Adolescent obesity and dietary decision making—a brain-health perspective

High-fat diet consumption promotes adolescent neurobehavioral abnormalities and hippocampal structural alterations via microglial overactivation accompanied by an elevated serum free fatty acid concentration

Mounting evidence suggests that high-fat diet (HFD) consumption increases the risk for depression, but the neurophysiological mechanisms involved remain to be elucidated. Here, we demonstrated that HFD feeding of C57BL/6J mice during the adolescent period (from 4 to 8 weeks of age) resulted in increased depression- and anxiety-like behaviors concurrent with changes in neuronal and myelin structure in the hippocampus. Additionally, we showed that hippocampal microglia in HFD-fed mice assumed a hyperactive state concomitant with increased PSD95-positive and myelin basic protein (MBP)-positive inclusions, implicating microglia in hippocampal structural alterations induced by HFD consumption. Along with increased levels of serum free fatty acids (FFAs), abnormal deposition of lipid droplets and increased levels of HIF-1α protein (a transcription factor that has been reported to facilitate cellular lipid accumulation) within hippocampal microglia were observed in HFD-fed mice. The use of minocycline, a pharmacological suppressor of microglial overactivation, effectively attenuated neurobehavioral abnormalities and hippocampal structural alterations but barely altered lipid droplet accumulation in the hippocampal microglia of HFD-fed mice. Coadministration of triacsin C abolished the increases in lipid droplet formation, phagocytic activity, and ROS levels in primary microglia treated with serum from HFD-fed mice. In conclusion, our studies demonstrate that the adverse influence of early-life HFD consumption on behavior and hippocampal structure is attributed at least in part to microglial overactivation that is accompanied by an elevated serum FFA concentration and microglial aberrations represent a potential preventive and therapeutic target for HFD-related emotional disorders.

Mapping the evolution of neurofeedback research: a bibliometric analysis of trends and future directions

Introduction

This study conducts a bibliometric analysis on neurofeedback research to assess its current state and potential future developments.

Methods

It examined 3,626 journal articles from the Web of Science (WoS) using co-citation and co-word methods.

Results

The co-citation analysis identified three major clusters: "Real-Time fMRI Neurofeedback and Self-Regulation of Brain Activity," "EEG Neurofeedback and Cognitive Performance Enhancement," and "Treatment of ADHD Using Neurofeedback." The co-word analysis highlighted four key clusters: "Neurofeedback in Mental Health Research," "Brain-Computer Interfaces for Stroke Rehabilitation," "Neurofeedback for ADHD in Youth," and "Neural Mechanisms of Emotion and Self-Regulation with Advanced Neuroimaging.

Discussion

This in-depth bibliometric study significantly enhances our understanding of the dynamic field of neurofeedback, indicating its potential in treating ADHD and improving performance. It offers non-invasive, ethical alternatives to conventional psychopharmacology and aligns with the trend toward personalized medicine, suggesting specialized solutions for mental health and rehabilitation as a growing focus in medical practice.

Fat loss and muscle gain: The possible role of cortical glutamate in determining the efficacy of physical exercise

BACKGROUND

Physical exercise is widely acknowledged for its health benefits, but its effectiveness in treating obesity remains contentious due to variability in response. Owing to the roles of glutamate in appetite regulation, food addiction, and impulsivity, this observational cohort-study evaluated medial prefrontal cortex (mPFC) glutamate as a predictor of variability in exercise response, specifically in terms of fat loss and muscle gain.

METHODS

Healthy non-exercising adult men (n = 21) underwent an 8-week supervised exercise program. Baseline glutamate levels in the mPFC were measured through magnetic resonance spectroscopy. For exercise-dependent changes in body composition (fat and muscle mass), basal metabolic rate (BMR), and blood metabolic biomarkers related to lipid and glucose metabolism, measurements were obtained through bioelectrical impedance and blood sample analyses, respectively.

RESULTS

The exercise program resulted in significant improvements in body composition, including reductions in percentage body fat mass, body fat mass, and waist-to-hip ratio and an increase in mean muscle mass. Furthermore, BMR and metabolic indicators linked to glucose and lipids exhibited significant changes. Notably, lower baseline glutamate levels were associated with greater loss in percentage body fat mass (r = 0.482, p = 0.027), body fat mass (r = 0.441, p = 0.045), and increase in muscle mass (r = -0.409, p = 0.066, marginal) following the exercise program.

CONCLUSION

These preliminary findings contribute to our understanding of the neurobiology of obesity and emphasize the significance of glutamate in regulating body composition. The results also highlight cortical glutamate as a potential predictor of exercise-induced fat loss and muscle gain.

Opposite changes in morphometric similarity of medial reward and lateral non-reward orbitofrontal cortex circuits in obesity

Obesity has a profound impact on metabolic health thereby adversely affecting brain structure and function. However, the majority of previous studies used a single structural index to investigate the link between brain structure and body mass index (BMI), which hinders our understanding of structural covariance between regions in obesity. This study aimed to examine the relationship between macroscale cortical organization and BMI using novel morphometric similarity networks (MSNs). The individual MSNs were first constructed from individual eight multimodal cortical morphometric features between brain regions. Then the relationship between BMI and MSNs within the discovery sample of 434 participants was assessed. The key findings were further validated in an independent sample of 192 participants. We observed that the lateral non-reward orbitofrontal cortex (lOFC) exhibited decoupling (i.e., reduction in integration) in obesity, which was mainly manifested by its decoupling with the cognitive systems (i.e., DMN and FPN) while the medial reward orbitofrontal cortex (mOFC) showed de-differentiation (i.e., decrease in distinctiveness) in obesity, which was mainly represented by its de-differentiation with the cognitive and attention systems (i.e., DMN and VAN). Additionally, the lOFC showed de-differentiation with the visual system in obesity, while the mOFC showed decoupling with the visual system and hyper-coupling with the sensory-motor system in obesity. As an important first step in revealing the role of underlying structural covariance in body mass variability, the present study presents a novel mechanism that underlies the reward-control interaction imbalance in obesity, thus can inform future weight-management approaches.

Neurocognitive factors predicting BMI changes from adolescence to young adulthood

OBJECTIVE

The objective of this study was to assess whether inhibitory task performance in adolescence could be prospectively related to weight gain in young adulthood. We proposed that this association would differ according to the BMI group in adolescence.

METHODS

A total of 318 adolescents performed the anti-saccade task, and 530 completed the Stroop test. Accuracy and reaction time were assessed for each incentive type (neutral, loss, and reward) in the anti-saccade task and for each trial type (control and incongruent trials) in the Stroop test. Changes in the BMI z score (∆BMI z score) from adolescence to young adulthood were calculated.

RESULTS

The relationship between the BMI z score and the anti-saccade task accuracy showed an effect on the ∆BMI z score (β = -0.002, p < 0.05). The neutral and loss accuracies were related to ∆BMI z score in the groups with overweight (all β = -0.004, p = 0.05) and obesity (β = -0.006 and β = -0.005, p < 0.01). The interaction between adolescents' BMI z score with control (β = -0.312, p < 0.001) and incongruent (β = -0.384, p < 0.001) trial reaction times showed an effect on the ∆BMI z score. Control (β = 0.730, p = 0.036) and incongruent (β = 0.535, p = 0.033) trial reaction times were related to ∆BMI z score in the group with overweight.

CONCLUSIONS

Our findings support the hypothesis that cognitive vulnerability could predict the BMI gain from adolescence to young adulthood.

Is this advertisement designed to appeal to you? Adolescents' views about Instagram advertisements promoting ultra-processed products

OBJECTIVE

Examine the key elements that characterise social media advertisements targeted at adolescents by asking adolescents which features of Instagram ads promoting ultra-processed products make them designed to appeal to adolescents.

DESIGN

Instagram ads promoting ultra-processed products and brands were selected from a database in which ads had been classified regarding whether they were primarily targeted at adolescents from an adult perspective. Adolescents completed a sorting task in small groups and were requested to reach a consensus through discussions and sticky notes regarding whether sixty ads were designed to appeal to them. The sorting task was analysed using content analysis based on inductive coding.

SETTING

One private secondary school and two after-school clubs.

PARTICIPANTS

Convenience sample of 105 Uruguayan adolescents aged 11-17 years.

