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Nikitina IL, Vtornikova NI, Kelmanson IA. Clinical heterogeneity of sleep quality, emotional and behavioral characteristics, and eating habits in adolescents with obesity: A cluster analysis. Eur J Pediatr 2024; 183:1571-1584. [PMID: 38177526 DOI: 10.1007/s00431-023-05406-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/18/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024]
Abstract
This study aims to examine the role of sleep quality, emotional and behavioral characteristics, and eating behavior in adolescents with obesity by means of cluster analysis. One hundred ninety-four adolescents (78 girls, 116 boys) aged 12-17 (mean 14.3 ± 2.7) with obesity (ICD-10 code E 66.0) entered the study. The Adolescent Sleep Wake Scale was used to evaluate sleep quality. The Achenbach Youth Self-Report for Ages 11-18 questionnaire was used to evaluate emotional and behavioral disturbances. The Dutch Eating Behavior Questionnaire was used to assess maladaptive eating. k-Means cluster analysis was used to clarify heterogeneity. Four clusters were identified: the first included anxious, depressed, socially withdrawn adolescents with thought problems and somatic complaints, non-aggressive, obedient, and having mean values on the sleep quality scale, inclined to restrict their food consumption. The second consisted of rule-breaking youngsters with poor sleep quality, reluctant to restrict their food consumption. The third comprised subjects with the highest values on the sleep quality and lowest values on emotional and behavioral problems, aimed at restricting food consumption. The fourth comprised adolescents with obvious signs of emotional disorders, poorest sleep quality, disinhibited behavior, and emotional and external eating. No statistically significant difference was found between the clusters in sex distribution. Patient allocation to the second or fourth cluster was associated with significantly higher body mass index values, as opposed to the reference third cluster. Conclusion: There is significant variation in teenagers with obesity who have divergent psychological profiles, which should be taken into account. What is Known: • Patients with obesity present with different clinical characteristics. What is New: • Adolescents with obesity may be partitioned into clusters described in terms of emotional, behavioral patterns, including sleep characteristics, and maladaptive eating habits.
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Affiliation(s)
- Irina L Nikitina
- Department of Children's Diseases With Clinics, Institute for Medical Education of the V.A. Almazov National Medical Research Centre, 2 Akkuratova Str., St. Petersburg, 197341, Russia
| | - Natalia I Vtornikova
- Department of Children's Diseases With Clinics, Institute for Medical Education of the V.A. Almazov National Medical Research Centre, 2 Akkuratova Str., St. Petersburg, 197341, Russia
| | - Igor A Kelmanson
- Department of Children's Diseases With Clinics, Institute for Medical Education of the V.A. Almazov National Medical Research Centre, 2 Akkuratova Str., St. Petersburg, 197341, Russia.
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Nogueira-de-Almeida CA, Weffort VRS, Ued FDV, Ferraz IS, Contini AA, Martinez EZ, Ciampo LAD. What causes obesity in children and adolescents? J Pediatr (Rio J) 2024; 100 Suppl 1:S48-S56. [PMID: 37918812 PMCID: PMC10960191 DOI: 10.1016/j.jped.2023.09.011] [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] [Received: 09/08/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVE To present the different aspects that may be involved in the genesis and maintenance of obesity in children and adolescents. DATA SOURCE Narrative review of articles published in the PubMed, Scielo, Lilacs, Scopus and Google Scholar databases, using the search terms: overweight, obesity, pre-conception, prenatal, infants, schoolchildren, children, and adolescents. The search was conducted in studies written in Portuguese, English and Spanish, including narrative, integrative or systematic reviews, meta-analyses, cross-sectional, case-control and cohort studies, published between 2003 and 2023. DATA SYNTHESIS A total of 598 studies were initially screened and 60 of them, which showed the main biopsychosocial aspects related to greater risks of excessive adiposity in the pediatric age, were included in the review. The data were presented taking into account the incidence of risk factors and their consequences in six periods: pre-conception, pre-natal, infant, preschool, school age, and adolescence. CONCLUSIONS The causal factors described in the scientific literature that have been shown to be related to obesity in childhood and adolescence are presented.
