Association between impulsivity, reward responsiveness and body mass index in children

Smaller subcortical volume relates to greater weight gain in girls with initially healthy weight

OBJECTIVE

Among 3614 youth who were 9 to 12 years old and initially did not have overweight or obesity (12% [n = 385] developed overweight or obesity), we examined the natural progression of weight gain and brain structure development during a 2-year period with a high risk for obesity (e.g., pre- and early adolescence) to determine the following: 1) whether variation in maturational trajectories of the brain regions contributes to weight gain; and/or 2) whether weight gain contributes to altered brain development.

METHODS

Data were gathered from the Adolescent Brain Cognitive Development (ABCD) Study. Linear mixed-effects regression models controlled for puberty, caregiver education, handedness, and intracranial volume (random effects: magnetic resonance scanner [MRI] scanner and participant). Because pubertal development occurs earlier in girls, analyses were stratified by sex.

RESULTS

For girls, but not boys, independent of puberty, greater increases in BMI were driven by smaller volumes over time in the bilateral accumbens, amygdala, hippocampus, and thalamus, right caudate and ventral diencephalon, and left pallidum (all p < 0.05).

CONCLUSIONS

The results suggest a potential phenotype for identifying obesity risk because underlying differences among regions involved in food intake were related to greater weight gain in girls, but not in boys. Importantly, 2 years of weight gain may not be sufficient to alter brain development, highlighting early puberty as a critical time to prevent negative neurological outcomes.

Sex-specific impulsivity, but not other facets of executive function, predicts fat and sugar intake two-years later amongst adolescents with a healthy weight: Findings from the ABCD study

During adolescence, processes that control food intake (executive functions [EF]) undergo extensive refinement; underlying differences in EF may explain the inability to resist overeating unhealthy foods. Yet, overeating fat and sugar also causes changes to EF and cognition but disentangling these relationships has been difficult, as previous studies included youth with obesity. Here, amongst youth initially of a healthy weight, we evaluate whether 1) sex-specific underlying variation in EF/cognition at 9/10-years-old predict fat/sugar two-years later (Y2) and 2) if these relationships are moderated by body mass index (BMI), using linear mixed effects models (controlled for puberty, caregiver education; random effect: study site). Data were leveraged from Adolescent Brain Cognitive Development Study (n = 2987; 50.4% male; 15.4% Latino/a/x; 100% healthy weight at baseline; 12.4% overweight/obese by Y2, data release 4.0). EF and cognition (e.g., inhibition, cognition, motor, memory, impulsivity) were assessed with the NIH toolbox, Rey Auditory Verbal Learning Task, Little Man Task, the BIS/BAS, and UPPS-P. A saturated fat/added sugar (kcals) composite score was extracted from the validated Kids Food Block Screener. For males, greater baseline impulsivity (e.g., Positive Urgency, Lack of Planning and Perseverance) and reward (e.g., Fun seeking, Drive) was related to greater Y2 intake. For both sexes, greater baseline Negative Urgency and higher BMI was related to greater Y2 intake. No other relationships were observed. Our findings highlight a phenotype that may be more at risk for weight gain due to overconsumption of fat/sugar. Thus, prevention efforts may wish to focus on impulsive tendencies for these foods.

Triangulating causality between childhood obesity and neurobehavior: Behavioral genetic and longitudinal evidence

Childhood obesity is a serious health concern that is not yet fully understood. Previous research has linked obesity with neurobehavioral factors such as behavior, cognition, and brain morphology. The causal directions of these relationships remain mostly untested. We filled this gap by using the Adolescent Brain Cognitive Development study cohort comprising 11,875 children aged 9-10. First, correlations between the age- and sex-specific 95th BMI percentile (%BMIp95) and neurobehavioral measures were cross-sectionally analyzed. Effects were then aggregated by neurobehavioral domain for causal analyses. Behavioral genetic Direction of Causation modeling was used to test the direction of each relationship. Findings were validated by longitudinal cross-lagged panel modeling. %BMIp95 correlated with impulsivity, motivation, psychopathology, eating behavior, and cognitive tests (executive functioning, language, memory, perception, working memory). Greater %BMIp95 was also associated with reduced cortical thickness in frontal and temporal brain areas but with increased thickness in parietal and occipital areas. Similar although weaker patterns emerged for cortical surface area and volume. Behavioral genetic modeling suggested causal effects of %BMIp95 on eating behavior (β = 0.26), cognition (β = 0.05), cortical thickness (β = 0.15), and cortical surface area (β = 0.07). Personality/psychopathology (β = 0.09) and eating behavior (β = 0.16) appeared to influence %BMIp95. Longitudinal evidence broadly supported these findings. Results regarding cortical volume were inconsistent. Results supported causal effects of obesity on brain functioning and morphology. The present study highlights the importance of physical health for brain development and may inform interventions aimed at preventing or reducing pediatric obesity. RESEARCH HIGHLIGHTS: A continuous measure related to obesity, %BMIp95, has correlations with various measures of brain functioning and structure Behavioral genetic and longitudinal modeling suggest causal links from personality, psychopathology, and eating behavior to %BMIp95 Results also indicate directional links from %BMIp95 to eating behavior, cognition, cortical thickness, and cortical surface area Obesity may play a role for healthy brain development during childhood.

Variation in executive function relates to BMI increases in youth who were initially of a healthy weight in the ABCD Study

OBJECTIVE

The study aim was to determine whether (A) differences in executive function (EF) and cognition precede weight gain or (B) weight gain causes changes to EF and cognition.

METHODS

Data were gathered from the Adolescent Brain Cognitive Development (ABCD) Study (release 4.0; ages 9-12 years old [N = 2794]; 100% had healthy weight at baseline [i.e., 9/10 years old], 12.4% had unhealthy weight by ages 11/12 years). EF and cognition were assessed across several domains (e.g., impulsivity, inhibitory control, processing speed, memory); BMI was calculated from height and weight. Nested random-effects mixed models examined (A) BMI ~ EF × Time (i.e., variation in EF/cognition precedes weight gain) and (B) EF ~ BMI × Time (weight gain causes changes to EF/cognition) and controlled for sex, puberty, and caregiver education; random effects were site and subject.

RESULTS

Variation in impulsivity, memory, learning, and processing speed was associated with greater increases in BMI trajectories from 9 to 12 years old. Weight gain was associated with a decrease in inhibitory control, but no other associations were observed.

CONCLUSIONS

Underlying variation in EF and cognition may be important for weight gain, but 2 years of weight gain may not be enough to have clinical implications for EF and cognition beyond inhibitory control. These findings suggest that more attention should be paid to the inclusion of EF programs in obesity prevention efforts.