RESULTS

Ten categories were identified regarding the reasons for sorting ads as (not) designed to appeal to adolescents: product type, graphic design, explicit references to age groups, language, activities or themes, memes, celebrities, characters, promotions and novelty. Product type emerged as a key element, with adolescents perceiving ads as designed to appeal to them simply because they promoted specific products.

CONCLUSIONS

This research contributes to the validation of criteria defined in previous studies and can be used for the development of tools to monitor the prevalence and power of adolescent-targeted digital marketing. However, the importance attributed to type of product suggests that regulations should not exclusively focus on exposure to digital marketing specifically targeted at adolescents but also on exposure to marketing in general.

Altered connectivity patterns of medial and lateral orbitofrontal cortex underlie the severity of bulimic symptoms

Objective

Compared to clinical bulimia nervosa, sub-threshold bulimic symptoms are becoming more prevalent in non-clinical or general population, which is repeatedly linked with the connectivity in orbitofrontal cortex (OFC), including functionally heterogeneous the medial and lateral OFC (mOFC; lOFC). However, the specific connectivity patterns of the mOFC and lOFC in individuals with severe or mild bulimic symptoms (SB; MB) remain poorly understood.

Methods

We first utilized resting-state functional connectivity (FC) and spectral dynamic causal modeling (spDCM) to investigate abnormal functional and effective connectivity (EC) of OFC subregions in adults with different severity of bulimic. The SB group (n = 21), MB group (n = 114), and healthy controls (HC, n = 91) underwent rs-fMRI scans. A generalized linear model was applied to determine the OFC-seeded whole-brain FC across the three groups. Subsequently, spDCM was used to estimate differences in EC among the three groups based on the FC results.

Results

We observed a shared neural basis for SB and MB groups (i.e., weaker lOFC-superior parietal lobule connectivity), which may support the role of dysfunctional inhibitory control in general bulimic symptomatology. Whereas, SB group displayed greater lOFC-occipital pole connectivity than MB group, suggesting the specificity of the neural correlates of full-threshold/severe bulimia. The directional links from the mOFC to lOFC and amygdala could further explain the aberrant interactions of reward sensitivity with inhibitory control and homeostatic energy in sub-threshold/mild condition.

Conclusion

The current study provides novel evidence that divergent connectivity patterns of the lOFC and mOFC may contribute to different severities of bulimia, which will expands our understanding of the neurobiological substrates underlying bulimia across a spectrum from healthy to unhealthy.

Hyperactivity in preschool age is associated with higher fat-free mass and healthy lifestyle behaviours five years later: A longitudinal study of Swedish children

BACKGROUND

There is evidence for a link between hyperactivity and obesity, especially among older children. Both conditions seem to be multifactorial in origin and hypotheses of common underlying issues, such as emotional dysregulation, have been suggested. However, studies of the co-occurrence of the two conditions in younger age groups have been inconclusive.

OBJECTIVES

We aimed to study the longitudinal associations of psychological strengths and difficulties at 4 years of age with health behaviours, body composition, physical fitness, and cardiovascular disease (CVD) risk factors 5 years later.

METHODS

Parents of 226 4-year-old children filled out the Strengths and Difficulties Questionnaire (SDQ). At 9 years of age, we assessed health behaviours, physical fitness, body composition, and CVD risk factors. Associations were examined with linear regression models that were adjusted for sex, age of the child at 9, and maternal education.

RESULTS

In the adjusted models, hyperactivity at 4 was associated with higher fat-free mass (β = 0.18, p = 0.007) and lower levels of sedentary behaviour (β -0.14, p = 0.043) at 9 years. Furthermore, greater emotional problems at 4 were associated with lower intake of fruit and vegetables (β -0.14, p = 0.038) at 9 years. However, there were no statistically significant associations between psychological difficulties and fat-mass index.

CONCLUSIONS

Our novel data provide no evidence of an association between hyperactivity in preschool age and obesity or obesity-related behaviours in school age. Future studies examining how psychological factors relate to obesity development should consider a developmental perspective.

Parent Experiences With Warning Labels After Policy Implementation in Uruguay

OBJECTIVE

To explore the perception and experiences of parents of children and adolescents during the first year of the mandatory implementation of nutritional warning labels in Uruguay.

DESIGN

Qualitative research based on semistructured interviews.

SETTING

Montevideo, Uruguay.

PARTICIPANTS

Twenty-eight parents of children and adolescents.

PHENOMENON OF INTEREST

Perception of and experiences with warning labels, a front-of-pack nutrition labeling scheme that has become increasingly popular in Latin America.

ANALYSIS

Content analysis of the transcripts based on a deductive-inductive approach.

RESULTS

Interview transcripts evidenced high awareness, acceptance, and understanding of warning labels among parents of children and adolescents. Most participants reported considering warnings for decision making and changing their purchase decisions because of their implementation, particularly when choosing foods for their children. They reported their children were aware of and understood warnings but did not tend to take them into account when choosing foods.

CONCLUSIONS AND IMPLICATIONS

Results from the present work contribute to the growing body of literature showing the effectiveness of warning labels. Lack of interest or perceived benefits and structural barriers emerged as key motives for not using the warnings when making purchasing decisions, suggesting the need to develop additional strategies to increase policy effectiveness.

Effects of pocket money on weight status among junior high school students: A longitudinal study in China

Overweight and obesity among adolescents has become a common public health problem, and both obesity rates and the amount of pocket money among adolescents in China are rising. We investigated to what extent the increase in pocket money could lead to weight gain of junior high school students and how this association may vary by school environment in China. Researchers utilized 3 waves of data from the China Education Panel Survey, a national longitudinal study, to investigate the likelihood of overweight and obesity. The Generalized Estimation Equation was employed to analyze the data. Three Generalized Estimation Equation models were constructed to explore the relationship between pocket money and overweight and obesity in 2 distinct food environments surrounding schools. A total of 8903 individuals (4604 boys and 4299 girls) from the China Education Panel Survey were analyzed. After adjusting for confounding factors, it was found that girls who received 20 to 49 yuan and ≥ 50 yuan per week had a higher risk of overweight and obesity compared to those who received 0 to 9 yuan per week (OR = 1.34, 95% CI: 1.07-1.69, OR = 1.53, 95% CI: 1.22-1.92). However, no significant association was observed between pocket money and overweight and obesity when food around the school was not easily accessible. The prevalence of overweight among Chinese teenagers has steadily increased from Wave1 to Wave3. Moreover, junior high school girls who receive more pocket money are at a greater risk of developing obesity and overweight issues.

Bringing down barriers to children's healthy eating: a critical review of opportunities, within a complex food system

This narrative review revises the scientific evidence of recent years on healthy eating in children and adolescents, making sense of promising avenues of action, from a food system perspective. A conceptual framework is provided to better understand how eating habits of children and adolescents are shaped to identify key multisectoral approaches that should be implemented to promote healthier diets. The following influencing factors are discussed: individual factors (physiological and psychological factors, food preferences and food literacy competencies), factors within the personal and socio-cultural food environments, external food environments, and the supply chain. In each section, the main barriers to healthy eating are briefly discussed focussing on how to overcome them. Finally, a discussion with recommendations of actions is provided, anchored in scientific knowledge, and transferable to the general public, industry, and policymakers. We highlight that multidisciplinary approaches are not enough, a systems approach, with a truly holistic view, is needed. Apart from introducing systemic changes, a variety of interventions can be implemented at different levels to foster healthier diets in children through fostering healthier and more sustainable food environments, facilitating pleasurable sensory experiences, increasing their food literacy, and enhancing their agency by empowering them to make better food related decisions. Acknowledging children as unique individuals is required, through interpersonal interactions, as well as their role in their environments. Actions should aim to enable children and adolescents as active participants within sustainable food systems, to support healthier dietary behaviours that can be sustained throughout life, impacting health at a societal level.