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Affiliation(s)
| | | | - Fábio da V Ued
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Ciências da Saúde, Ribeirão Preto, SP, Brazil
| | - Ivan S Ferraz
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Puericultura e Pediatria, Ribeirão Preto, SP, Brazil
| | - Andrea A Contini
- Universidade Federal de São Carlos, Departamento de Medicina, São Carlos, SP, Brazil
| | - Edson Zangiacomi Martinez
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Medicina Social, Ribeirão Preto, SP, Brazil
| | - Luiz A Del Ciampo
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Puericultura e Pediatria, Ribeirão Preto, SP, Brazil
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Harris HA, Friedman C, Starling AP, Dabelea D, Johnson SL, Fuemmeler BF, Jima D, Murphy SK, Hoyo C, Jansen PW, Felix JF, Mulder RH. An epigenome-wide association study of child appetitive traits and DNA methylation. Appetite 2023; 191:107086. [PMID: 37844693 PMCID: PMC11156223 DOI: 10.1016/j.appet.2023.107086] [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: 06/19/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 10/18/2023]
Abstract
The etiology of childhood appetitive traits is poorly understood. Early-life epigenetic processes may be involved in the developmental programming of appetite regulation in childhood. One such process is DNA methylation (DNAm), whereby a methyl group is added to a specific part of DNA, where a cytosine base is next to a guanine base, a CpG site. We meta-analyzed epigenome-wide association studies (EWASs) of cord blood DNAm and early-childhood appetitive traits. Data were from two independent cohorts: the Generation R Study (n = 1,086, Rotterdam, the Netherlands) and the Healthy Start study (n = 236, Colorado, USA). DNAm at autosomal methylation sites in cord blood was measured using the Illumina Infinium HumanMethylation450 BeadChip. Parents reported on their child's food responsiveness, emotional undereating, satiety responsiveness and food fussiness using the Children's Eating Behaviour Questionnaire at age 4-5 years. Multiple regression models were used to examine the association of DNAm (predictor) at the individual site- and regional-level (using DMRff) with each appetitive trait (outcome), adjusting for covariates. Bonferroni-correction was applied to adjust for multiple testing. There were no associations of DNAm and any appetitive trait when examining individual CpG-sites. However, when examining multiple CpGs jointly in so-called differentially methylated regions, we identified 45 associations of DNAm with food responsiveness, 7 associations of DNAm with emotional undereating, 13 associations of DNAm with satiety responsiveness, and 9 associations of DNAm with food fussiness. This study shows that DNAm in the newborn may partially explain variation in appetitive traits expressed in early childhood and provides preliminary support for early programming of child appetitive traits through DNAm. Investigating differential DNAm associated with appetitive traits could be an important first step in identifying biological pathways underlying the development of these behaviors.
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Affiliation(s)
- Holly A Harris
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Erasmus University Rotterdam, Department of Psychology, Education & Child Studies, Rotterdam, the Netherlands.
| | - Chloe Friedman
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Anne P Starling
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Susan L Johnson
- Department of Pediatrics, Section of Nutrition, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Bernard F Fuemmeler
- Virginia Commonwealth University, Massey Comprehensive Cancer Center, Richmond, VA, USA.
| | - Dereje Jima
- Bioinformatics Research Center, North Carolina State University, Raleigh, NC, USA; Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA.
| | - Susan K Murphy
- Duke University Medical Center, Department of Obstetrics and Gynecology, Reproductive Sciences, Durham, NC, USA.
| | - Cathrine Hoyo
- Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA.
| | - Pauline W Jansen
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Erasmus University Rotterdam, Department of Psychology, Education & Child Studies, Rotterdam, the Netherlands.
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - Rosa H Mulder
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
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Harris HA, Friedman C, Starling AP, Dabelea D, Johnson SL, Fuemmeler BF, Jima D, Murphy SK, Hoyo C, Jansen PW, Felix JF, Mulder R. An epigenome-wide association study of child appetitive traits and DNA methylation. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.17.549289. [PMID: 37503194 PMCID: PMC10370073 DOI: 10.1101/2023.07.17.549289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Childhood appetitive traits are consistently associated with obesity risk, and yet their etiology is poorly understood. Appetitive traits are complex phenotypes which are hypothesized to be influenced by both genetic and environmental factors, as well as their interactions. Early-life epigenetic processes, such as DNA methylation (DNAm), may be involved in the developmental programming of appetite regulation in childhood. In the current study, we meta-analyzed epigenome-wide association studies (EWASs) of cord blood DNAm and early-childhood appetitive traits. Data were from two independent cohorts: the Generation R Study (n=1,086, Rotterdam, the Netherlands) and the Healthy Start study (n=236, Colorado, USA). DNAm at autosomal methylation sites in cord blood was measured using the Illumina Infinium HumanMethylation450 BeadChip. Parents reported on their child's food responsiveness, emotional undereating, satiety responsiveness and food fussiness using the Children's Eating Behaviour Questionnaire at age 4-5 years. Multiple regression models were used to examine the association of DNAm (predictor) at the individual site- and regional-level (using DMRff) with each appetitive trait (outcome), adjusting for covariates. Bonferroni-correction was applied to adjust for multiple testing. There were no associations of DNAm and any appetitive trait at the individual site-level. However, at the regional level, we identified 45 associations of DNAm with food responsiveness, 7 associations of DNAm with emotional undereating, 13 associations of DNAm with satiety responsiveness, and 9 associations of DNAm with food fussiness. This study shows that DNAm in the newborn may partially explain variation in appetitive traits expressed in early childhood and provides preliminary support for early programming of child appetitive traits through DNAm. Investigating differential DNAm associated with appetitive traits could be an important first step in identifying biological pathways underlying the development of these behaviors.