Child-reported vegetable neophobia is associated with risk avoidance for distaste in children aged 4-15 years

Children who are food neophobic and/or picky eaters often refuse intake of especially fruits and vegetables, thereby narrowing their dietary variety and impairing the quality of their food intake. In this preregistered study, we investigated whether picky eating and food neophobia are related to bitter taste sensitivity (PROP taster status) and risk avoidance for distaste. A total of 367 children (201 girls; M age = 8.7 years, range: 4-15 years) participated in the study. They completed the vegetable neophobia subscale of the fruit and vegetable neophobia instrument (FVNI). A caregiver completed the child food rejection scale (CFRS), a parent-report measure of food neophobia and picky eating. Children's bitter taste sensitivity was measured with a PROP (6-n-propylthiouracil) taste strip, and the children completed a modified Children's Gambling Task (Candy Gambling Game) to measure risk avoidance for distaste. In this task, children could select cards from a risky deck (chance of winning two tasty cherry-flavoured jelly beans, but also the risk of getting a distasteful soap-flavoured jelly bean) or a safe deck (chance of winning one tasty jelly bean or no jelly bean). The results show that picky eating and food neophobia (either parent- or self-reported) are not related to PROP taster status. However, children who self-reported higher levels of vegetable neophobia showed less risky choice behaviour in the Candy Gambling Game, although this relationship was not found with parent-reported food neophobia. We conclude that risk avoidance for distaste, but not taste function, is associated with children's self-reported food rejection tendencies. To broaden the food repertoire of children high in food neophobia, it might be useful to reduce the perceived risk of distaste, when introducing a novel food or meal.

Comparison of behavioral activation/inhibition systems, emotional regulation difficulties, and selective attention in adolescents with and without parents

Existing literature has established a relationship between adverse childhood experiences and negative outcomes in cognitive and affective functioning. However, further research is needed to thoroughly understand and validate these findings. In this regard, the current study aimed to compare behavioral activation/inhibition systems, emotional regulation difficulties, and selective attention in adolescents with and without parents. A sample of 70 adolescents (M age = 16.36, SD = 1.09, 48.57% female) with caretakers from schools and 55 parentless adolescents (M age = 16.58, SD = 1.28, 52.00% female) from orphanage centers in Tehran were recruited and completed the measures tapping behavioral activation/inhibition systems, emotion dysregulation difficulties, and selective attention. The results revealed that parentless adolescents exhibited significantly higher levels of behavioral activation/inhibition scores, emotion regulation difficulties, and impaired selective attention. These findings suggest that the absence of parents during the early years of life may have detrimental effects on behavioral inhibition and activation systems, emotional regulation abilities, and selective attention capabilities. The implications of these findings are further discussed.

Facets of impulsivity and reward in relation to binge-eating disorder course of illness among children: findings from the Adolescent Brain Cognitive Development study

BACKGROUND

The present study examined facets of impulsivity and reward sensitivity [as measured by the UPPS-P Impulsive Behavior Scale and Behavioral Activation and Behavioral Inhibition Scales (BIS/BAS)] as multivariable predictors of subsequent binge-eating disorder (BED) course of illness in middle childhood.

METHODS

The current sample included children aged 9-10 years (N = 9,438) who took part in the baseline and 1-year follow-up assessments of the Adolescent Brain Cognitive Development (ABCD) study. BED course was operationalized as those who never developed BED or subthreshold BED (SBED) ('control'), were diagnosed with BED/SBED at year 1 but not baseline ('developers'), were diagnosed with BED/SBED at baseline but not year 1 ('remitters'), or were diagnosed with BED/SBED at both times ('maintainers').

RESULTS

Higher baseline BIS/BAS reward responsivity scores were related to the greater likelihood of belonging to the maintainer group relative to the control and remitter groups (ORs1.12-1.19). Regarding covariates, higher baseline body mass index percentile and internalizing symptoms were related to the greater likelihood of BED development, remittance, and maintenance compared to the control group (ORs = 1.04-1.14); no variables were uniquely related to BED development. Exploratory analyses showed that the likelihood of belonging to the maintainer group compared to the control group was greatest at higher levels of negative urgency in combination with high reward responsivity.

CONCLUSIONS

Heightened reward responsivity may convey risk for poorer BED course in children, while emotional disorder symptomatology may act as a more general risk and maintenance factor for BED.

Weight status impacts children's incidental statistical learning

The expanding literature investigating the cognitive effects of childhood weight status has not included examinations of incidental statistical learning, the process by which children unintentionally acquire knowledge about patterns in their environments, despite evidence that it underlies many higher-level information processing capabilities. In the present study, we measured event-related potentials (ERPs) while school-aged participants completed a variation of an oddball task in which stimuli predicted the appearance of a target. Children were asked to respond to the target but were not given any information about the existence of predictive dependencies. We found that children with a healthy weight status had larger P3 amplitudes in response to the predictors that were most meaningful in completing the task, a finding that may suggest optimized learning mechanisms influenced by weight status. These findings offer an important first step to understanding how healthy lifestyle factors may influence incidental statistical learning.

Excess BMI in early adolescence adversely impacts maturating functional circuits supporting high-level cognition and their structural correlates

BACKGROUND/OBJECTIVES

Adverse effects of excess BMI (affecting 1 in 5 children in the US) on brain circuits during neurodevelopmentally vulnerable periods are incompletely understood. This study investigated BMI-related alterations in maturating functional networks and their underlying brain structures, and high-level cognition in early adolescence.

SUBJECTS/METHODS

Cross-sectional resting-state fMRI, structural sMRI, neurocognitive task scores, and BMI from 4922 youth [median (IQR) age = 120.0 (13.0) months, 2572 females (52.25%)] from the Adolescent Brain Cognitive Development (ABCD) cohort were analyzed. Comprehensive topological and morphometric network properties were estimated from fMRI and sMRI, respectively. Cross-validated linear regression models assessed correlations with BMI. Results were reproduced across multiple fMRI datasets.

RESULTS

Almost 30% of youth had excess BMI, including 736 (15.0%) with overweight and 672 (13.7%) with obesity, and statistically more Black and Hispanic compared to white, Asian and non-Hispanic youth (p < 0.01). Those with obesity or overweight were less physically active, slept less than recommended, snored more frequently, and spent more time using an electronic device (p < 0.01). They also had lower topological efficiency, resilience, connectivity, connectedness and clustering in Default-Mode, dorsal attention, salience, control, limbic, and reward networks (p ≤ 0.04, Cohen's d: 0.07-0.39). Lower cortico-thalamic efficiency and connectivity were estimated only in youth with obesity (p < 0.01, Cohen's d: 0.09-0.19). Both groups had lower cortical thickness, volume and white matter intensity in these networks' constituent structures, particularly anterior cingulate, entorhinal, prefrontal, and lateral occipital cortices (p < 0.01, Cohen's d: 0.12-0.30), which also mediated inverse relationships between BMI and regional functional topologies. Youth with obesity or overweight had lower scores in a task measuring fluid reasoning - a core aspect of cognitive function, which were partially correlated with topological changes (p ≤ 0.04).

CONCLUSIONS

Excess BMI in early adolescence may be associated with profound aberrant topological alterations in maturating functional circuits and underdeveloped brain structures that adversely impact core aspects of cognitive function.