Higher body weight-dependent neural activation during reward processing

Obesity is associated with alterations in brain structure and function, particularly in areas related to reward processing. Although brain structural investigations have demonstrated a continuous association between higher body weight and reduced gray matter in well-powered samples, functional neuroimaging studies have typically only contrasted individuals from the normal weight and obese body mass index (BMI) ranges with modest sample sizes. It remains unclear, whether the commonly found hyperresponsiveness of the reward circuit can (a) be replicated in well-powered studies and (b) be found as a function of higher body weight even below the threshold of clinical obesity. 383 adults across the weight spectrum underwent functional magnetic resonance imaging during a common card-guessing paradigm simulating monetary reward. Multiple regression was used to investigate the association of BMI and neural activation in the reward circuit. In addition, a one-way ANOVA model comparing three weight groups (normal weight, overweight, obese) was calculated. Higher BMI was associated with higher reward response in the bilateral insula. This association could no longer be found when participants with obesity were excluded from the analysis. The ANOVA revealed higher activation in obese vs. lean, but no difference between lean and overweight participants. The overactivation of reward-related brain areas in obesity is a consistent finding that can be replicated in large samples. In contrast to brain structural aberrations associated with higher body weight, the neurofunctional underpinnings of reward processing in the insula appear to be more pronounced in the higher body weight range.

Altered effective connectivity between reward and inhibitory control networks in people with binge eating episodes: A spectral dynamic causal modeling study

BACKGROUND

Converging evidence points to the crucial role of brain connectivity involved in aberrant behavioral control and reward reactivity in the onset and maintenance of binge eating. However, the directional interaction pattern between brain's reward and inhibitory control systems in people with binge eating episodes is largely unknown.

METHODS

Resting-state fMRI data were collected from 36 adults with binge eating episodes (age: 19.05 ± 0.90) and 36 well-matched controls (age: 18.88 ± 0.78). We applied spectral dynamic causal modeling approach to estimate effective connectivity of the executive control network (ECN) and reward network (RN) with 15 predefined regions of interest, and investigate the between-group differences in directional connectivity.

RESULTS

Compared with controls, the positive connections within the ECN were significantly strengthened in individuals with binge eating episodes, while the negative connections from the ECN to RN and from the RN to ECN were significantly weakened. In adults with binge eating episodes, the RN→ECN connectivity was positively related to binge frequency even controlling for age, sex, and body mass index.

CONCLUSION

This study represents an important first step in addressing the role of directional integration between reward and inhibitory control networks in binge eating, and provides novel evidence that the ability of people with binge eating episodes to maintain a balance between inhibitory control and reward reactivity is decreased, as reflected by diminished bidirectional negative effects of prefrontal-subcortical circuitry at rest.

Factors associated with adherence to the Mediterranean diet among medical students at a private university in Lima, Peru

<b>Introduction:</b> The Mediterranean diet (MedD)is a characteristic eating pattern of the countries of the Mediterranean region. Nonetheless, is unknown its adherence in medical students. We aimed to determine the prevalence of adherence to the Mediterranean diet (AMedD) and associated factors in medical students from Peru.<br /> <b>Material and methods</b>: Analytical cross-sectional study carried out by means of a virtual survey. PREDIMED scale was used to evaluate AMedD. The factors assessed were age, sex, academic year, body mass index (BMI), place of lunch consumption, cigarette smoking, and physical activity. Poisson regression with robust variance was used to present it in crude and adjusted prevalence ratios (PRa).<br /> <b>Results:</b> High AMedD was present in 38.50%. Statistically significant association was found for sex (PRa: 0.623; 95%CI 0.488-0.796); for overweight (PRa: 0.417; 95%CI 0.270-0.644), obesity (PRa: 0.591; 95%CI 0.400-0.874) versus normopese; cigarette smoking (PRa: 0.450; 95%CI 0.263-0.773); and high physical activity (PRa: 1.652; 95%CI 1.233-2.215).<br /> <b>Conclusions</b>: AMedD was low. The related factors were sex, BMI, consumption of lunch outside the home, cigarette smoking, and a high level of physical activity. If this is confirmed in future studies, it would be necessary to consider these elements to encourage greater consumption of MedD components by students, which would help to improve their long-term health.

Young Adult Brain Capital: A New Opportunity for Dementia Prevention

The potential for future prevention of Alzheimer's disease and related dementias (ADRD) through healthy lifestyle change is spurring a positive brain health movement. However, most ADRD research continues to focus on mid- and later life. We lack evidence regarding risk exposure and protective factors in young adulthood, i.e., 18-39 years. Brain capital is an emerging framework that represents the combination of education, knowledge, skills, and optimal brain health that people accumulate over their lives. Building on this framework, we present a new model that focuses on optimizing brain health in young adulthood; namely, young adult brain capital. Increasing focus on younger populations is critical for developing citizens who are emotionally intelligent, resilient and can anticipate and cope with rapid changes in the world. By understanding the values that are key drivers and motivators for young adults, we can empower the next generation to become active agents in optimizing their brain health and reducing their risk for future ADRD.

Obesogenic Diet Cycling Produces Graded Effects on Cognition and Microbiota Composition in Rats

SCOPE

The effects of diet cycling on cognition and fecal microbiota are not well understood.

METHOD AND RESULTS

Adult male Sprague-Dawley rats were cycled between a high-fat, high-sugar "cafeteria" diet (Caf) and regular chow. The impairment in place recognition memory produced by 16 days of Caf diet was reduced by switching to chow for 11 but not 4 days. Next, rats received 16 days of Caf diet in 2, 4, 8, or 16-day cycles, each separated by 4-day chow cycles. Place recognition memory declined from baseline in all groups and was impaired in the 16- versus 2-day group. Finally, rats received 24 days of Caf diet continuously or in 3-day cycles separated by 2- or 4-day chow cycles. Any Caf diet access impaired cognition and increased adiposity relative to controls, without altering hippocampal gene expression. Place recognition and adiposity were the strongest predictors of global microbiota composition. Overall, diets with higher Caf > chow ratios produced greater spatial memory impairments and larger shifts in gut microbiota species richness and beta diversity.

CONCLUSION

Results suggest that diet-induced cognitive deficits worsen in proportion to unhealthy diet exposure, and that shifting to a healthy chow for at least a week is required for recovery under the conditions tested here.

Children's and adolescents' rising animal-source food intakes in 1990-2018 were impacted by age, region, parental education and urbanicity

Animal-source foods (ASF) provide nutrition for children and adolescents' physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the world's child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 15-19 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes.

Longitudinal study of energy, neurosensory and eating responses durinG pregnancY (ENERGY cohort): A study protocol

BACKGROUND AND AIMS

Physiological changes that occur during pregnancy can have long-term impacts on metabolism and neurosensory responses to food, which can impact nutrition and health outcomes. The ENERGY cohort is a longitudinal study that aims to capitalizes on pregnancy as a natural model of metabolic reprogramming in order to understand the neurosensory mechanisms underpinning links between metabolism and dietary behaviour. The study objectives are to test for multi-sensory shifts during pregnancy, and the effect of sensory changes on dietary choices and bodyweights, and to identify neurosensory mechanisms that determine macronutrient selection before and after pregnancy.

METHODS

A longitudinal cohort study involving 130 pregravid women planning to conceive with the next 12-months and 65 pregravid women with no short-term plans to conceive. Participants will be recruited from Dunedin and Auckland, New Zealand. The study will test for changes in diet, neurosensory outcomes, and metabolism across the reproductive cycle, from pre-pregnancy to 1-year post-pregnancy. Data will be collected at six timepoint throughout the pregnancy which will occur approximately every 3 months. The primary response variables will be changes in supra-threshold sensitivity across modalities, dietary intake, and metabolism between pre-pregnancy and post-pregnancy. Longitudinal data analysis will use linear mixed models to assess changes in the response outcomes over time adjusted for age, ethnicity, and socioeconomic status.

DISCUSSION

Understanding the relationship between metabolism, sensory processing, and macronutrient preferences will provide crucial insights into diet-related health issues, including obesity. This study will lead to the formation of a prospective research cohort that is unique to Aotearoa New Zealand, and will develop multidisciplinary skills that are increasingly necessary to addressing the obesity epidemic.

Children's eating behaviours and related constructs: conceptual and theoretical foundations and their implications

BACKGROUND

There is a substantial body of research on children's eating behaviours (e.g., food responsiveness and fussiness) and related constructs (e.g., eating in the absence of hunger, appetite self-regulation). This research provides a foundation for understanding children's dietary intakes and healthy eating behaviours, as well as efforts at intervention, whether in relation to food avoidance, overeating and/or trajectories to excess weight gain. The success of these efforts and their associated outcomes is dependent on the theoretical foundation and conceptual clarity of the behaviours and constructs. This, in turn contributes to the coherence and precision of the definitions and measurement of these behaviours and constructs. Limited clarity in these areas ultimately creates uncertainty around the interpretation of findings from research studies and intervention programs. At present there does not appear to be an overarching theoretical framework of children's eating behaviours and associated constructs, or for separate domains of children's eating behaviours/constructs. The main purpose of the present review was to examine the possible theoretical foundations of some of the main current questionnaire and behavioural measures of children's eating behaviours and related constructs.

