Individual variability in preference for energy-dense foods fails to predict child BMI percentile

Food cue images and subjective appetitive responses in obese children

BACKGROUND

Food decision-making is based on various intrinsic and extrinsic factors of an individual. Food preferences and food cue sensitivity influence energy intake, which in turn affects body weight.

AIM

The present study assessed the subjective appetite of obese children in response to food cue images.

METHODS

A total of 70 obese children (37 boys and 33 girls) of the age group 7-10 years were recruited for the study; 34 images of food items grouped under ten food blocks were used as cues to study the self-reported hunger, appetite and satiety sensations among the participants. A visual analogue scale (VAS) was used to measure participant responses for each food block.

RESULTS

The mean (standard deviation (SD)) body mass index-for-age 'Z' scores (BAZ) of the participants was found to be 2.15 (0.36). The subjective appetitive responses assessed using VAS showed that the hunger ratings of participants were found to be higher in response to images of cereals and cereal products (92.86%), and sweets (97.14%); satiety ratings of the participants were observed to be higher for milk and milk products (87.14%); cereals and savoury foods (78.57%); and higher appetite ratings of participants were recorded for sweets (97.14%) and cereals (92.86%).

CONCLUSION

Sophisticated neuroimaging techniques are well established in measuring appetite, but our study focused on the subjective analysis of appetite using cost-effective tools such as food cue images and visual analogue scales to further expand the research platform in appetite regulation and obesity.

A laboratory-based assessment of mother-child snack food selections and child snack food consumption: Associations with observed and maternal self-report of child feeding practices

This study explored how mothers' observed and self-reported child feeding practices (child control over food choices, encouragement of balance and variety, and teaching about nutrition) were associated with mother-child snack food selections and child snack food consumption in a laboratory setting. Mothers (N = 107) and their 4.5-year-old children (52% female) selected up to 5 snack foods (out of 9 snack foods: 6 higher-energy-density [ED] and 3 lower-ED) for optional child consumption throughout a one-hour laboratory visit. Mothers' in-the-moment child feeding practices during the snack food selection task were coded using observational coding schemes, and mothers' global child feeding practices (i.e., across meals and snacking occasions) were self-reported using the Comprehensive Feeding Practices Questionnaire (Musher-Eizenman & Holub, 2007). Results of multiple linear regression analyses with covariates showed that higher-ED snack food selections were positively associated with observed child control over food choices (B = 0.35, SE = 0.12, p = .006) and self-reported teaching about nutrition (B = 0.49, SE = 0.19, p = .010), and negatively associated with self-reported encouragement of balance and variety (B = -0.66, SE = 0.24, p = .007). Lower-ED snack food selections were positively associated with self-reported encouragement of balance and variety (B = 0.53, SE = 0.20, p = .008). Child consumption of higher-ED or lower-ED snack foods were not significantly associated with mothers' child feeding practices (observed or self-reported). We discuss the implications of these findings for future research on children's snack food selection and consumption.

Pediatric-Adapted Liking Survey (PALS): A Diet and Activity Screener in Pediatric Care

Clinical settings need rapid yet useful methods to screen for diet and activity behaviors for brief interventions and to guide obesity prevention efforts. In an urban pediatric emergency department, these behaviors were screened in children and parents with the 33-item Pediatric-Adapted Liking Survey (PALS) to assess the reliability and validity of a Healthy Behavior Index (HBI) generated from the PALS responses. The PALS was completed by 925 children (average age = 11 ± 4 years, 55% publicly insured, 37% overweight/obese by Body Mass Index Percentile, BMI-P) and 925 parents. Child–parent dyads differed most in liking of vegetables, sweets, sweet drinks, and screen time. Across the sample, child and parent HBIs were variable, normally distributed with adequate internal reliability and construct validity, revealing two dimensions (less healthy—sweet drinks, sweets, sedentary behaviors; healthy—vegetables, fruits, proteins). The HBI showed criterion validity, detecting healthier indexes in parents vs. children, females vs. males, privately- vs. publicly-health insured, and residence in higher- vs. lower-income communities. Parent’s HBI explained some variability in child BMI percentile. Greater liking of sweets/carbohydrates partially mediated the association between low family income and higher BMI percentile. These findings support the utility of PALS as a dietary behavior and activity screener for children and their parents in a clinical setting.

Individual differences in appeal of energy dense foods predicts lower body mass change during adolescence

Highly energy dense foods are often synonymous with high palatability, excess intake and weight gain. However, food preferences show individual differences. Food preferences are closely related to food intake, which can impact weight change over time. We examined whether the energy density of food images rated as appetizing and unappetizing foods related to baseline BMI and change in BMI over 3-year follow-up (n = 117; 45% Male, Baseline BMI: 21.1 ± 1.9. Participants completed hedonic visual analog scales (-100 to 100) ratings of 103 food images, and reported dietary intake at baseline, and had their height and weight directly measured over 3-year follow-up. Energy density (ED) of the food depicted in each image was calculated. For each participant, food images (kcal/g) were categorized into appetizing (32 images) and unappetizing foods (32 images) based on each individual's hedonic ratings. We observed significant interaction between energy density and hedonic value driven by an inverse relation between unappetizing food energy density and BMI change (p = 0.008). Specifically, participants who rated higher energy dense foods as unappetizing showed less weight gain (β= -0.83; p = 0.00052). There was no significant relation between the energy density of appetizing foods and weight change (p = 0.67), suggesting that dislike of highly energy dense foods more strongly associates with lower weight gain than preference for low energy dense foods. Post-hoc analyses revealed that individuals with a higher preference for low energy density foods showed less weight gain over 3-years (β = - 0.007, p = 0.02). Results support the idea that individual hedonic ratings for foods varying in energy density is a determinant of weight change in adolescents and may represent an important intervention target for obesity prevention programs.