Computational mechanisms underpinning greater exploratory behaviour in excess weight relative to healthy weight adolescents

Obesity in adolescence is associated with cognitive changes that lead to difficulties in shifting unhealthy habits in favour of alternative healthy behaviours, similar to addictive behaviours. An outstanding question is whether this shift in goal-directed behaviour is driven by over-exploitation or over-exploration of rewarding outcomes. Here, we addressed this question by comparing explore/exploit behaviour on the Iowa Gambling Task in 43 adolescents with excess weight against 38 adolescents with healthy weight. We computationally modelled both exploitation behaviour (e.g., reinforcement sensitivity and inverse decay parameters), and explorative behaviour (e.g., maximum directed exploration value). We found that overall, adolescents with excess weight displayed more behavioural exploration than their healthy-weight counterparts - specifically, demonstrating greater overall switching behaviour. Computational models revealed that this behaviour was driven by a higher maximum directed exploration value in the excess-weight group (U = 520.00, p = .005, BF₁₀ = 5.11). Importantly, however, we found substantial evidence that groups did not differ in reinforcement sensitivity (U = 867.00, p = .641, BF₁₀ = 0.30). Overall, our study demonstrates a preference for exploratory behaviour in adolescents with excess weight, independent of sensitivity to reward. This pattern could potentially underpin an intrinsic desire to explore energy-dense unhealthy foods - an as-yet untapped mechanism that could be targeted in future treatments of obesity in adolescents.

Influence of Executive Function Training on BMI, Food Choice, and Cognition in Children with Obesity: Results from the TOuCH Study

BACKGROUND

Children with obesity have a higher risk of future health and psychological problems. Executive functions (EFs) play a key role in successful dietetic and exercise planning; therefore, new treatments aimed at improving EFs may optimize outcomes.

OBJECTIVES

This study evaluates the impact of EF training on body mass index (BMI), food choice, and cognition in children with obesity. We also examine their real-life executive functioning, emotional state, and quality of life.

METHODS

Randomized controlled double-blind trial. Forty-six children with obesity were randomly allocated into an executive functions training or a control task training group and attended 30-45 min of daily training (5/week over 6 weeks), with both groups receiving counseling on diet and wearing an activity/sleep tracker. Participants were evaluated at baseline and after treatment.

RESULTS

BMI decreased over time in the whole sample, although there were no differences between groups at post-training in BMI, food choice, and cognition. Both groups showed significant improvements in attention, speed, cognitive flexibility, and inhibitory control. Additionally, there were some benefits in real-life executive functioning and self-esteem. Over the 6 weeks, participants showed worse food choices in both groups.

CONCLUSIONS

EFs training showed a lack of significant effects. The executive function enhancement alone did not explain these changes, as there were no significant differences between the experimental groups. It might be that the control task training could also produce some benefits, and multi-component interventions might be useful for weight loss.

Impulsivity and reward sensitivity facets as predictors of weight change in children: Differences by binge-eating disorder diagnostic status

BACKGROUND

Impulsivity and reward sensitivity are personality traits associated with obesity and binge-eating disorder (BED), but little research has examined prospective associations between these traits and body mass index z-score (BMI-z) differentially for children with and without BED.

OBJECTIVE

Using data from the Adolescent Brain and Cognitive Development study, the present analysis examined predictive associations between impulsivity and reward sensitivity facets with BMI-z 1 year later in children with versus without BED.

METHODS

Nine-to-ten-year-old children were recruited across the United States and completed self-report questionnaires and clinical interviews at baseline, and height and weight were taken at baseline and 1-year follow-up. Multivariable models were run with baseline impulsivity and reward sensitivity facets predicting 1-year BMI-z in children with versus without BED.

RESULTS

Reward sensitivity and impulsivity were unrelated to BMI-z at follow-up in children without BED. Greater negative urgency (i.e., proclivity to act rashly without forethought in response to negative emotions) and lower positive urgency (i.e., proclivity to act rashly without forethought due to positive emotions) predicted increased BMI-z at 1-year follow-up in children with BED subsample.

CONCLUSIONS

Findings indicate the importance of developing theoretical models and interventions for obesity prevention in children with BED that address emotional impulsivity.

The Mediation Role of Health Behaviors in the Association between Self-Regulation and Weight Status among Preschool Children: A Sex-Specific Analysis

Previous studies have supported the link between children’s self-regulation (CSR) and weight status, but the potential pathways have not been elucidated yet. We aimed to investigate whether and to what extent health behaviors mediate this association, as well as to explore the sex effect. For this study, we recruited 3740 preschoolers in Wuhan, China. The height and weight of children were measured, and a body mass index of the ≥85th percentile was defined as overweight/obesity (OWO). We used the Children’s Behavior Questionnaire, with measured domains including inhibitory control, impulsivity, anger, and attentional focusing, to assess CSR. The primary caregivers’ SR (PSR) was assessed with the Self-Control Scale. Information on lifestyles collected from questionnaires was utilized to construct the health behavior index (HBI). We found that Children’s HBI was associated with both CSR and PSR, inhibitory control (OR = 0.81, p < 0.001), anger (OR = 1.23, p < 0.001), attentional focusing (OR = 0.70, p < 0.001), impulsivity (OR = 1.23, p < 0.001), and PSR (OR = 0.73, p < 0.001). Children’s impulsivity was associated with their OWO (OR = 1.11, p = 0.013) which was partly mediated by the HBI (direct effect: β = 0.092, p = 0.026; indirect effect: β = 0.011, p = 0.007). The sex-specific analysis indicated that this mediation effect was only significant in boys. These results indicated that impulsivity is associated with childhood weight status, which is partially mediated by health behaviors, especially in boys.

Taste of Fat and Obesity: Different Hypotheses and Our Point of View

Obesity results from a temporary or prolonged positive energy balance due to an alteration in the homeostatic feedback of energy balance. Food, with its discriminative and hedonic qualities, is a key element of reward-based energy intake. An alteration in the brain reward system for highly palatable energy-rich foods, comprised of fat and carbohydrates, could be one of the main factors involved in the development of obesity by increasing the attractiveness and consumption of fat-rich foods. This would induce, in turn, a decrease in the taste of fat. A better understanding of the altered reward system in obesity may open the door to a new era for the diagnosis, management and treatment of this disease.

Interactions among Reward Sensitivity and Fast-Food Access on Healthy Eating Index Scores in Adolescents: A Cross-Sectional Study

Food cues in the environment may contribute to obesity as the consumption of unhealthy foods may reinforce reward pathways in the brain. To understand how person-level differences in reward sensitivity may be associated with diet quality, this study aimed to examine the moderating role of the availability of fast food in the environment on the relationship between reward sensitivity and diet quality in adolescents. Participants (n = 152; 55% female; Mage: 12.5 ± 0.93 y) completed the drive and reward subscales of the Behavioral Inhibition System (BIS)/Behavioral Activation System (BAS) Scale to assess reward sensitivity and completed two 24 h dietary recalls from which Healthy Eating Index (HEI) scores (total score and subscales of adequacy and moderation) were calculated. Fast-food environment (FFE) was operationalized as the total number of fast-food outlets within 1 km around participants' home address. Linear regressions were used to examine the main effects and interactions between reward sensitivity and FFE in relation to HEI score. Interactions were found between FFE and BAS drive (p = 0.02) and BAS reward (p < 0.01) on HEI adequacy. There were no interaction effects on HEI moderation or HEI total scores. For individuals who had lower access exposure to fast-food outlets (-1 SD), there was a stronger positive association between higher BAS drive (t = 2.85, p = 0.01, 95% CI (0.35, 1.94)) and HEI adequacy scores and between higher BAS reward (t = 3.27, p > 0.01, 95% CI (0.72, 2.93)) and HEI adequacy scores. By examining reward sensitivity to potential food cues in residential neighborhood food environments, it is possible to understand which adolescents are more sensitive to environmental food cues and implement interventions to buffer these influences.