METHODS

We reviewed the literature on the most prominent measures of children's eating behaviours for use with children aged ~ 0-12 years. We focused on the explanations and justifications for the original design of the measures and whether these included theoretical perspectives, as well as current theoretical interpretations (and difficulties) of the behaviours and constructs.

RESULTS

We found that the most commonly used measures had their foundations in relatively applied or practical concerns rather than theoretical perspectives.

CONCLUSIONS

We concluded, consistent with Lumeng & Fisher (1), that although existing measures have served the field well, to advance the field as a science, and better contribute to knowledge development, increased attention should be directed to the conceptual and theoretical foundations of children's eating behaviours and related constructs. Suggestions for future directions are outlined.

Morphology of the prefrontal cortex predicts body composition in early adolescence: cognitive mediators and environmental moderators in the ABCD Study

Morphological features of the lateral prefrontal cortex (PFC) in late childhood and early adolescence may provide important clues as to the developmental etiology of clinical conditions such as obesity. Body composition measurements and structural brain imaging were performed on 11 226 youth at baseline (age 9 or 10 years) and follow-up (age 11 or 12 years). Baseline morphological features of the lateral PFC were examined as predictors of body composition. Findings revealed reliable associations between middle frontal gyrus volume, thickness and surface area and multiple indices of body composition. These findings were consistent across both time points and remained significant after covariate adjustment. Cortical thicknesses of the inferior frontal gyrus and lateral orbitofrontal cortex were also reliable predictors. Morphology effects on body composition were mediated by performance on a non-verbal reasoning task. Modest but reliable moderation effects were observed with respect to environmental self-regulatory demand after controlling for sex, race/ethnicity, income and methodological variables. Overall findings suggest that PFC morphology is a reliable predictor of body composition in early adolescence, as mediated through select cognitive functions and partially moderated by environmental characteristics.

Bidirectional Associations Between Adiposity and Cognitive Function and Mediation by Brain Morphology in the ABCD Study

Importance

Most epidemiologic studies examine the brain as an outcome in relation to adiposity (ie, the brain-as-outcome perspective), but it is also a potential risk factor associated with adiposity accumulation over time (ie, the brain-as-risk factor perspective). The bidirectionality hypothesis has not been fully explored in adolescent samples previously.

Objective

To assess bidirectional associations between adiposity and cognitive function in youth and test mediational pathways through brain morphology (specifically the lateral prefrontal cortex [LPFC]), lifestyle behaviors, and blood pressure.

Design, Setting, and Participants

This cohort study uses data (wave 1-3; 2 years of follow-up) from the Adolescent Brain Cognitive Development (ABCD) Study, a long-term longitudinal investigation of brain development in the United States launched in 2015, which recruited 11 878 children aged 9 to 10 years at inception. Data analysis was performed from August 2021 to June 2022.

Main Outcomes and Measures

Multivariate multivariable regression analyses were used to assess bidirectional associations of indicators of cognitive function (eg, executive function, processing speed, episodic memory, receptive vocabulary and reading skills) and adiposity (eg, body mass index z scores [zBMI] and waist circumference [WC]). Mediators considered for this investigation were lifestyle variables (eg, diet and physical activity), blood pressure, and the morphology of the LPFC and its subregions.

Results

A total of 11 103 individuals (mean [SD] age, 9.91 [0.6] years; 5307 females [48%]; 8293 White individuals [75%] and 2264 Hispanic individuals [21%]) were included in the current study. Multivariate multivariable regression analyses revealed that higher baseline zBMI and WC were associated with worse follow-up episodic memory (β, -0.04; 95% CI, -0.07 to -0.01) and better vocabulary (β, 0.03; 95% CI, 0.002 to 0.06) task performance, in covariate adjusted models. Similarly, superior baseline executive function (zBMI: β, -0.03; 95% CI, -0.06 to -0.01; WC: β, -0.04; 95% CI, -0.07 to -0.01) and episodic memory (zBMI: β, -0.04; 95% CI, -0.07 to -0.02; WC: β, -0.03; 95% CI, -0.06 to -0.002) task performance were associated with better follow-up adiposity status in covariate adjusted models. Cross-lagged panel models with latent variable modeling had a bidirectional association with executive function task performance (brain-as-outcome: β, -0.02; 95% CI, -0.05 to -0.001; brain-as-risk factor: β, -0.01; 95% CI, -0.02 to -0.003). The hypothesized associations were statistically mediated by LPFC volume and thickness, physical activity, and blood pressure.

Conclusions and Relevance

In this cohort study, executive function and episodic memory were bidirectionally associated with adiposity indices over time in this adolescent sample. These findings suggest that the brain can be both a risk factor and an outcome of adiposity; this complex bidirectional association should be taken into account in future research and clinical practice.

The content of Instagram posts featuring ultra-processed products through the lens of the heuristic-systematic model

Digital marketing has seen a rapid rise in the last decade as a consequence of the increased popularity of social media. However, few studies so far have analyzed the prevalence and persuasive power of digital marketing of ultra-processed products. The present study aimed at: (i) analyzing the content of Instagram posts of ultra-processed products through the lens of the heuristic-systematic model, and (ii) evaluating the influence of the content of the posts on user interactions. A search for Instagram accounts of ultra-processed products was performed using a master list of products commercialized in the two most popular online supermarkets in Uruguay. For each of the identified Instagram accounts, all the content posted in a 6-month period was recorded (August 15th, 2020 to February 15th, 2021). The posts were analyzed using content analysis based on inductive coding, and gradient boosting models (GBMs) were used to address the second study objective. A total of 2178 Instagram posts promoting specific ultra-processed products or brands were identified. The posts included a diverse set of cues to trigger both systematic and heuristic processing. References to the pleasure derived from product consumption as well as health-related cues were most prevalent. The GBM showed that references to contests and raffles and invitations to interact encouraged users to engage with the posts through posting comments. Taken together, results stress the need to implement comprehensive regulatory approaches to reduce exposure to and the power of digital marketing of ultra-processed products given the harmful health-related consequences associated with excessive consumption of such products.

Effects of aerobic exercise training in oxidative metabolism and mitochondrial biogenesis markers on prefrontal cortex in obese mice

BACKGROUND

To evaluate the effects of 8 weeks of Aerobic Physical Training (AET) on the mitochondrial biogenesis and oxidative balance in the Prefrontal Cortex (PFC) of leptin deficiency-induced obese mice (ob/ob mice).

METHODS

Then, the mice were submitted to an 8-week protocol of aerobic physical training (AET) at moderate intensity (60% of the maximum running speed). In the oxidative stress, we analyzed Malonaldehyde (MDA) and Carbonyls, the enzymatic activity of Superoxide Dismutase (SOD), Catalase (CAT) and Glutathione S Transferase (GST), non-enzymatic antioxidant system: reduced glutathione (GSH), and Total thiols. Additionally, we evaluated the gene expression of PGC-1α SIRT-1, and ATP5A related to mitochondrial biogenesis and function.

RESULTS

In our study, we did not observe a significant difference in MDA (p = 0.2855), Carbonyl's (p = 0.2246), SOD (p = 0.1595), and CAT (p = 0.6882) activity. However, the activity of GST (p = 0.04), the levels of GSH (p = 0.001), and Thiols (p = 0.02) were increased after 8 weeks of AET. Additionally, there were high levels of PGC-1α (p = 0.01), SIRT-1 (p = 0.009), and ATP5A (p = 0.01) gene expression after AET in comparison with the sedentary group.

CONCLUSIONS

AET for eight weeks can improve antioxidant defense and increase the expression of PGC-1α, SIRT-1, and ATP5A in PFC of ob/ob mice.

