs about their cause, by child age, and in one case by temporal context (around vs. outside mealtimes). Key caregiver responses were providing the need (e.g., offer food) and/or asking the child if they had a need (e.g., hungry?). Each type of response could potentially support a different form of interoceptive learning. In conclusion, we suggest the necessary conditions for children to learn interoceptive hunger and thirst cues, are present in many caregiver-offspring dyads.

Calorie Compensation and Self-Regulation of Food Intake in College Students

OBJECTIVE

To examine self-regulation of food intake among college students.

DESIGN

Randomized cross-over study completed between September and November, 2019.

SETTING

A large public university, Florida International University in South Florida.

PARTICIPANTS

A total of 60 undergraduate college students, mean age of 19.8 ± 1.43 years old, 62% female, 74% Hispanic, 76% White.

INTERVENTION(S)

Participants attended 2 trials 1 week apart. During each visit, students were offered a preload drink (either 0 or 210 kcal) followed by a buffet-style lunch. Food intake was estimated using weights and pictures of the plates before and after eating and was compared between the 2 sessions.

MAIN OUTCOME MEASURE(S)

Self-regulation by calculating compensation indices (COMPX) and their correlation with students' body mass index (BMI).

ANALYSIS

Intake differences were examined using Welch and t tests. Regression analysis was used to assess correlations.

RESULTS

Students exhibited the ability to calorie compensate when intake is manipulated with a mean COMPX of 95.57 ± 71.19. No score was perfect. There was a significant correlation between BMI and COMPX scores (F = 10.71, P < 0.001, r² = 0.292). Food choices differed between different BMI categories.

CONCLUSIONS AND IMPLICATIONS

Participants showed some degree of self-regulation, which suggests opportunities for creating effective interventions to improve health status and promote a more sustainable method to control consumption among college students.

Decision-Making Processes Related to Perseveration Are Indirectly Associated With Weight Status in Children Through Laboratory-Assessed Energy Intake

Decision-making contributes to what and how much we consume, and deficits in decision-making have been associated with increased weight status in children. Nevertheless, the relationships between cognitive and affective processes underlying decision-making (i.e., decision-making processes) and laboratory food intake are unclear. We used data from a four-session, within-subjects laboratory study to investigate the relationships between decision-making processes, food intake, and weight status in 70 children 7-to-11-years-old. Decision-making was assessed with the Hungry Donkey Task (HDT), a child-friendly task where children make selections with unknown reward outcomes. Food intake was measured with three paradigms: (1) a standard ad libitum meal, (2) an eating in the absence of hunger (EAH) protocol, and (3) a palatable buffet meal. Individual differences related to decision-making processes during the HDT were quantified with a reinforcement learning model. Path analyses were used to test whether decision-making processes that contribute to children’s (a) expected value of a choice and (b) tendency to perseverate (i.e., repeatedly make the same choice) were indirectly associated with weight status through their effects on intake (kcal). Results revealed that increases in the tendency to perseverate after a gain outcome were positively associated with intake at all three paradigms and indirectly associated with higher weight status through intake at both the standard and buffet meals. Increases in the tendency to perseverate after a loss outcome were positively associated with EAH, but only in children whose tendency to perseverate persistedacross trials. Results suggest that decision-making processes that shape children’s tendencies to repeat a behavior (i.e., perseverate) are related to laboratory energy intake across multiple eating paradigms. Children who are more likely to repeat a choice after a positive outcome have a tendency to eat more at laboratory meals. If this generalizes to contexts outside the laboratory, these children may be susceptible to obesity. By using a reinforcement learning model not previously applied to the study of eating behaviors, this study elucidated potential determinants of excess energy intake in children, which may be useful for the development of childhood obesity interventions.