Randomized controlled trials of self-monitoring interventions with or without incentives for diet and exercise among individuals with overweight or obesity: Psychological and behavioural effects

OBJECTIVES

To test the effects of three behavioural interventions (daily monetary incentives + self-monitoring, delayed lump sum monetary incentives + self-monitoring, and self-monitoring only) on psychological constructs and fruit and vegetable consumption or physical activity behaviour change among a sample of adults with overweight or obesity.

DESIGN

A pair of 3-arm longitudinal randomized controlled trials compared daily monetary incentives + self-monitoring, delayed lump sum monetary incentives + self-monitoring, and self-monitoring only interventions for either fruit and vegetable consumption or physical activity.

METHODS

Individuals reporting elevated weight status and insufficient engagement in one of the target behaviours were randomly assigned to one of three 3-week interventions. All three interventions involved daily self-monitoring of the behaviour, and two provided monetary incentives contingent upon reported behaviour. Participants completed measures of psychological constructs and reported behaviour at baseline, the end of the intervention, and two and four weeks post-intervention.

RESULTS

Participants across all three intervention conditions demonstrated increased engagement in the target behaviour from pre- to post-intervention and reported behaviour remained above baseline levels at both follow-up time points. Increases in reported behaviour during the intervention were associated with increases in self-efficacy, and this enhanced self-efficacy prospectively predicted sustained reported behaviour at follow-up. However, contrary to hypotheses, the incentive interventions including self-monitoring were not more efficacious than self-monitoring alone, and increased reported behaviour was not associated with enhancements in attitudes.

CONCLUSIONS

Self-monitoring interventions can aid behaviour change efforts, and behavioural practice during these interventions can increase self-efficacy. However, among adults with overweight or obesity who are seeking behaviour change interventions, incentive-based self-monitoring approaches may not be superior to self-monitoring alone in driving behaviour change and maintenance.

Associations between objective physical activity and emotional eating among adiposity-discordant siblings using ecological momentary assessment and accelerometers

BACKGROUND

Emotional eating is associated with obesity, though less is known regarding factors that predict emotional eating episodes in children and adolescents.

OBJECTIVES

To investigate whether moderate to vigorous physical activity (MVPA) or total activity counts 60 minutes prior to psychological stress predicted stress-related eating and positive emotional eating (ie, eating while happy), and whether adiposity (z-BMI) moderated these associations.

METHODS

Participants were drawn from a prior study of siblings (N = 77; mean age = 15.4 ± 1.4 years) discordant for weight status (39 non-overweight siblings, 38 siblings with overweight/obesity) who completed an ecological momentary assessment protocol with accelerometer-based assessment of physical activity.

RESULTS

Greater MVPA was associated with lower stress-related eating across the sample. Lower total activity (between-person effects) and lower MVPA (within-person effects) were associated with greater stress-related eating for siblings with greater z-BMI. Greater total activity was associated with lower positive emotional eating for siblings with lower z-BMI (between- and within-person).

CONCLUSIONS

Findings demonstrate potential regulating effects of prior physical activity on emotional eating at the individual and momentary level, though there are nuances depending on z-BMI. Future work is needed to examine underlying mechanisms and timescale of effects, and particularly the extent to which enhancing MVPA time among youth with z-BMI may mitigate momentary risk of stress-related eating episodes.

Interactions of approach motivation and self-regulation in relation to obesity in children

BACKGROUND

Motivation and self-regulation are two psychological systems that have been shown to be related to childhood obesity.

OBJECTIVE

This study evaluated independent and interactive associations of approach-oriented motivation (i.e., drive and reward responsiveness) and self-regulation (i.e., self-control and behavioral regulation) in relation to age- and sex-adjusted body mass index-z scores (BMI-z) in children.

METHODS

Children (55% female; M_age = 12.5 years ± .93) completed questionnaires assessing motivation and self-regulation, and anthropometric measurements were taken by research staff cross-sectionally.

RESULTS

Regressions revealed no independent associations of approach motivation or self-regulation and BMI-z. There were interactions between the drive facet of approach motivation, which assesses motivation to follow goals, and self-regulation in relation to BMI-z. Children with lower motivation to follow goals and lower self-regulation had higher BMI-z, and children with lower motivation to follow goals and higher self-regulation had lower BMI-z. Children with higher motivation to follow goals had similar BMI-z at all levels of self-regulation.

CONCLUSION

For children with low motivation to follow goals, self-regulation may be an important buffer of high BMI-z.

LEVEL OF EVIDENCE

Level V: cross-sectional descriptive study.

Does temperament make children differently susceptible to their home physical food environment? A cross-sectional DAGIS study on 3-6 year old Finnish children's food consumption

Consistently linked with children's food consumption are food availability and accessibility. However, less is known about potential individual differences among young children in their susceptibility to home food environments. The purpose of the study was to examine whether the association between home food availability and accessibility of sugar-rich foods and drinks (SFD) or fruits and vegetables (FV) and children's consumption of these foods differ according to their temperament. The study used two cross-sectional datasets collected as part of the Increased Health and Wellbeing in Preschools (DAGIS) study: 1) a cross-sectional data of 864 children aged 3-6 years old collected between fall 2015 and spring 2016, and 2) an intervention baseline data of 802 children aged 3-6 collected in fall 2017. Parents reported their children's temperament, consumption of FV and SFD, and home availability and accessibility of SFD and FV. Examination of whether associations between home availability and accessibility of FV and their consumption differ according to children's temperament involved using linear regression models. Similar models were used to examine association between home availability and accessibility of SFD and their consumption, and the moderating role of temperament. The association between home accessibility of SFD and their consumption frequency was dependent on the level of children's negative affectivity. More frequent consumption of SFD was observed with higher home accessibility of SFD. The association was stronger in children with higher scores in negative affectivity. No other interactions were found. Children with higher negative affectivity are possibly more vulnerable to food cues in the home environment than children with lower negative affectivity. Consideration of children's individual characteristics is necessary in supporting their healthy eating.

Gray matter volumetric correlates of behavioral activation and inhibition system traits in children: An exploratory voxel-based morphometry study of the ABCD project data

Approach and avoidance represent two fundamental behavioral traits that develop early in life. Previous studies have examined the neural correlates of approach and avoidance traits in adults and adolescents. Here, using the data set of the Adolescent Brain Cognition Development project, we investigated the structural cerebral bases of behavioral activation system (BAS) and behavioral inhibition system (BIS) in children. We employed voxel-based morphometry to examine how gray matter volumes (GMV) related specifically to BAS and BIS traits in 11,542 children (5491 girls, age 9-10 years) with 648 and 2697 identified as monozygotic twins (MZ) and dizygotic twins/siblings (DZ), respectively. After accounting for the BIS score, higher BAS scores (residuals) were positively correlated with the GMV of the ventral striatum (VS), and the correlation was stronger in MZ than in DZ and unrelated children, with a heritability (h²) of 0.8463. Higher BAS scores were negatively correlated with the GMV of bilateral visual, lateral orbitofrontal, temporal, and inferior frontal cortex, as well as the precuneus. Higher BIS (after accounting for BAS) scores were negatively correlated with the GMVs of the ventral caudate and bilateral putamen/pallidum, hypothalamus, and right anterior insula, and the correlation was stronger in MZ than in DZ and unrelated children, with a heritability of 0.8848. A cluster in the VS showed positive and negative correlation with the BAS and BIS scores, respectively. These findings suggest shared and distinct cerebral volumetric bases of the BAS and BIS traits in children. Whereas both traits have a strong genetic basis, the BAS relative to BIS appears to be more amenable to environmental influences. These findings add to the literature of developmental neuroscience and may help identify genetic risk factors of externalizing and internalizing psychopathology.