Individualized morphometric similarity predicts body mass index and food approach behavior in school-age children

Childhood obesity is associated with alterations in brain structure. Previous studies generally used a single structural index to characterize the relationship between body mass index(BMI) and brain structure, which could not describe the alterations of structural covariance between brain regions. To cover this research gap, this study utilized two independent datasets with brain structure profiles and BMI of 155 school-aged children. Connectome-based predictive modeling(CPM) was used to explore whether children’s BMI is reliably predictable by the novel individualized morphometric similarity network(MSN). We revealed the MSN can predict the BMI in school-age children with good generalizability to unseen dataset. Moreover, these revealed significant brain structure covariant networks can further predict children’s food approach behavior. The positive predictive networks mainly incorporated connections between the frontoparietal network(FPN) and the visual network(VN), between the FPN and the limbic network(LN), between the default mode network(DMN) and the LN. The negative predictive network primarily incorporated connections between the FPN and DMN. These results suggested that the incomplete integration of the high-order brain networks and the decreased dedifferentiation of the high-order networks to the primary reward networks can be considered as a core structural basis of the imbalance between inhibitory control and reward processing in childhood obesity.

Disinhibited Eating and Executive Functioning in Children and Adolescents: A Systematic Review and Meta-Analysis

A growing body of research suggests disinhibited eating and weaker executive function (EF) are two risk factors for pediatric obesity. Emerging brain imaging and behavioral findings support the notion that EF skills impact eating regulation. However, a major gap in the current literature is a synthesis of the association between various EF skills and disinhibited eating patterns across child development. To address this gap, a systematic review and meta-analysis was conducted to examine the effect of EF skills on disinhibited eating behaviors among youth ages 3-18 years old. PubMed and PsychINFO databases were utilized and data from 15 studies with a total sample of 4909 youth were included. A random effects meta-analysis revealed a small negative effect of overall EF skills on disinhibited eating behavior, r = -0.14, p < 0.01. Analysis of individual EF skills found working memory had an overall medium negative effect on disinhibited eating behavior, r = -0.25, p < 0.05. Taken together, findings from this meta-analysis support an inverse relationship between EF abilities and disinhibited eating patterns in children and adolescents, such that poorer EF abilities are associated with higher levels of disinhibited eating. Given the effect on eating behavior, future research is needed to assess whether EF difficulties may be a barrier to effective weight management in youth. Specifically, research is needed to examine whether EF skills may be a key target to consider for effective obesity prevention and treatment in children and adolescents.

Dietary and Nutritional Profiles among Brazilian Adolescents

(1) Background: The present study analyzed the prevalence of dietary and nutritional profiles among Brazilian adolescents and their associations with social determinants of health. (2) Methods: A population-based survey was administered to 16,409 adolescents assessed by the 2015 National School Health Survey. A multivariate model of dietary and nutritional profiles was estimated from correspondence analysis. (3) Results: The dietary and nutritional profiles more prevalent among Brazilian adolescents were “lower nutritional risk dietary pattern and eutrophic” (42.6%), “lower nutritional risk dietary pattern and overweight” (6.8%), and “higher nutritional risk dietary pattern and overweight” (6.0%). Healthier profiles were associated with less urbanized territories, health-promoting behaviors, and families with worse material circumstances. The less healthy profiles were associated with more urbanized environments, health risk behaviors, and families with better material circumstances. (4) Brazilian adolescents have different dietary and nutritional profiles that are characterized by sociopolitical and economic contexts, family material and school circumstances, and the behavioral and psychosocial health factors of the individuals. All of this points to the social determination of these health problems among adolescents in Brazil.

Predictors of non-alcoholic fatty liver disease in children

OBJECTIVE

Abdominal obesity is strongly associated with the development of non-alcoholic fatty liver disease (NAFLD). Early identification and intervention may reduce the risk. We aim to improve pediatric NAFLD screening by comparing discriminative performance of six abdominal obesity indicators.

METHODS

We measured anthropometric indicators (waist circumference [WC], waist-to-hip ratio [WHR], waist-to-height ratio [WHtR]), body composition indicators (trunk fat index [TFI], visceral fat area [VFA]), and endocrine indicator (visceral adiposity index [VAI]) among 1350 Chinese children aged 6-8 years. Using Spearman correlation, receiver operating characteristic (ROC) curves, and Logistic regression, we validated their ability to predict NAFLD.

RESULTS

All six indicators can predict NAFLD robustly, with area under the curve (AUC) values ranged from 0.69 to 0.96. TFI, WC, and VFA rank in the top three for the discriminative performance. TFI was the best predictor with AUC values of 0.94 (0.92-0.97) and 0.96 (0.92-0.99), corresponding to cut-off values of 1.83 and 2.31 kg/m² for boys and girls, respectively. Boys with higher TFI (aOR = 13.8), VFA (aOR = 11.1), WHtR (aOR = 3.1), or VAI (aOR = 2.8), and girls with higher TFI (aOR = 21.0) or VFA (aOR = 17.5), were more likely to have NAFLD.

CONCLUSION

User-friendly body composition indicators like TFI can identify NAFLD and help prevent the progress of liver disease.

TRIAL REGISTRATION

Chinese Clinical Trial Registry (ChiCTR) ( www.chictr.org.cn/enIndex.aspx , No. ChiCTR2100044027); retrospectively registered on 6 March 2021.

IMPACT

Abdominal obesity increases the risk of pediatric non-alcoholic fatty liver disease (NAFLD). This study compared the discriminative performance of multiple abdominal obesity indicators measured by different methods in terms of accuracy and fastidious cut-off values through a population-based child cohort. Our results provided solid evidence of abdominal obesity indicators as an optimal screening tool for pediatric NAFLD, with area under the curve (AUC) values ranged from 0.69 to 0.96. User-friendly body composition indicators like TFI show a greater application potential in helping physicians perform easy, reliable, and interpretable weight management to prevent the progress of liver damage.

The knowledge, barriers and opportunities to improve nutrition and physical activity amongst young people attending an Australian youth mental health service: a mixed-methods study

Background

Mental illnesses are the leading cause of disability in young people, and lifestyle interventions in young people at risk of mental illness remain a priority. Opportunities to improve nutrition and physical activity among young people through youth mental health services remain unclear. This study aimed to determine the knowledge and behaviors towards nutrition and physical activity, the barriers and enablers to improving behaviors, and the preferred providers and sources of information for nutrition and physical activity among a sample of young people attending a youth mental health service.

Methods

A mixed-method study was conducted in regional Tasmania, Australia in a sample of young people (15–25 years) attending a youth mental health service (headspace). A quantitative survey (n = 48) determined young people’s nutrition and physical activity knowledge, behaviors, barriers and enablers to achieving recommendations, and their preferred providers and sources of information. Structured interviews and a focus group further explored these concepts (n = 8), including the role of the mental health service as a provider of this support.

Results

The majority of participants did not meet national recommendations for nutrition and physical activity, despite possessing a high level of knowledge regarding their importance for mental health. Improving mental health was a common enabling factor for participants choosing to alter diet and physical activity habits, but also the leading barrier for participating in physical activity. Young people wanted to receive information from reputable health providers, ideally through social media sources. headspace was seen as an important potential provider of this information.

Conclusions

Our results indicate that there is a clear need to improve diet and physical activity habits to enhance mental and physical health outcomes in this at-risk group, and youth mental health services could provide further interventions to support their clients. Specialized staff (e.g. dietitians and exercise physiologists) may provide additional benefits alongside existing mental health care support.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-08182-0.

'Even if you don't pay attention to it, you know it's there': A qualitative exploration of adolescents' experiences with digital food marketing

Adolescents are particularly vulnerable to digital food marketing. However, research on adolescents' recall, awareness, and opinions of this type of marketing is still scarce. Accordingly, the present study aimed to conduct an in-depth examination of adolescents' experiences with digital food marketing. A convenience sample of 209 adolescents was recruited at two private educational institutions and a public health facility in Montevideo, the capital city of Uruguay. Semi-structured group interviews were conducted, recorded in audio and transcribed. The transcripts were analyzed using content analysis based on a deductive-inductive approach. Results showed that participants were highly exposed to digital food marketing, as they all remembered having seen advertisements, with those of fast-food restaurants and food-ordering apps being the most frequently mentioned. According to the adolescents' accounts, images, colors, music, oversized portions, product novelty, price promotions and celebrities were the most memorable aspects of food advertisements. Participants recognized the effect of advertisements on product awareness and wanting, and, to a lesser extent, on actual purchase and consumption behavior. Factors that were thought to mediate the impact of digital marketing on food choice were also identified. In the final part of the interviews, participants proposed strategies to reduce the effect of digital marketing on their food choices, which included both regulatory approaches to reduce exposure to digital marketing of unhealthy foods and behavior change communication. Together, the current findings provide insights for the development of multifaceted strategies to reduce the effects of digital food marketing on the eating habits of adolescents.