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Affiliation(s)
- Holly A. Harris
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Erasmus University Rotterdam, Department of Psychology, Education & Child Studies, Rotterdam, the Netherlands
| | - Chloe Friedman
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Anne P. Starling
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Susan L. Johnson
- Department of Pediatrics, Section of Nutrition, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Bernard F. Fuemmeler
- Virginia Commonwealth University, Mase Comprehensive Cancer Center, Richmond, VA, USA
| | - Dereje Jima
- Bioinformatics Research Center, North Carolina State University, Raleigh, NC, USA
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
| | - Susan K. Murphy
- Duke University Medical Center, Department of Obstetrics and Gynecology, Reproductive Sciences, Durham, NC, USA
| | - Cathrine Hoyo
- Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
| | - Pauline W. Jansen
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Erasmus University Rotterdam, Department of Psychology, Education & Child Studies, Rotterdam, the Netherlands
| | - Janine F. Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Rosa Mulder
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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Beker F, Hughes IP, Jacobs S, Liley HG, Bora S, Simcock G, Davis PG. Smell and taste of milk during tube feeding of preterm infants: neurodevelopmental follow-up of the randomized TASTE trial, study protocol. Trials 2023; 24:290. [PMID: 37085869 PMCID: PMC10121423 DOI: 10.1186/s13063-023-07224-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 03/06/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND The Taste And Smell To Enhance nutrition (TASTE) trial investigated the effects of smell and taste of milk with tube feeding compared to routine care on the growth of preterm infants. There was no difference between groups in growth (weight, head circumference, length) z-scores at discharge from the hospital. Infants in the intervention group had higher head circumference and length z-scores at 36 weeks postmenstrual age, both secondary outcomes. The objective of this follow-up study is to assess 2-year neurodevelopmental and growth outcomes after exposure of preterm infants to the smell and taste of milk with tube feeding compared to routine care. METHODS This is a neurodevelopmental follow-up study of a two-center, placebo-controlled randomized trial. Infants born before 29 weeks postmenstrual age and/or with a birth weight of less than 1250 g were randomized to smell and taste of milk with each tube feed or routine care. The current follow-up assessed the 2-year neurodevelopmental and growth outcomes of participants of the TASTE trial discharged from the hospital (n = 334). The primary outcome is survival free of any major neurodevelopmental impairment comprising any moderate/severe cerebral palsy (Gross Motor Function Classification System score II-V), Bayley Scales of Infant and Toddler Development, Third/Fourth Edition (Bayley-III/Bayley-4) motor, cognitive, or language scores < -2SD, blindness, or deafness at 2 years of age. Other outcomes include death, breastfeeding within the first year, and respiratory support, oral feeding, and anthropometric parameters at 2 years of age. The Human Research Ethics Committees of Mater Misericordiae Limited and the Royal Women's Hospital approved the TASTE trial including the neurodevelopmental follow-up described in this protocol. DISCUSSION For patients and their families, the neurodevelopmental outcomes of preterm infants are of utmost importance. Consequently, they should be investigated following any interventional study performed during the newborn period. Furthermore, improved weight gain and head growth in the hospital are associated with better long-term neurodevelopmental outcomes. Smelling and tasting of milk is an uncomplicated and cost-effective intervention that may improve the growth and neurodevelopmental outcomes of preterm infants. Potential limitations affecting this follow-up study, caused by the COVID-19 pandemic, are anticipated and discussed in this protocol. TRIAL REGISTRATION Name of the registry: Australian and New Zealand Clinical Trials Registry; Registration number: ACTRN12617000583347 ; Registration date: 26 April 2017.
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Affiliation(s)
- Friederike Beker
- Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia.
- Neonatal Critical Care Unit, Mater Mothers' Hospitals, South Brisbane, Queensland, Australia.
| | - Ian P Hughes
- Office of Research Governance and Development, Gold Coast University Hospital, Southport, Queensland, Australia
| | - Sue Jacobs
- Neonatal Services and Newborn Research, The Royal Women's Hospital, Melbourne, Victoria, Australia
- Clinical Sciences Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen G Liley
- Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
- Neonatal Critical Care Unit, Mater Mothers' Hospitals, South Brisbane, Queensland, Australia
| | - Samudragupta Bora
- Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Gabrielle Simcock
- School of Applied Psychology, Griffith University, Southport, Queensland, Australia
| | - Peter G Davis
- Neonatal Services and Newborn Research, The Royal Women's Hospital, Melbourne, Victoria, Australia
- Clinical Sciences Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
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Curtin EL, Johnson L, Salway R, Hinton EC. Snacking and anxiety during the coronavirus disease (COVID-19) pandemic: A prospective cohort study. Appetite 2023; 183:106491. [PMID: 36775067 PMCID: PMC9912813 DOI: 10.1016/j.appet.2023.106491] [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: 11/04/2022] [Revised: 02/03/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023]
Abstract
Anxiety and snacking increased during the initial coronavirus disease 2019 (COVID-19) lockdowns, but it remains unknown whether this change in snacking persisted and if it related to anxiety levels. We used prospective data to examine changes in snacking frequency from t1 (eased restrictions in England in May-June 2020) to t2 (national lockdown in December 2020-March 2021), the association of anxiety (assessed by the Generalised Anxiety Disorder-7 questionnaire at t1) with the snacking change, and the mediating and moderating effects of disinhibition and flexible restraint (assessed by the Three Factor Eating Questionnaire in 2016-17). Analyses including 2128 adults (mean age 28.4 y) residing in England from the Avon Longitudinal Study of Parents and Children showed that snacking frequency increased over time (mean change 1.23 (95% CI 0.81, 1.65) snacks/wk). Linear regressions of snacking adjusted for sociodemographic covariates showed that having clinical levels of generalised anxiety at t1, versus not, was associated with 1.22 (95% CI 0.07, 2.37) more snacks/wk at t2. Disinhibition partially mediated the association between Generalised Anxiety Disorder and snacking (βindirect = 0.15, 95% CI 0.01, 0.32), while there was no evidence that flexible restraint moderated the association (β = 0.05, 95% CI -0.57, 0.66). Our longitudinal findings highlight a detrimental anxiety-snacking association partly operating via disinhibition, suggesting future research could target mitigating anxiety and disinhibited eating behaviours to benefit diet-related outcomes following the pandemic.