Common etiological architecture underlying reward responsiveness, externally driven eating behaviors, and BMI in childhood: findings from the Gemini twin cohort

BACKGROUND

Studies have reported that impulsivity predicts childhood BMI and that the association is mediated by eating behaviors. One aspect of impulsivity-potentially crucial in the obesity context-is reward responsiveness, which may predispose to responsiveness to palatable food cues. The behavioral susceptibility theory hypothesizes that genetic susceptibility to obesity operates partly via genetically determined differences in appetite regulation. Reward responsiveness may therefore be one of the neuro-endophenotypes that mediates genetic susceptibility to obesity.

OBJECTIVE

To test whether reward responsiveness, eating behaviors, and child BMI share common genetic architecture.

METHODS

We examined reward responsiveness, eating behaviors, and BMI in 5-year-old children from Gemini, a UK birth cohort of 2402 twin pairs born in 2007. All measures were collected by parent report. Reward responsiveness was derived from the Behavioral Approach System. Compulsion to eat and eating for pleasure was measured with the "food responsiveness" scale of the Child Eating Behavior Questionnaire. Wanting to eat in response to environmental food cues was measured with the "external eating" scale of the Dutch Eating Behavior Questionnaire. Maximum-likelihood structural equation modeling was used to establish underlying common genetic and environmental influences.

RESULTS

There were significant positive phenotypic correlations between all traits except for reward responsiveness and BMI. Genetic factors explained the majority of the association between food responsiveness and external eating (74%, 95% CI: 61, 87), whereas common shared environmental factors explained the majority of the associations between reward responsiveness with both food responsiveness (55%, 95% CI: 20, 90) and external eating (70%, 95% CI: 39, 100).

CONCLUSIONS

Our study demonstrates the importance of common environmental factors in the shared etiology between reward responsiveness and childhood eating behaviors. However, the common etiology underlying both reward responsiveness and BMI is unclear, as there was no phenotypic correlation between reward responsiveness and BMI at this age. Further longitudinal research needs to detangle this complex relationship throughout development.

Resting and Functional Pupil Response Metrics Indicate Features of Reward Sensitivity and ASD in Children

The current study examined the relationship between quantitative measures of reward and punishment sensitivity, features of autism spectrum disorder (ASD), and resting and functional pupil response metrics across a clinically heterogeneous sample. Scores on a parent-report measure of punishment and reward sensitivity were correlated with ASD features. We also assessed whether pupil measurements could be used as a physiologic correlate of reward sensitivity and predictor of ASD diagnosis. In a logistic regression model, pupil dilation metrics, sex, and IQ, correctly classified 86.3% of participants as having an ASD diagnosis versus not. This research highlights individual differences of reward sensitivity associated with ASD features. Results support the use of pupil metrics and other patient-level variables as predictors of ASD diagnostic status.

The role of reward sensitivity in obesity and its association with Transcription Factor AP-2B: A longitudinal birth cohort study

OBJECTIVE

One factor potentially contributing to obesity is reward sensitivity. We investigated the association between reward sensitivity and measures of obesity from 9-33 years of age, paying attention to the inner structure of reward sensitivity.

METHODS

The sample included both birth cohorts (originally n = 1176) of the Estonian Children Personality Behaviour and Health Study. The association between reward sensitivity and measures of obesity was assessed using mixed-effects regression models. Associations at ages 9 (younger cohort only), 15, 18, 25 and 33 (older cohort) years were analyzed by one-way ANOVA. The indirect effect of the gene encoding transcription factor 2 beta (TFAP2B) on obesity through reward sensitivity was tested using mediation analysis.

RESULTS

According to linear mixed effects regression models, an increase in scores of Insatiability by Reward and both of its components, Excessive Spending and Giving in to Cravings, significantly increased body weight, body mass index, sum of five skinfolds, waist circumference, hip circumference and waist-to-height ratio from 15 to 25 years of age. Findings were similar at age 9 and 33 years. In contrast, no association between obesity and Openness to Rewards or its facets was observed. The TFAP2B genotype was also associated with fixation to rewards in females, but not with striving towards reward multiplicity.

CONCLUSION

Our results suggest that reward sensitivity is associated with obesity by its reward fixation component. The heterogeneity of the reward sensitivity construct should be taken into account in studies on body composition.

Initial Responsiveness to Reward Attainment and Psychopathology in Children and Adults: An RDoC Study

The Research Domain Criteria (RDoC) initiative of the National Institute of Mental Health (NIMH) established a dimensional framework for understanding psychiatric constructs. Initial Responsiveness to Reward Attainment (IRRA) was identified as a dimensional construct relevant to several psychiatric disorders. The current study aimed to (1) examine IRRA as a predictor of psychopathology and impairment in children and their parents, and (2) examine the potential effects of sex and ancestry on the relationship between IRRA and psychopathology. Participants included 1127 children ages 6 to 12, and 1018 of their parents. Parents and children completed self-report measures of IRRA. Psychopathology and impairment were measured using self-report for adults, and parent-report and semi-structured interview for children. In adults, IRRA was significantly, but modestly, related to adaptive functioning. In children, IRRA was significantly, but modestly, related to overall, school, spare time, home, and peer functioning. Findings suggest IRRA may be a helpful construct for understanding adaptive functioning in adults and children, however it may be less helpful for understanding specific dimensions of psychopathology. Additionally, ancestry should be taken into consideration when examining how IRRA relates to psychopathology and functioning.

Is cognitive training an effective tool for improving cognitive function and real-life behaviour in healthy children and adolescents? A systematic review

Computerised cognitive training (CCT) has been applied to improve cognitive function in pathological conditions and in healthy populations. Studies suggest that CCT produces near-transfer effects to cognitive functions, with less evidence for far-transfer. Newer applications of CTT in adults seem to produce certain far-transfer effects by influencing eating behaviour and weight loss. However, this is more unexplored in children and adolescents. We conducted a systematic review of 16 studies with randomised controlled design to assess the impact of CCT on cognitive functioning and real-life outcomes, including eating behaviour, in children and adolescents with typical development (PROSPERO registration number: CRD42019123889). Results show near-transfer effects to working memory, with inconsistent results regarding far-transfer effects to other cognitive functions and real-life measures. Long-term effects show the same trend. Far-transfer effects occurred after cue-related inhibitory control and attentional training, although effects seem not to last. CCT may be a potential weight-loss treatment option but more research is needed to determine the specific characteristics to enhance treatment outcomes.