Prevalence of food addiction using the Yale-C scale in Mexican children with overweight and obesity

Background

The prevalence of excess weight and obesity in children has increased significantly worldwide. The concept of food addiction (FA) has been associated with eating-related problems and obesity. Studies on this topic have primarily examined adult samples and little is known about addictive-like eating among Mexican children and adolescents.

Methods

We conducted this study to examinate the prevalence of FA in a group of 291 overweight and obese children and adolescents using YFAS scale for children (YFAS-C) in Mexico.

Results

According to the YFAS-C approximately 14.4% of participants met for FA diagnosis. Forty-two (14.4%) received a FA diagnosis: 14 children and 28 adolescents. The number of FA symptoms in participants who received an FA diagnosis (M = 4.35, SD = 1.07) compared to participants with no FA diagnosis (M = 1.70, SD = 1.53) was significantly higher (p ≤ 0.001). There were no statistically significant gender differences and the proportion of subjects with an FA diagnosis did not differ by age between children and adolescents. FA is a focus of interest in attempting to explain certain behaviors that may contribute to the development of obesity and explain the failure of the weight loose programs in children.

Neurodevelopment, nutrition and genetics. A contemporary retrospective on neurocognitive health on the occasion of the 100th anniversary of the National Institute of Nutrition, Hyderabad, India

In celebration of the centenary of the National Institute of Nutrition (NIN), Hyderabad, India (1918-2018), a symposium highlighted the progress in nutrition knowledge made over the century, as well as major gaps in implementation of that knowledge. Brain famine caused by a shortage of nutrients required for perinatal brain development has unfortunately become a global reality, even as protein-calorie famine was largely averted by the development of high yield crops. While malnutrition remains widespread, the neglect of global food policies that support brain development and maintenance are most alarming. Brain disorders now top the list of the global burden of disease, even with obesity rising throughout the world. Neurocognitive health, remarkably, is seldom listed among the non-communicable diseases (NCDs) and is therefore seldom considered as a component of food policy. Most notably, the health of mothers before conception and through pregnancy as mediated by proper nutrition has been neglected by the current focus on early death in non-neurocognitive NCDs, thereby compromising intellectual development of the ensuing generations. Foods with balanced essential fatty acids and ample absorbable micronutrients are plentiful for populations with access to shore-based foods, but deficient only a few kilometres away from the sea. Sustained access to brain supportive foods is a priority for India and throughout the world to enable each child to develop to their intellectual potential, and support a prosperous, just, and peaceful world. Nutrition education and food policy should place the nutritional requirements for the brain on top of the list of priorities.

The 'big four' health risk behaviors among Vietnamese adolescents: co-occurrence and socio-cultural risk factors

Background

Health Risk Behaviors (HRBs) represent significant health threats for adolescents. However, there has been relatively little research on multiple HRBs in low-and-middle-income countries (LMIC), where the majority of the world’s youth reside. This study’s objective was to investigate common HRB, their co-occurrence, and socio-demographic risk and protective factors among Vietnamese adolescents.

Methods

A cross-sectional self-report survey examined four major HRBs (tobacco use, alcohol consumption, physical inactivity, unhealthy diet) among 431 adolescents aged 15–17 years in five Vietnam provinces. Key HRB risk and protective factors assessed included perceived social norms, parental monitoring of adolescents’ behavior, and health behavior literacy.

Results

Forty-one percent of participants reported no HRB, 39% reported one, and 20% reported two or more HRBs. The four HRBs appeared to be independent, with an exploratory factor analysis indicating no common factors. The most prevalent HRB was unhealthy diet (45%), the least prevalent smoking (1%). The most frequent co-occurring HRBs were unhealthy diet and physical inactivity. Adolescents’ perceptions of norms regarding HRBs and related healthy behaviors were the most consistent risk factor for the HRB. Diet was the HRB most influenced by the social variables perceived norms, monitoring, and health literacy.

Conclusions

Results highlight the importance of future research identifying the temporal order of co-occurrence of multiple HRB, how differing conceptualizations of socio-cultural roles impact on HRB, and health-related effects of HRB co-occurrence. Such information will be useful for maximizing the efficiency and effectiveness of prevention and intervention programs in LMIC.

Risky behaviors, substance use, and other lifestyle correlates of energy drink consumption in children and adolescents: a systematic review

Increasing concerns have been raised on the health-related risks connected with energy drink (ED) consumption in children and adolescents, with high acute or chronic consumers exceeding 10% in either age group in Europe in 2011. Preliminary evidence has suggested a common pattern of ED and substance use, especially alcohol. Additional evidence has been accumulating very fast; in addition, other lifestyle and risky behaviors may contribute to shed light on the complex interplay of factors involved in ED consumption. We have undertaken a comprehensive systematic review of the evidence on psychosocial correlates of ED consumption in 0-18 years subjects, as published up to April 1, 2021, in MEDLINE/PubMed, PsycINFO, and Cochrane Reviews and Central Register of Controlled Trials, which allowed to select 104 original articles. Only ~ 10% of the papers provided results based on longitudinal analyses. A common pattern of ED consumption and polysubstance use, including alcohol, tobacco, and soft and hard drugs, was still confirmed in adolescents; violent and risky behaviors were also related to a higher ED consumption. In addition, frequent ED consumers are more likely to have bad dietary habits, including consumption of sugar-sweetened beverages and junk foods. A generally inconclusive evidence was found for sport/physical activities, although sedentary behaviors were generally related to ED consumption.

CONCLUSIONS

Frequent ED consumption might be a screening indicator to identify students at risk of substance use or other risky/problem behaviors; enquiring about an adolescent's recent ED consumption could create opportunities for early intervention/prevention by informed pediatricians.

WHAT IS KNOWN

• Substances, especially alcohol, are associated with energy drinks in most cross-sectional studies.

WHAT IS NEW

• Violent behaviors are associated with energy drink consumption, in the absence of longitudinal studies; problematic use of internet/videogames deserves further investigation; unhealthy dietary patterns are related to energy drinks; evidence on physical activity is inconclusive, but sedentary behaviors are related to energy drinks.

Executive functions and eating behavior: Commentary on Steegers et al. (2021)

Alterations in executive functions have repeatedly been found in individuals suffering from eating and weight disorders. However, less is known about how these cognitive processes might contribute to the etiology of the disorders, as large prospective population-based studies have been missing. Here, we comment on the results of Steegers et al. (2021), a study that helped to fill this gap with a focus on set-shifting abilities predicting symptoms of anorexia nervosa (AN) in children. The main goal of this commentary is to encourage further interpretation of the population-based data beyond its relevance to AN. More specifically, we discuss the role of impaired inhibition as a risk factor for weight gain and obesity.

Adolescents' proxy reports on obesity-related parenting practices: factorial validity and reliability across four behavioral domains

Background

Adolescents’ energy balance behaviors are precursors to obesity shaped by the practices or strategies that many parents implement. Although key stakeholders to their families, adolescents are rarely considered to report on these obesity-related parenting practices. The aim of this study is to assess the factorial and predictive validity of adolescents’ proxy-report of parents’ obesity-related parenting across four behavioral domains.

Methods

This study used data from the Family Life, Activity, Sun, Health, and Eating (FLASHE) study. This study tests whether adolescents’ proxy reports about their parents’ obesity-related parenting are significantly associated with parents’ responses on their own obesity-related parenting, as well as whether these reports are significantly associated to parent-adolescent energy balance behaviors. Factorial validity was assessed using linear regression and Confirmatory Factor Analysis (CFA), whereas predictive validity was assessed using Actor-Partner Interdependence Modeling (APIM).

Results

Regression results indicated that adolescents’ proxy report is significantly associated with parents’ report of their own parenting in all four domains (β = .59—.71; p < 0.05). CFA results indicated a final factor structure that loaded significantly onto hypothesized obesity-related parenting domains (β > .30) in both adolescents and parents. APIM results indicated that both parent- (β = .32; p < 0.05) and adolescent-(β = .21; p < 0.05) reported obesity parenting for fruit and vegetable consumption were associated with their own fruit and vegetable intake. In addition, adolescent-reported physical activity parenting was significantly associated with adolescent physical activity (β = 0.23; p < 0.05). Regarding partner effects, only parent-reported parenting for fruit and vegetable consumption were significantly associated with adolescent intake of fruit and vegetables (β = 0.15, p < 0.05) and adolescent-reported physical activity parenting was significantly associated with parental physical activity (β = 0.16, p < 0.05). Neither adolescent nor parent reported parenting were significantly associated with screen time or junk food intake outcomes. Each final obesity-related parenting scale had good internal consistency (a = .74-.85).