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Affiliation(s)
- Esther L. Curtin
- Population Health Sciences, University of Bristol, BS8 2PS, UK,Corresponding author. Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Laura Johnson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, BS8 1TZ, Bristol, UK; NatCen Social Research, 35 Northampton Square, London, EC1V 0AX, UK.
| | - Ruth Salway
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, BS8 1TZ, Bristol, UK.
| | - Elanor C. Hinton
- NIHR Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, BS2 8AE, Bristol, UK
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Dietary Risk Factors and Eating Behaviors in Peripheral Arterial Disease (PAD). Int J Mol Sci 2022; 23:ijms231810814. [PMID: 36142725 PMCID: PMC9504787 DOI: 10.3390/ijms231810814] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022] Open
Abstract
Dietary risk factors play a fundamental role in the prevention and progression of atherosclerosis and PAD (Peripheral Arterial Disease). The impact of nutrition, however, defined as the process of taking in food and using it for growth, metabolism and repair, remains undefined with regard to PAD. This article describes the interplay between nutrition and the development/progression of PAD. We reviewed 688 articles, including key articles, narrative and systematic reviews, meta-analyses and clinical studies. We analyzed the interaction between nutrition and PAD predictors, and subsequently created four descriptive tables to summarize the relationship between PAD, dietary risk factors and outcomes. We comprehensively reviewed the role of well-studied diets (Mediterranean, vegetarian/vegan, low-carbohydrate ketogenic and intermittent fasting diet) and prevalent eating behaviors (emotional and binge eating, night eating and sleeping disorders, anorexia, bulimia, skipping meals, home cooking and fast/ultra-processed food consumption) on the traditional risk factors of PAD. Moreover, we analyzed the interplay between PAD and nutritional status, nutrients, dietary patterns and eating habits. Dietary patterns and eating disorders affect the development and progression of PAD, as well as its disabling complications including major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Nutrition and dietary risk factor modification are important targets to reduce the risk of PAD as well as the subsequent development of MACE and MALE.
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Sleep duration and eating behaviours are associated with body composition in 5-year-old children: findings from the ROLO longitudinal birth cohort study. Br J Nutr 2022; 127:1750-1760. [PMID: 34284833 DOI: 10.1017/s0007114521002725] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Inadequate sleep and poor eating behaviours are associated with higher risk of childhood overweight and obesity. Less is known about the influence sleep has on eating behaviours and consequently body composition. Furthermore, whether associations differ in boys and girls has not been investigated extensively. We investigate associations between sleep, eating behaviours and body composition in cross-sectional analysis of 5-year-old children. Weight, height, BMI, mid upper arm circumference (MUAC), abdominal circumference (AC) and skinfold measurements were obtained. Maternal reported information on child's eating behaviour and sleep habits were collected using validated questionnaires. Multiple linear regression examined associations between sleep, eating behaviours and body composition. Sleep duration was negatively associated with BMI, with 1-h greater sleep duration associated with 0·24 kg/m2 (B = 0·24, CI -0·42, -0·03, P = 0·026) lower BMI and 0·21 cm lower (B = -0·21, CI -0·41, -0·02, P = 0·035) MUAC. When stratified by sex, girls showed stronger inverse associations between sleep duration (h) and BMI (kg/m2) (B = -0·32; CI -0·60, -0·04, P = 0·024), MUAC (cm) (B = -0·29; CI -0·58, 0·000, P = 0·05) and AC (cm) (B = -1·10; CI -1·85, -0·21, P = 0·014) than boys. Positive associations for 'Enjoys Food' and 'Food Responsiveness' with BMI, MUAC and AC were observed in girls only. Inverse associations between sleep duration and 'Emotional Undereating' and 'Food Fussiness' were observed in both sexes, although stronger in boys. Sleep duration did not mediate the relationship between eating behaviours and BMI. Further exploration is required to understand how sleep impacts eating behaviours and consequently body composition and how sex influences this relationship.
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Subtyping youngsters with obesity: A theory-based cluster analysis. Appetite 2022; 168:105723. [PMID: 34606939 DOI: 10.1016/j.appet.2021.105723] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/15/2021] [Accepted: 09/28/2021] [Indexed: 11/24/2022]
Abstract
Psychological mechanisms play a crucial role in explaining weight gain. Aim of the present study was to identify subtypes in youngsters with obesity in line with these mechanisms. Defining homogeneous clusters within this heterogeneous group provides relevant information for personalized treatments. Data were collected in N = 572 participants (51% boys, aged 7-19) with extreme obesity (%BMI M = 187.8; SD = 30.9) recruited in an inpatient treatment centre. Based on psychological models of overweight/obesity, the Affect Regulation Model, the Reward Deficiency Model and The Dual Pathway Model, cluster variables were selected assessing emotional eating, reward reactivity and regulative capacities. Youngsters reported on emotional eating (DEBQ Emotional Eating) and reward sensitivity (BAS), while parents reported on children's regulative Executive Functions (BRIEF). Characteristics of the different clusters were examined concerning weight variables (pre and post treatment) and variables indexing problematic eating (DEBQ External Eating, Ch-EDE), affect regulation (FEEL-KJ) and depressive symptoms (CDI). Hierarchical cluster analyses supported the presence of three clusters, further evaluated by K-means cluster analyses. The cluster solutions differed according to age and sex (boys 7-13, boys 14-19, girls 7-13, girls 14-19). In all four age and gender subsamples, an "Emotional Eating" cluster displaying a vulnerable profile (high depression, maladaptive emotion regulation, problematic eating) and a "Reward Deficiency" cluster displaying a more resilient profile were detected. In girls 7-13, a "Weak Executive Functioning" indicative of insufficient self-regulative capacities, showed moderate to high emotional problems and problematic eating. In the other subgroups, the "Mean Level Functioning" cluster also showed elevated emotional problems and problematic eating. Given that different clusters can be identified, and given that these clusters have different profiles on emotional problems and problematic eating, subtyping youngsters with severe obesity is indicated, setting the stage for personalized treatments.