Individual Differences in Hippocampal Volume as a Function of BMI and Reward Sensitivity

Sensitivity to reward is a personality trait that predisposes a person to several addictive behaviors, including the presence of different risky behaviors that facilitates uncontrolled eating. However, the multifactorial nature of obesity blurs a direct relationship between the two factors. Here, we studied the brain anatomic correlates of the interaction between reward sensitivity and body mass index (BMI) to investigate whether the coexistence of high BMI and high reward sensitivity structurally alters brain areas specifically involved in the regulation of eating behavior. To achieve this aim, we acquired T1-weighted images and measured reward sensitivity using the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ) and BMI in a sample of 206 adults. Results showed that reward sensitivity and BMI were not significantly correlated. However, neuroimaging results confirmed a relationship between BMI and reduced volume in the medial and lateral orbitofrontal cortex, and between reward sensitivity and lower striatum volume. Importantly, the interaction between the two factors was significantly related to the right anterior hippocampus volume, showing that stronger reward sensitivity plus a higher BMI were associated with reduced hippocampal volume. The hippocampus is a brain structure involved in the higher-order regulation of feeding behavior. Thus, a dysfunctional hippocampus may contribute to maintaining a vicious cycle that predisposes people to obesity.

Association between impulsivity traits and body mass index at the observational and genetic epidemiology level

We investigated the association between impulsivity related traits and BMI at the observational and genetic epidemiology level in a cross-sectional population of healthy young American-European adults. We studied 998 students and university staff of European ancestry recruited from Chicago (Illinois) and Athens (Georgia). We measured 14 impulsivity variables using three broad categories: impulsive choice, action and personality. Weight and height of participants were measured by research assistants. The single-nucleotide polymorphism (SNP) rs3751812 in the fat mass and obesity-associated (FTO) gene was genotyped using the Illumina PsychArray BeadChip platform. Within the three broad domains of impulsivity, 4 parameters (delay discounting of rewards area under the curve and average of k indexes, Conner's continuous performance test, and negative urgency) were associated with BMI. The FTO rs3751812 minor allele T was associated with higher BMI. Of the 14 impulsivity variables, rs3751812 T was associated with more premeditation and perseverance, before and after adjusting for BMI. The association between FTO rs3751812 and BMI adjusted for premeditation remained significant, but disappeared after adjusting for perseverance and for both perseverance and premeditation traits. Our observational and genetic data indicate a complex pattern of association between impulsive behaviors and BMI in healthy young American-European adults.

No Differential Reward Responsivity and Drive, Punishment Sensitivity or Attention for Cues Signaling Reward or Punishment in Adolescents With Obesity

Although it has been proposed that obese and healthy weight individuals might differ in their reward and punishment sensitivity, the literature shows diverse and inconsistent findings. The current study was set out to examine the role of reward and punishment sensitivity in adolescent obesity by differentiating between reward responsivity and reward drive, and by complementing self-report measures with performance-based measures indexing attention for cues signaling reward and punishment as well as effort to approach reward and avoid punishment. Participants were adolescents aged 12-23, with obesity (n = 51, adjusted BMI [(actual BMI/Percentile 50 of BMI for age and gender) × 100) between 143 and 313%], and with a healthy weight (n = 51, adjusted BMI between 75 and 129%). Individuals with obesity did not significantly differ from adolescents with a healthy weight in reward responsivity, reward drive or attention to cues signaling reward. Further, no differences in self-reported punishment sensitivity or attention for cues signaling punishment were found between obese and healthy weight adolescents. The current study thus does not corroborate the theories that general reward and punishment sensitivity play a role in obesity.

[Impulsivity and obesity in children with Attention Deficit Hyperactivity Disorder: A clinical, neuropsychological and magnetic resonance spectroscopy exploratory study]

OBJECTIVES

Relationship between Attention Deficit Hyperactivity Disorder (ADHD) and obesity in adults and children had previously been established in research studies. Brain imaging studies pointed out the important role of the prefrontal region in both ADHD and obesity. However, the underlying link between ADHD and obesity is not well understood. The hypothesis that impulsivity could play a role has been explored in clinical studies of ADHD and Binge Eating Disorders or Loss of Control Eating, with contradictory results. Our study aims to compare children with ADHD and obesity to children with ADHD and normal weight. We propose to compare these two populations with clinical, neuropsychological and brain spectroscopy investigation, focusing specifically on impulsivity items.

METHOD

Ten children presenting overweight or obesity were selected from a larger population of children with ADHD (5-12y) and paired with regard to gender and age with ten children with ADHD and normal weight from the same population. Conners Rating scales version parents (CPRS) and teachers (CTRS), Conners' Continuous Performance Test II (CPT-II), and Magnetic Resonance Spectroscopy (MRS) metabolites in five regions of interest (left and right prefrontal, left and right striatal and left cerebellum regions) were measured for all the children. For MRS, ratio to creatinine levels of following metabolites were measured: glycerophosphocholine+phosphocholine/creatinine (GPC+PCh/Cr), glutamate+glutamine (Glu+Gln/Cr), myoinositol (mI/Cr) et N-acétylaspartate+N-acétylaspartylglutamate (NAA+NAAG/Cr).

RESULTS

Hyperactivity/Impusivity and Conners Global Index (CGI) subscales of Conners rating scales showed a higher rate of impulsivity in children with ADHD and obesity as compared to children with ADHD and normal weight. Neuropsychological results were comparable in the two groups. Finally, MRS showed a higher GPC+PCh/Cr ratio in right prefrontal cortex in children with ADHD and obesity as compared to children with ADHD and normal weight.

CONCLUSIONS

Our results are concordant with the hypothesis that impulsivity could be the link between obesity and ADHD in a population of children with ADHD. The right prefrontal regions seem to be areas of interests that need more research in the study of the link between obesity and ADHD.

Owner and Cat-Related Risk Factors for Feline Overweight or Obesity

Feline obesity is a highly prevalent disease that poses an urgent and serious challenge. Attempted treatment by weight reduction is often unsuccessful; a new preventative approach that focuses on the role of the owner may be helpful. This study used data collected from an international survey of cat owners designed to assess owner personality and self-control, owner-pet attachment, feeding practices, and the cat's body condition. Owner-reported body condition scores (BCS) of cats were assessed using images adapted from a 5-point BCS system and categorized as a binary dependent variable: overweight/obese (BCS 4-5) and not overweight (BCS 1-3). Owner-reported BCS scores using a verbal BCS scale were also used as a binary dependent variable. Of the 6,835 respondents, 30.5% described their cat as overweight/obese using the visual BCS scale, and 32.5% using the verbal scale. Multivariable logistic regression models were built using stepwise-backward selection. A total of 8 variables were significant using the visual score as the dependent variable, while 11 variables were significant using the verbal score as the dependent variable (p < 0.05). Low owner conscientiousness was associated with an increased risk of feline overweight/obesity (OR = 1.23, 95% CI 1.10-1.38), whereas preference for delayed reward was associated with a decreased risk (OR = 0.84, 95% CI 0.75-0.96). Contrary to expectation, indulgent (OR = 0.76, 95% CI 0.53-0.91) and inconsistent (OR = 0.86, 95% CI 0.76-0.93) feeding practices appeared protective. Other significant variables (p < 0.05) included cat-related factors (age, gender, housing, source) and management-related factors (dry diet, supermarket dry diet, raw diet, stealing, hunting, and measuring food with a scoop). A third multivariable analysis was performed, using results from cats classified as overweight/obese using both scoring methods, compared with cats classified as a healthy weight using both scoring methods. A total of 10 variables were found to be significant (p < 0.05). There was significant overlap of results from all three analyses. The results of this study indicate that feline obesity is a complex problem, with many contributing risk factors. It is essential to recognize the importance of owner characteristics, and that the prevention of obesity in cats may require the development of a range of interventional strategies.