Conclusions

We found that adolescent- and parent-reported obesity-related parenting were significantly associated, while adolescent-reported parenting were more explanatory of fruit and vegetable intake and physical activity than parent-reported parenting. These findings suggest that adolescent proxy reports may be a valid source of information on obesity-related parenting.

Nutrition in adolescent growth and development

During adolescence, growth and development are transformative and have profound consequences on an individual's health in later life, as well as the health of any potential children. The current generation of adolescents is growing up at a time of unprecedented change in food environments, whereby nutritional problems of micronutrient deficiency and food insecurity persist, and overweight and obesity are burgeoning. In a context of pervasive policy neglect, research on nutrition during adolescence specifically has been underinvested, compared with such research in other age groups, which has inhibited the development of adolescent-responsive nutritional policies. One consequence has been the absence of an integrated perspective on adolescent growth and development, and the role that nutrition plays. Through late childhood and early adolescence, nutrition has a formative role in the timing and pattern of puberty, with consequences for adult height, muscle, and fat mass accrual, as well as risk of non-communicable diseases in later life. Nutritional effects in adolescent development extend beyond musculoskeletal growth, to cardiorespiratory fitness, neurodevelopment, and immunity. High rates of early adolescent pregnancy in many countries continue to jeopardise the growth and nutrition of female adolescents, with consequences that extend to the next generation. Adolescence is a nutrition-sensitive phase for growth, in which the benefits of good nutrition extend to many other physiological systems.

Intergenerational effects of a paternal Western diet during adolescence on offspring gut microbiota, stress reactivity, and social behavior

The global consumption of highly processed, calorie-dense foods has contributed to an epidemic of overweight and obesity, along with negative consequences for metabolic dysfunction and disease susceptibility. As it becomes apparent that overweight and obesity have ripple effects through generations, understanding of the processes involved is required, in both maternal and paternal epigenetic inheritance. We focused on the patrilineal effects of a Western-style high-fat (21%) and high-sugar (34%) diet (WD) compared to control diet (CD) during adolescence and investigated F0 and F1 mice for physiological and behavioral changes. F0 males (fathers) showed increased body weight, impaired glycemic control, and decreased attractiveness to females. Paternal WD caused significant phenotypic changes in F1 offspring, including higher body weights of pups, increased Actinobacteria abundance in the gut microbiota (ascertained using 16S microbiome profiling), a food preference for WD pellets, increased male dominance and attractiveness to females, as well as decreased behavioral despair. These results collectively demonstrate the long-term intergenerational effects of a Western-style diet during paternal adolescence. The behavioral and physiological alterations in F1 offspring provide evidence of adaptive paternal programming via epigenetic inheritance. These findings have important implications for understanding paternally mediated intergenerational inheritance, and its relevance to offspring health and disease susceptibility.

Food-Focused Media Literacy for Remotely Acculturating Adolescents and Mothers: A Randomized Controlled Trial of the "JUS Media? Programme"

PURPOSE

Unhealthy eating is a major modifiable risk factor for noncommunicable diseases and obesity, and remote acculturation to U.S. culture is a recently identified cultural determinant of unhealthy eating among adolescents and families in low/middle-income countries. This small-scale randomized controlled trial evaluated the efficacy of the "JUS Media? Programme," a food-focused media literacy intervention promoting healthier eating among remotely acculturating adolescents and mothers in Jamaica.

METHODS

Gender-stratified randomization of 184 eligible early adolescents and mothers in Kingston, Jamaica (i.e., 92 dyads: M_{adolescent.age} = 12.79 years, 51% girls) determined 31 "Workshops-Only" dyads, 30 "Workshops + SMS/texting" dyads, and 31 "No-Intervention-Control" dyads. Nutrition knowledge (food group knowledge), nutrition attitudes (stage of nutritional change), and nutrition behavior (24-hour recall) were primary outcomes assessed at four time points (T1/baseline, T2, T3, T4) across 5 months using repeated measures analysis of covariances.

RESULTS

Compared to control, families in one or both intervention groups demonstrated significantly higher nutrition knowledge (T3 adolescents, T4 mothers: mean differences .79-1.08 on a 0-6 scale, 95% confidence interval [CI] .12-1.95, Cohen's ds = .438-.630); were more prepared to eat fruit daily (T3 adolescents and mothers: .36-.41 on a 1-5 scale, 95% CI .02-.77, ds = .431-.493); and were eating more cooked vegetables (T4 adolescents and T2 and T4 mothers: .20-.26 on a 0-1 scale, 95% CI -.03-.50, ds = .406-.607). Postintervention focus groups (6-month-delay) revealed major positive impacts on participants' health and lives more broadly.

CONCLUSIONS

A food-focused media literacy intervention for remotely acculturating adolescents and mothers can improve nutrition. Replication in Jamaica and extension to the Jamaican diaspora would be useful.

Odor-Taste-Texture Interactions as a Promising Strategy to Tackle Adolescent Overweight

The adolescence period is characterized by a considerable risk to weight gain due to the high consumption of food rich in sugar. A promising strategy to reduce sugar consumption may lie in exploiting the ability of our senses to interact to each other (cross-modal interactions). The aims were to investigate the cross-modal interactions and gustatory function in normal-weight and overweight adolescents. Fifty adolescents (25 overweight and 25 normal-weight) were involved. Subjects rated liking and attribute intensity in pudding samples obtained by adding vanilla aroma (0.1%; 0.3%), butter aroma (0.05%; 0.1%) or a thickener agent (1%; 1.5%) to a base formulation. The gustatory function was also measured through the “taste strips” methodology. Overweight adolescents were found to have a significantly (p < 0.001) worse ability to correctly identify all tastes. Cross-modal interactions occurred differently according to their body mass index, with a significant increase (p < 0.05) in sensory desirable characteristics (e.g., sweet and creaminess) due to aroma addition, especially in overweight subjects. Furthermore, butter aroma significantly increased hedonic responses only in overweight subjects. Tricking our senses in the way of perceiving sensory attributes could be a promising strategy to develop innovative food formulations with a reduced sugar amount, which will lead to a potential decrease in caloric intake and help to tackle the obesity epidemic.

A narrative review of reward sensitivity, rash impulsivity, and food addiction in adolescents

Adolescence represents a neurodevelopmental period characterised by heightened reward drive and weaker inhibitory control that may increase vulnerability to compulsive overconsumption of highly-palatable foods and food addiction. This narrative review aimed to summarise research investigating the presence of food addiction in adolescents and establish the role that impulsivity traits (i.e., reward sensitivity and rash impulsivity), previously linked to substance and behavioural addictions, play in contributing to food addiction in this cohort. It was found that the prevalence of food addiction was typically higher in studies that recruited adolescents who were overweight/obese or from clinical populations. Overall, impulsivity was found to be more consistently associated with food addiction, while the relationships between measures of reward sensitivity and food addiction were mixed. Findings of this review suggest trait impulsivity may contribute to food addiction in adolescents, however, further longitudinal and prospective research is recommended to confirm these findings and to investigate the potential interactive effects of reward sensitivity and rash impulsivity.

Dietary Restraint Related to Body Weight Maintenance and Neural Processing in Value-Coding Areas in Adolescents

BACKGROUND

There is an alarming increase in the obesity prevalence among children in an environment of increasing availability of preprocessed high-calorie foods. However, some people maintain a healthy weight even in such obesogenic environments. This difference in body weight management could be attributed to individual differences in dietary restraint; however, its underlying neurocognitive mechanisms in adolescents remain unclear.

OBJECTIVES

This study aimed to elucidate these neurocognitive mechanisms in adolescents by examining the relationships between dietary restraint and the food-related value-coding region located in the ventromedial prefrontal cortex (vmPFC).