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Beker F, Liley HG, Hughes IP, Jacobs SE, Macey J, Twitchell E, Davis PG. Effects on Growth of Smell and Taste of Milk During Tube Feeding of Preterm Infants: A Randomized Clinical Trial. JAMA Pediatr 2021; 175:1115-1123. [PMID: 34369975 PMCID: PMC8353575 DOI: 10.1001/jamapediatrics.2021.2336] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
IMPORTANCE Smell and taste of food increase food anticipation, activate gut motility, and stimulate digestion and metabolism. Despite poor growth of many preterm infants in neonatal intensive care units, the smell and taste of milk with tube feeding are not generally considered a regular component of care. OBJECTIVE To determine the effect of smell and taste of milk with tube feeding on weight z scores at discharge from the hospital. DESIGN, SETTING, AND PARTICIPANTS A randomized, controlled, nonblinded, superiority trial was conducted at 2 perinatal centers between May 9, 2017, and February 1, 2020. Eligible infants (n = 659) were born at less than 29 weeks' postmenstrual age (PMA) and/or with a birth weight of less than 1250 g. INTERVENTIONS Infants were randomly assigned to receive either the smell and taste of milk with each tube feeding or routine care without the provision of smell and taste of milk. MAIN OUTCOMES AND MEASURES The primary outcome was weight z score at discharge from any hospital. Secondary outcomes included anthropometric measures at predefined time points, time to full enteral feeds, and other health outcomes associated with prematurity. RESULTS Of the 658 infants, a total of 396 infants were randomized; some parents had not been approached for consent (n = 144) or declined participation (n = 117), and 1 infant with consent was not randomized. Of the 396 infants, 196 were assigned to the treatment group (51% male; mean [SD] PMA at birth, 27.5 [2.2] weeks) and 200 were assigned to the control group (52% male; mean [SD] PMA at birth, 27.6 (2.3) weeks). Mean weight z scores at discharge were -0.87 (95% CI, -1.02 to -0.72) for the treatment group and -0.97 (95% CI, -1.11 to -0.83) for the control group (P = .40). The mean difference in z scores between the treatment and control groups at 36 weeks' PMA was 0.21 (95% CI, 0.01 to 0.4; P = .04) for head circumference and 0.26 (95% CI, 0.05 to 0.51; P = .04) for length. There were no clinically notable differences between the study groups for any other anthropometric, feeding, or health outcomes. CONCLUSIONS AND RELEVANCE In this randomized clinical trial, regular smell and taste of milk included with tube feeding did not improve weight at discharge in preterm infants. Secondary outcomes suggest exposure to smell and taste may improve head circumference and length at 36 weeks' PMA, but not at discharge. Regular exposure to the smell and taste of milk is a simple and inexpensive intervention with potential benefits and no apparent adverse effects. TRIAL REGISTRATION anzctr.org.au Identifier: ACTRN12617000583347.
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Affiliation(s)
- Friederike Beker
- Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia,Neonatal Critical Care Unit, Mater Health, South Brisbane, Queensland, Australia
| | - Helen G. Liley
- Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia,Neonatal Critical Care Unit, Mater Health, South Brisbane, Queensland, Australia
| | - Ian P. Hughes
- Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia,Office for Research Governance and Development, Gold Coast University Hospital, Southport, Queensland, Australia
| | - Susan E. Jacobs
- Neonatal Services and Newborn Research, the Royal Women’s Hospital, Melbourne, Victoria, Australia,Clinical Sciences Research, Murdoch Children’s Research Institute, Parkville, Victoria, Australia,Department of Obstetrics and Gynaecology, University of Melbourne, the Royal Women’s Hospital, Melbourne, Victoria, Australia
| | - Judith Macey
- Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
| | - Emily Twitchell
- Neonatal Services and Newborn Research, the Royal Women’s Hospital, Melbourne, Victoria, Australia
| | - Peter G. Davis
- Neonatal Services and Newborn Research, the Royal Women’s Hospital, Melbourne, Victoria, Australia,Clinical Sciences Research, Murdoch Children’s Research Institute, Parkville, Victoria, Australia,Department of Obstetrics and Gynaecology, University of Melbourne, the Royal Women’s Hospital, Melbourne, Victoria, Australia
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11
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Complementary Feeding Methods-A Review of the Benefits and Risks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137165. [PMID: 34281101 PMCID: PMC8297117 DOI: 10.3390/ijerph18137165] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 06/19/2021] [Accepted: 06/24/2021] [Indexed: 12/24/2022]
Abstract
Complementary feeding methods have the potential to not only ensure a diet of nutritional adequacy but also promote optimal food-related behaviours and skills. While the complementary feeding practice known as baby-led weaning (BLW) has gained popularity, evidence supporting the potential benefits and/or risks for infant growth, development, and health warrants consideration. A review of 29 studies was conducted with findings indicating that parents who implement BLW typically have higher levels of education, breastfeed for longer, and differ in other personality traits. Fear of choking was an important factor in parents’ decision not to implement BLW; however, this fear was not supported by the literature. Benefits of BLW included lower food fussiness, higher food enjoyment, lower food responsiveness, and higher satiety responsiveness. While this profile of eating behaviours confers a reduced obesity risk, few studies have examined the relationship between BLW and infant growth robustly. BLW does not seem to increase the risk of inadequate zinc or iron intake; however, emphasis needs to be given to ensuring adequate intake of these micronutrients among all infants. A better understanding of the impacts of BLW is needed to inform evidence-based recommendations to support and guide parents in complementary feeding methods.