Owner and Cat-Related Risk Factors for Feline Overweight or Obesity

Feline obesity is a highly prevalent disease that poses an urgent and serious challenge. Attempted treatment by weight reduction is often unsuccessful; a new preventative approach that focuses on the role of the owner may be helpful. This study used data collected from an international survey of cat owners designed to assess owner personality and self-control, owner-pet attachment, feeding practices, and the cat's body condition. Owner-reported body condition scores (BCS) of cats were assessed using images adapted from a 5-point BCS system and categorized as a binary dependent variable: overweight/obese (BCS 4-5) and not overweight (BCS 1-3). Owner-reported BCS scores using a verbal BCS scale were also used as a binary dependent variable. Of the 6,835 respondents, 30.5% described their cat as overweight/obese using the visual BCS scale, and 32.5% using the verbal scale. Multivariable logistic regression models were built using stepwise-backward selection. A total of 8 variables were significant using the visual score as the dependent variable, while 11 variables were significant using the verbal score as the dependent variable (p < 0.05). Low owner conscientiousness was associated with an increased risk of feline overweight/obesity (OR = 1.23, 95% CI 1.10-1.38), whereas preference for delayed reward was associated with a decreased risk (OR = 0.84, 95% CI 0.75-0.96). Contrary to expectation, indulgent (OR = 0.76, 95% CI 0.53-0.91) and inconsistent (OR = 0.86, 95% CI 0.76-0.93) feeding practices appeared protective. Other significant variables (p < 0.05) included cat-related factors (age, gender, housing, source) and management-related factors (dry diet, supermarket dry diet, raw diet, stealing, hunting, and measuring food with a scoop). A third multivariable analysis was performed, using results from cats classified as overweight/obese using both scoring methods, compared with cats classified as a healthy weight using both scoring methods. A total of 10 variables were found to be significant (p < 0.05). There was significant overlap of results from all three analyses. The results of this study indicate that feline obesity is a complex problem, with many contributing risk factors. It is essential to recognize the importance of owner characteristics, and that the prevention of obesity in cats may require the development of a range of interventional strategies.

Toddlers' impulsivity, inhibitory control, and maternal eating-related supervision in relation to toddler body mass index: Direct and interactive effects

Previous studies have noted that child temperament characteristics, such as aspects of self-regulation, as well as parental feeding practices contribute to children's body mass index (BMI), and have implications for identifying children who may be at risk of being overweight or obese. While studies have considered children's temperament or maternal feeding practices separately, few have considered these correlates of children's BMI jointly or in interaction in relation to children's BMI. The current study included 179 mother-child dyads participating in a longitudinal study. Information on children's impulsivity and inhibitory control was collected when children were 24 months of age. Children's tendency to emotionally overeat, maternal supervision of children's eating, and toddler and maternal BMI were assessed when children reached 30 months of age. Higher toddler impulsivity and emotional overeating, as well as maternal BMI were positively associated with toddler BMI. Inhibitory control and maternal supervision of toddler eating were not directly associated with toddler BMI. However, the main effect of toddler impulsivity was qualified by a significant interaction with maternal supervision of toddler eating. For children high in impulsivity, there was a significant negative association between maternal eating supervision and toddler BMI. For children low in impulsivity, there was a trend level (p = .059) positive relation between maternal eating supervision and toddler BMI. These findings suggest that increased maternal supervision of children's eating may be beneficial for helping children maintain a healthy BMI when they exhibit high impulsivity.

Trait-level facets of impulsivity and momentary, naturalistic eating behavior in children and adolescents with overweight/obesity

Impulsivity, and specific subdomains of inhibitory control and reward sensitivity, are trait-level factors that have been implicated in the onset and maintenance of pediatric obesity and disordered eating, but their associations with real-world eating behavior are unknown. We investigated associations of these trait-level constructs with naturalistic, momentary measures of loss of control (LOC) eating and overeating severity in a heterogeneous sample of youth (n = 40), aged 8-14y, with overweight/obesity. Self-report, parent-report, and behavioral data on trait-level impulsivity, reward sensitivity, and inhibitory control, respectively, were collected in the context of a 14-day ecological momentary assessment (EMA) protocol in which participants reported on their eating behavior, mood, hunger, and palatability of foods consumed in real-time. Generalized estimating equations revealed that more perseverative errors on a behavioral measure of visuomotor processing speed and a lower self-reported tendency to act without thinking (at a trend level) were related to greater overall LOC severity. Momentary associations between negative affect and LOC severity were stronger among individuals with greater perseverative errors. Results suggest that trait-level facets of impulsivity may directly influence an individual's tendency to engage in dysregulated eating behaviors, and may also impact susceptibility to state-level factors associated with occurrence of these behaviors. Momentary interventions for LOC eating may require tailoring to address temperamental factors related to impulsivity and inhibitory control.

Executive Control and Adolescent Health: Toward A Conceptual Framework

Executive control is a set of cognitive abilities that may impact a variety of adolescent health behaviors and outcomes; however, research on executive control as a contributor to the physical health of youth is relatively limited. Therefore, the current article explores the possible role of executive control in adolescent health by reviewing relevant literature and proposing a conceptual framework to guide future research in this area. The development of executive control from preschool through adolescence is described, with particular attention to executive control in the unique health context of adolescence. A new conceptual model is proposed, focusing on how executive control may play a critical role in supporting health in adolescence and beyond through the mechanisms of attentional, behavioral, and emotional control. Literature exploring associations between youth executive control and key health behaviors (including diet, physical activity, sleep and substance use) is reviewed. Researchers and clinicians are encouraged to consider executive control as an important cross-cutting contributor to health during adolescence and beyond and to incorporate this construct into longitudinal studies of health.

Neuropsychological and Neurophysiological Indicators of General and Food-Specific Impulsivity in Children with Overweight and Obesity: A Pilot Study

Impulsivity, particularly towards food, is a potential risk factor for increased energy intake and the development and maintenance of obesity in children. However, neuropsychological and neurophysiological indicators of general and food-specific impulsivity and their association with children's weight status are poorly understood. This pilot study examined electroencephalography (EEG) frequency band profiles during eyes-closed and eyes-open resting state in n = 12 children with overweight or obesity versus n = 22 normal-weight controls and their link to child- and parent-reported and experimentally assessed impulsivity of children (e.g., risk-taking behavior, approach-avoidance behavior towards food). The main results indicated that children with overweight/obesity versus normal weight showed significantly increased delta and decreased alpha band activity during eyes-closed resting state. Across the total sample, EEG slow-wave band activity was particularly linked to self- and parent-reported impulsivity and greater risk-taking behavior, but not to approach behavior towards food, after controlling for children's age and weight status. The identification of specific EEG patterns in children with excess weight may provide a new basis for developing neurophysiological diagnostic and treatment approaches for childhood obesity. Future studies with larger samples and longitudinal designs are needed to replicate the present findings and test their stability over time.