METHODS

The association between dietary restraint and BMI was tested using a multilinear regression analysis in a large early adolescent cohort (n = 2554; age, 12.2 ± 0.3 years; BMI, 17.9 ± 2.5 kg/m2; 1354 boys). Further, an fMRI experiment was designed to assess the association between the vmPFC response to food images and dietary restraint in 30 adolescents (age, 17.6 ± 1.9 years; BMI, 20.7 ± 2.2 kg/m2; 13 boys). Additionally, using 54 individuals from the cohort (age, 14.5 ± 0.6 years; BMI, 18.8 ± 2.6 kg/m2; 31 boys), we assessed the association between dietary restraint and intrinsic vmPFC-related functional connectivity.

RESULTS

In the cohort, adolescents with increased dietary restraint showed a lower BMI (β = -0.38; P < 0.001; B = -0.06; SE = 0.003). The fMRI results showed a decreased vmPFC response to high-calorie food were correlated with greater dietary restraint. Moreover, there was an association of attenuated intrinsic vmPFC-related functional connectivity in the superior and middle frontal gyrus and the middle temporal gyrus with greater dietary restraint.

CONCLUSIONS

Our findings suggest that dietary restraint in adolescents could be a preventive factor for weight gain; its effect involves modulating the vmPFC, which is associated with food value coding.

Listening to the voices of adolescents for the design of strategies to promote healthy eating: an exploratory study in a Latin American country

OBJECTIVE

To explore adolescents' views about the foods they consume and to identify their ideas about strategies to encourage healthier eating habits.

DESIGN

Individual questionnaires based on open-ended questions and group discussions (6-8 participants) were used to address the objectives. Data were analysed using content analysis based on deductive-inductive coding.

SETTING

Montevideo and its metropolitan area (Uruguay, Latin America).

PARTICIPANTS

Totally, 102 adolescents (aged between 11 and 15 years, 52 % female) recruited at two educational institutions.

RESULTS

Adolescents reported frequently consuming ultra-processed products and fast food although they were perceived as bad for their health, whereas they reported an infrequent consumption of fruits and vegetables. Multifaceted strategies to promote healthy eating habits emerged from adolescents' accounts, including public awareness campaigns, nutrition education programmes, nutrition label standards and regulations, and changes in food availability and affordability.

CONCLUSIONS

Results from the present work suggest that co-creation with adolescents may be an effective way to inform the development of strategies to promote healthier eating habits. The strategies suggested by adolescents were mainly focused on behaviour change communication, who emphasised the importance of social media and the involvement of celebrities and influencers. The need for educational and communication strategies to raise awareness of the social and environmental drivers of eating patterns among adolescents was identified.

Nutritional Strategies for Childhood Obesity Prevention

BACKGROUND

Reducing the spread of obesity represents a challenge for clinicians in which obesity prevention plays a key role in achieving this purpose. The aim of this review is to analyze the nutritional interventions that can be implemented to prevent childhood obesity.

METHODS

Searching PubMed and Cochrane Library between 2019 and 2021. Further searching with no date range for articles selected for their specific relevance in the pediatric area or for their scientific relevance. A total of 871 articles were identified and 90 were included.

RESULTS

We organized the results of the selected articles into age groups, and according to the subjects targeted for interventions or to the site of interventions, reserving an in-depth analysis on specific nutritional aspects. Promotion of breastfeeding, reduction of protein content of formulated milks, and diet of the first 12-24 months, involving family and schools in interventions that promote physical activity and healthy diet, are promising strategies for reduction of the risk of obesity. To increase the efficacy of interventions, a multidimensional approach is crucial.

CONCLUSIONS

A multidimensional approach, which takes into consideration different areas of intervention, is pivotal for childhood obesity prevention. Integrated programs involving several components (nutrition and physical activity at first) at different levels (individual, family, school, and institutional) are crucial.

Developmental Changes in Food Perception and Preference

Food choices are a key determinant of dietary intake, with brain regions, such as the mesolimbic and prefrontal cortex maturing at differential rates into adulthood. More needs to be understood about developmental changes in healthy and unhealthy food perceptions and preference. We investigated how food perceptions and preference vary as a function of age and how food attributes (taste and health) impact age-related changes. One hundred thirty-nine participants (8–23 years, 60 females) completed computerized tasks to rate high-calorie and low-calorie food cues for taste, health, and liking (preference), followed by 100 binary food choices based on each participant’s ratings. Dietary self-control was considered successful when the healthier (vs. tastier) food was chosen. Self-control success ratio was the proportion of success trials over total number of choices. Beta-weights for health (β-health) and taste (β-taste) were calculated as each attribute’s influence on food preference. Adiposity measurements included BMI z-score and waist-to-height ratio (WHtR). High-calorie foods were rated more tasty and less healthy with increasing age. Older participants liked high-calorie foods more (vs. younger participants), and β-taste was associated with age. Significant age-by-WHtR interactions were observed for health and taste ratings of high-calorie foods, β-taste, and marginally for preference of high-calorie foods. Stratifying by WHtR (high, low), we found age-related increases in taste and preference ratings of high-calorie foods in the high WHtR group alone. In contrast, age-related decreases in health ratings of high-calorie foods were significant in the low WHtR group alone. Age and β-taste were significantly associated in the high WHtR group and only marginally significant with low WHtR. Although participants rated low-calorie foods as less tasty and less healthy with increasing age, there was no association between age and preference for low-calorie foods. Participants made faster food choices with increasing age regardless of WHtR, with a significant age-by-WHtR interaction on reaction time (RT). There were no age-related effects in self-control success ratio and β-health. These results suggest that individual differences in age and central adiposity play an important role in preference for high-calorie foods, and a higher importance of food tastiness in food choice may contribute to greater preference for high-calorie foods with increasing age.

Do children favor snacks and dislike vegetables? Exploring children's food preferences using drawing as a projective technique. A cross-cultural study

OBJECTIVE

To avoid the rising spread of childhood obesity and preserve resources within planetary boundaries, healthy and sustainable eating habits and the consumption of adequate amounts of fruits and vegetables should be encouraged. Children's food preference was found to be an important determinant for food choice and consumption. The aim of this study was to explore children's food preferences using drawing as a projective technique in terms of healthy and sustainable eating and compare food preference patterns in Denmark and Lithuania.

METHOD

In total 484 children, aged between 8 and 13 years old, participated in the study (147 in Denmark and 337 in Lithuania). Participants were asked to fill the food preference questionnaire and answer questions about their daily intake of fruits, vegetables, and snacks and draw their favorite meal afterward. Sociodemographic questions about children's age, gender, parents' employment, and family composition were also included in the questionnaire.

RESULTS

Fruits, vegetables, highly-processed and animal-based foods were not included in a large part of children's most preferred meal composition. Favorite meals' composition varied among children in both countries and included different products from separate food groups. Vegetables were more likely to be present in the children's favorite meals together with meat products. Girls in both countries had more expressed vegetable preferences than boys. Boys in Lithuania had a relatively more expressed preference for highly-processed foods, while Danish girls had a more expressed preference for animal-based products.

CONCLUSIONS

Children's preferences for foods such as meat and animal-based products expressed in children's drawings, might be considered as relatively positive in terms of sustainable eating. However, children's preferences and intake of fruits and vegetables should still be encouraged among young consumers. Cultural and gender differences in children's food preferences should be considered while creating interventions and marketing strategies for promoting healthy and sustainable eating among young consumers.

How do we harness adolescent values in designing health behaviour change interventions? A qualitative study

OBJECTIVES

Adolescent health behaviours do not support optimal development. Adolescents are reportedly difficult to engage in health behaviour improvement initiatives. Little is known about what adolescents value in relation to diet and physical activity or how best to target these in health interventions. This study explored adolescents' values in relation to diet and physical activity and how these values can inform health intervention design.

DESIGN

Qualitative semi-structured interviews explored adolescents' lives, what they thought about diet and physical activity and what might support them to improve their health behaviours.

METHODS

A total of 13 group interviews were conducted with 54 adolescents aged 13-14 years, of whom 49% were girls and 95% identified as White British. Participants were recruited from a non-selective secondary school in a large southern UK city. Inductive thematic analysis was used to identify key adolescent values.

RESULTS

Adolescents valued being with their friends, doing what they enjoyed and were good at; being healthy was important to them but only if achievable without compromising other things that are important to them. The need to be healthy was not aligned with adolescents' basic psychological needs, nor their strongly held priorities and values.

CONCLUSIONS

Health is not a motivating factor for adolescents; therefore, interventions designed solely to improve health are unlikely to engage them. Instead, interventions that align with the values and priorities specified by adolescents are more likely to be effective in supporting them to eat well and be more active.