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12
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Hübel C, Herle M, Santos Ferreira DL, Abdulkadir M, Bryant-Waugh R, Loos RJF, Bulik CM, Lawlor DA, Micali N. Childhood overeating is associated with adverse cardiometabolic and inflammatory profiles in adolescence. Sci Rep 2021; 11:12478. [PMID: 34127697 PMCID: PMC8203659 DOI: 10.1038/s41598-021-90644-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 05/07/2021] [Indexed: 12/15/2022] Open
Abstract
Childhood eating behaviour contributes to the rise of obesity and related noncommunicable disease worldwide. However, we lack a deep understanding of biochemical alterations that can arise from aberrant eating behaviour. In this study, we prospectively associate longitudinal trajectories of childhood overeating, undereating, and fussy eating with metabolic markers at age 16 years to explore adolescent metabolic alterations related to specific eating patterns in the first 10 years of life. Data are from the Avon Longitudinal Study of Parents and Children (n = 3104). We measure 158 metabolic markers with a high-throughput (1H) NMR metabolomics platform. Increasing childhood overeating is prospectively associated with an adverse cardiometabolic profile (i.e., hyperlipidemia, hypercholesterolemia, hyperlipoproteinemia) in adolescence; whereas undereating and fussy eating are associated with lower concentrations of the amino acids glutamine and valine, suggesting a potential lack of micronutrients. Here, we show associations between early behavioural indicators of eating and metabolic markers.
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Affiliation(s)
- Christopher Hübel
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK
- National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Moritz Herle
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Diana L Santos Ferreira
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Mohamed Abdulkadir
- Department of Pediatrics Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Rachel Bryant-Waugh
- Maudsley Centre for Child and Adolescent Eating Disorders, Michael Rutter Centre for Children and Young People, Maudsley Hospital, London, UK
| | - Ruth J F Loos
- Icahn School of Medicine At Mount Sinai, New York, NY, USA
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - Deborah A Lawlor
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Bristol National Institute of Health Research Biomedical Research Centre, Bristol, UK
| | - Nadia Micali
- Department of Pediatrics Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- Great Ormond Street Institute of Child Health, University College London, London, UK.
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13
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Amissah E, Gamble GD, Wall CR, Crowther CA, Harding JE. The relationship between maternal dietary patterns during pregnancy in women with gestational diabetes mellitus and infant appetitive feeding behaviour at 6 months. Sci Rep 2020; 10:20516. [PMID: 33239632 PMCID: PMC7689419 DOI: 10.1038/s41598-020-77388-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/09/2020] [Indexed: 11/21/2022] Open
Abstract
Early dietary exposure may influence infant appetitive feeding behaviour, and therefore their later health. Maternal diabetes in pregnancy is associated with an increased risk of obesity in the offspring. We, therefore, examined third-trimester dietary patterns of women with gestational diabetes, their offspring's appetitive feeding behaviour at 6 months of age, and relationships between these. We used data from a prospective cohort of women with gestational diabetes and assessed maternal dietary patterns at 36 weeks' gestation using principal component analysis; infant appetitive feeding behaviour at 6 months of age using the Baby Eating Behaviour Questionnaire; and relationships between these using general linear modelling and chi-square tests. In 325 mother-infant dyads, we identified three distinct maternal dietary patterns: 'Junk,' 'Mixed,' and 'Health-conscious.' The maternal 'Health-conscious' pattern was inversely associated with 'enjoyment of food' in their sons (β - 0.24, 95% CI - 0.36 to - 0.11, p = 0.0003), but not daughters (β - 0.02, 95% CI - 0.12 to 0.08, p = 0.70), and was positively associated with 'slowness in eating,' (β 0.13, 95% CI 0.02 to 0.24, p = 0.01). Third-trimester dietary patterns in women with gestational diabetes may have sex-specific effects on infant appetitive feeding behaviour at 6 months of age.
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Affiliation(s)
- Emma Amissah
- Liggins Institute, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand
| | - Gregory D Gamble
- Liggins Institute, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand
| | - Clare R Wall
- Centre for Longitudinal Research-He Ara ki Mua, University of Auckland, Auckland, 1072, New Zealand
- Discipline of Nutrition and Dietetics, School of Medical Sciences, University of Auckland, Auckland, 1072, New Zealand
| | - Caroline A Crowther
- Liggins Institute, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand
| | - Jane E Harding
- Liggins Institute, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand.
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14
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Orsso CE, Colin-Ramirez E, Field CJ, Madsen KL, Prado CM, Haqq AM. Adipose Tissue Development and Expansion from the Womb to Adolescence: An Overview. Nutrients 2020; 12:E2735. [PMID: 32911676 PMCID: PMC7551046 DOI: 10.3390/nu12092735] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/29/2020] [Accepted: 09/02/2020] [Indexed: 02/07/2023] Open
Abstract
Prevalence rates of pediatric obesity continue to rise worldwide. Adipose tissue (AT) development and expansion initiate in the fetus and extend throughout the lifespan. This paper presents an overview of the AT developmental trajectories from the intrauterine period to adolescence; factors determining adiposity expansion are also discussed. The greatest fetal increases in AT were observed in the third pregnancy trimester, with growing evidence suggesting that maternal health and nutrition, toxin exposure, and genetic defects impact AT development. From birth up to six months, healthy term newborns experience steep increases in AT; but a subsequent reduction in AT is observed during infancy. Important determinants of AT in infancy identified in this review included feeding practices and factors shaping the gut microbiome. Low AT accrual rates are maintained up to puberty onset, at which time, the pattern of adiposity expansion becomes sex dependent. As girls experience rapid increases and boys experience decreases in AT, sexual dimorphism in hormone secretion can be considered the main contributor for changes. Eating patterns/behaviors and interactions between dietary components, gut microbiome, and immune cells also influence AT expansion. Despite the plasticity of this tissue, substantial evidence supports that adiposity at birth and infancy highly influences its levels across subsequent life stages. Thus, a unique window of opportunity for the prevention and/or slowing down of the predisposition toward obesity, exists from pregnancy through childhood.
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Affiliation(s)
- Camila E. Orsso
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2E1, Canada; (C.E.O.); (C.J.F.); (C.M.P.)
| | | | - Catherine J. Field
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2E1, Canada; (C.E.O.); (C.J.F.); (C.M.P.)
| | - Karen L. Madsen
- Department of Medicine, University of Alberta, Edmonton, AB T6G 2C2, Canada;
| | - Carla M. Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2E1, Canada; (C.E.O.); (C.J.F.); (C.M.P.)
| | - Andrea M. Haqq
- Department of Pediatrics and Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2R7, Canada
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15
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Vervoort L, Naets T, De Guchtenaere A, Tanghe A, Braet C. Using confidence interval-based estimation of relevance to explore bottom-up and top-down determinants of problematic eating behavior in children and adolescents with obesity from a dual pathway perspective. Appetite 2020; 150:104676. [PMID: 32198094 DOI: 10.1016/j.appet.2020.104676] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/12/2020] [Accepted: 03/12/2020] [Indexed: 10/24/2022]
Abstract
Prevalence of overweight and obesity in children and adolescents is high, not only in Western countries but also in developing countries. Efforts to improve prevention and treatment programs are needed. Given their essential role in weight problems, knowledge of determinants of problematic eating behavior ('External Eating' and 'Emotional Eating') is crucial for intervention development. Inspired by Appelhans' Dual Process Theory of Eating Behavior, the present study evaluated the importance of top-down regulative capacities and bottom-up reactivity, using the CIBER approach. CIBER is an innovative statistical approach to test the importance of behavior determinants, based on confidence intervals, instead of significance testing of point estimates. Survey data on different aspects of executive functioning (as indices of regulative capacities: Inhibition, Cognitive Flexibility, Emotional Control, Initiation, Working Memory, Planning/Organizing, Organization of materials, and Monitoring) and reward sensitivity (as an index of reactivity) were collected in a large sample of children and adolescents (n = 572) with severe obesity (adjBMI > 180%). Results showed that Emotional Eating is determined by Emotional Control, while External Eating is determined by Reward Sensitivity. The finding that differential mechanisms underlie different aspects of problematic eating suggests the need for using tailored intervention techniques to address altered reactivity and weak regulative capacities.
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Affiliation(s)
- L Vervoort
- Department of Developmental, Personality and Social Psychology, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium.
| | - T Naets
- Department of Developmental, Personality and Social Psychology, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium; Odisee University College, Department Health Care (Dietetics), Gebroeders de Smetstraat 1, 9000, Gent, Belgium.
| | - A De Guchtenaere
- Zeepreventorium, Koninklijke Baan 5, 8420, De Haan, Belgium; Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, C. Heymanslaan 10, 9000, Ghent, Belgium.
| | - A Tanghe
- Zeepreventorium, Koninklijke Baan 5, 8420, De Haan, Belgium.
| | - C Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium.
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16
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Naets T, Vervoort L, Tanghe A, De Guchtenaere A, Braet C. Maladaptive Eating in Children and Adolescents With Obesity: Scrutinizing Differences in Inhibition. Front Psychiatry 2020; 11:309. [PMID: 32425824 PMCID: PMC7212434 DOI: 10.3389/fpsyt.2020.00309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/27/2020] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION In order to grasp the complex etiology of childhood obesity, we aim to clarify the relationship between external eating and weight. Based on theory and empirical evidence, we claim that inhibition is an important moderator in this association. In our first research question we expected that high external eating would be related to a higher weight status, especially for those with high inhibition problems. Secondly, we explored the moderating role of inhibition in the association between external eating and weight change after a multidisciplinary obesity treatment. METHOD We investigated n=572 participants (51% boys, aged 7-19) with moderate to extreme obesity recruited in a Belgian inpatient treatment center. At intake, parents reported on inhibition (BRIEF), while the children and adolescents reported on their eating behavior (DEBQ). Weight and length were objectively measured pre and post treatment (ADJUSTED BMI). Two hierarchical linear regression models were built to scrutinize the influence of inhibition on the association between external eating and both baseline weight and weight change. RESULTS First, predicting baseline weight, we found no significant moderating effect of inhibition problems. Second, predicting weight loss, inhibition turned out to be a substantial moderator, specifically in adolescents. Some unexpected gender differences occurred in favor of adolescent boys, in a way that those with high external eating and low inhibition problems lost most weight. CONCLUSION Inhibition problems act as a moderator explaining weight loss, but this only holds for adolescents. This suggests that external eating and inhibition play a complex role in weight loss in certain age and gender categories, and stresses the importance of identifying subgroups for tailoring interventions. For those with high inhibition problems, interventions aimed at increasing inhibition skills might be needed to optimize treatment outcomes.
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Affiliation(s)
- Tiffany Naets
- Clinical Child and Adolescent Psychology (CCAP) Lab, Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Leentje Vervoort
- Clinical Child and Adolescent Psychology (CCAP) Lab, Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Ann Tanghe
- Obesity Department, Zeepreventorium vzw, De Haan, Belgium
| | | | - Caroline Braet
- Clinical Child and Adolescent Psychology (CCAP) Lab, Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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17
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Nicklaus S, Schwartz C. Early influencing factors on the development of sensory and food preferences. Curr Opin Clin Nutr Metab Care 2019; 22:230-235. [PMID: 30883465 DOI: 10.1097/mco.0000000000000554] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The current review focuses on studies investigating the factors related to the development of preferences for foods and sensory inputs (tastes, odours, and food textures) in the first years of life, which constitutes a specific window for food learning. RECENT FINDINGS Foetal nutrition, intrauterine growth, and prematurity influence food preferences; this topic warrants more research to broaden our understanding of the 1000 days phenomenon. Although it is less studied than other sensory inputs, food texture acceptance, and the related sensitive period for texture introduction are attracting more attention, as is the impact of fat acceptance. Research should focus not on vegetables alone but on diverse foods whose consumption is encouraged (e.g., fishes and legumes). The role of parental feeding practices, as another major determinant, continues to inspire research exploring the bidirectional influences between children and caregivers. New interventions have confirmed the strong positive influence of repeated exposure to foods through familiarization via taste lessons, cooking, or play activities on acceptance. Interventions that consider individuals traits are necessary. SUMMARY Although new evidence is available, it remains a challenge to consider both individual traits and bidirectional influences between parents and children and to investigate this issue worldwide and in all socioeconomic status groups.
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Affiliation(s)
- Sophie Nicklaus
- Centre des Sciences du GoÛt et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Université Bourgogne Franche-Comté, Dijon, France
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18
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Shriver LH, Dollar JM, Lawless M, Calkins SD, Keane SP, Shanahan L, Wideman L. Longitudinal Associations between Emotion Regulation and Adiposity in Late Adolescence: Indirect Effects through Eating Behaviors. Nutrients 2019; 11:E517. [PMID: 30823405 PMCID: PMC6470565 DOI: 10.3390/nu11030517] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 11/29/2022] Open
Abstract
The prevalence of obesity among U.S. youth continues to increase, with many adolescents engaging in unhealthy eating behaviors. Increasingly, research points to the role of self-regulation in obesity development, yet existing work has largely focused on young children and/or clinical adult populations. This multi-method longitudinal study (N = 153) utilized a path analysis to delineate links between emotion regulation (age 15), emotional eating and dietary restraint (age 16), and adiposity (% body fat) using a BodPod for body composition assessment (age 19). Emotion regulation was negatively associated with emotional eating (β = -0.30, p < 0.001) and positively associated with dietary restraint (β = 0.15, p < 0.05) at age 16, but was not associated with age 19 adiposity (β = -0.01, p = ns). Emotional eating was positively associated with adiposity (β = 0.24, p < 0.01). Indirect effects suggested that emotional eating, but not dietary restraint, at age 16 serves as a mechanism that helps explain the associations between emotion regulation and adiposity four years later. Results from this study suggest that both emotion regulation and emotional eating represent promising targets for that should be included in future interventions aimed at preventing adolescent obesity.
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Affiliation(s)
- Lenka H Shriver
- Department of Nutrition, University of North Carolina at Greensboro (UNCG), Greensboro, NC 27412, USA.
| | - Jessica M Dollar
- Department of Human Development and Family Studies, University of North Carolina at Greensboro (UNCG), Greensboro, NC 27412, USA.
| | - Meg Lawless
- Department of Nutrition, University of North Carolina at Greensboro (UNCG), Greensboro, NC 27412, USA.
| | - Susan D Calkins
- Department of Human Development and Family Studies, University of North Carolina at Greensboro (UNCG), Greensboro, NC 27412, USA.
| | - Susan P Keane
- Department of Psychology, University of North Carolina at Greensboro (UNCG), Greensboro, NC 27412, USA.
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, 8050 Zurich, Switzerland.
| | - Laurie Wideman
- Department of Kinesiology, University of North Carolina at Greensboro (UNCG), Greensboro, NC 27412, USA.
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