Impulsivity and consideration of future consequences as moderators of the association between emotional eating and body weight status

Background

Emotional eating (EmE) is characterized by an over consumption of food in response to negative emotions and is associated with an increased weight status. Consideration of Future Consequences (CFC) or a low level of impulsivity could influence the association between EmE and weight status. The objective was to analyze the moderating influence of CFC and impulsivity on the relationship between EmE and BMI.

Methods

A total of 9974 men and 39,797 women from the NutriNet-Santé cohort study completed the revised 21-item Three-Factor Eating Questionnaire to assess their EmE, the CFC questionnaire (CFC-12) to assess their level of time perspective, and the Barratt Impulsiveness Scale (BIS-11) to assess their impulsivity. Weight and height were self-reported each year over a median follow-up of 5.3 years. The associations between EmE and repeated measures of BMI were estimated by multiple linear mixed-effects regression models stratified by gender, tertiles of the CFC, or tertiles of the BIS-11, taking into account sociodemographic and lifestyle factors.

Results

Overall, EmE was positively associated with BMI. CFC and impulsivity did not moderate the effect of EmE on changes of BMI per year, but quantitatively moderated the effect of EmE on overall BMI. In women, the strength of the association between EmE and weight status increased with CFC level. Difference of BMI slopes between a low and a high level of CFC was − 0.43 kg/m² (95% CI: -0.55, − 0.30) (p < .0001). In addition, the strength of the association between emotional eating and weight status increased with impulsivity level. Difference of BMI slopes between a low and a high level of impulsivity was + 0.37 kg/m² (95% CI: 0.24, 0.51) (p < .0001). In men, only individuals with a low CFC presented a stronger association of EmE with BMI.

Conclusions

Impulsivity and consideration of future consequences moderated the association between emotional eating and body weight status. This study emphasizes the importance of taking into account psychological traits in obesity prevention.

Electronic supplementary material

The online version of this article (10.1186/s12966-018-0721-1) contains supplementary material, which is available to authorized users.

Impulsiveness in Reactive Dieters: Evidence From Delay Discounting in Orthodontic Patients

Introduction: Researchers have made efforts to distinguish the behavioral differences and underlying mechanisms that explain the various possible outcomes of dieting (success, failure and relapse). Although extensive research has demonstrated that eating behavior and individual impulsiveness are closely related to subjective appetite and decision making, very few studies have investigated how subjective and appetite impulsiveness is affected by reactive dieting. Methods: In the present study, we utilized the power of food scale (PFS) and the intertemporal choice task and to examine subjective appetite and impulsivity of decision making in orthodontic patients. As a result of their orthodontic devices and the subsequent pain and discomfort caused by eating, these patients become reactive dieters. In order to explore the dynamic influence of orthodontic treatment on appetite and impulsiveness, we collected data for both patients and control participants across three testing sections. We also computed a regression model for further exploration in explaining how potential factors contributed to different choices. Results: We found that the orthodontic group scored significantly lower in PFS than the control group, which indicated a suppression in appetite. Besides, reward and waiting time were significant factors in computational perspective. Moreover, although patients showed a bias in choosing smaller, immediate reward options, they exhibited a decrease in the delay discounting rate as treatment progressed. These findings confirm that subjective appetite and impulsiveness were inhibited due to reactive dieting.

Executive and Reward-Related Function in Pediatric Obesity: A Meta-Analysis

OBJECTIVE

This study examined the effect of pediatric obesity on executive function and reward-related decision-making, cognitive processes that are relevant to obesogenic behaviors, and evaluated their association with sample (e.g., age, gender, intelligence, and socioeconomic status, SES) and study/task (e.g., categorical/continuous variable, food stimuli) characteristics.

METHODS

A random-effects meta-analysis was conducted using Hedge's g effect sizes of published studies from 1960 to 2016, limited to children younger than the age of 21 years without medical comorbidities. Analysis included estimation of heterogeneity (τ²), publication bias (funnel-plot symmetry and fail-safe N), and sensitivity analyses for sample and study/task characteristics.

RESULTS

Across 68 studies with 70 samples, obesity was associated with worse functioning overall (-0.24; 95CI: -0.30 to -0.19; p < 0.001) and for each component process (attention, switching, inhibition, interference, working memory, reward, delay of gratification: -0.19 to -0.38; p's < 0.017), except trait impulsivity (-0.06; 95CI: -0.18 to 0.07). Deficits increased with age and female composition of the sample for inhibition (p = 0.002). No other characteristics moderated effect of obesity.

CONCLUSIONS

Small-to-moderate negative associations with obesity were observed for executive and reward-related performance, but not on reported impulsivity in studies with children younger than the age of 21 years. These results were not moderated by IQ, SES, and study/task characteristics. Age and gender moderated association with inhibition, with a larger obesity-related deficit in older and predominantly female samples. These results suggest cognitive and demographic intervention targets for prevention and mitigation of obesogenic behavior.

Impulsivity and vitamin D in bariatric surgery candidates

BACKGROUND

Obesity is recognized as a major health problem. Vitamin D is involved in maintaining energy metabolism by regulation of glucose transporters, uncoupling proteins, and normal brain function. We aimed to explore a relationship between impulsivity, eating behaviors, and 25-hydroxyvitamin D concentration in a sample of 322 bariatric surgery candidates.

METHODS

Participants completed a questionnaire on their health, eating habits and The Eating Disorders Examination-Questionnaire (EDE-Q). Impulsivity was evaluated with the Barratt Impulsiveness Scale (BIS-11). Blood samples were obtained to measure levels of 25(OH)D, lipids (cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol), and glucose.

RESULTS

Overall scores on the BIS-11, along with scores on the Attentional Subscale of the BIS were significantly higher in participants with higher frequency of snack food consumption. Scores on the Attentional Subscale of the BIS were higher in participants who self-reported eating in response to emotions. Participants who reported eating at night or declared intense emotions associated with a desire-to-eat had the highest global, attentional, and non-planning impulsivity levels. Scores on the Non-planning Subscale of the BIS-11 were elevated in participants with 25-hydroxyvitamin D concentrations lower than 10ng/ml.

CONCLUSIONS

The results suggest that the higher level of impulsivity among the patients with obesity is associated with eating habits, and support the hypothesis that vitamin D deficiency may contribute to impulsiveness.

Parenting practices and overweight status of junior high school students in China: A nationally representative study of 19,487 students from 112 schools

The study aimed to examine the level of parental responsiveness and demandingness for junior high students in China and its association with child weight status; assess if it differs by student socio-demographic characteristics; and to test the association between parenting and child physical activity. Nationally representative survey data collected from 19,487 students in 112 middle schools across China in 2013-2014 academic year were analyzed in 2016. Children's anthropometrics and perceptions of parenting practices were accessed by self-administered questionnaire. Multilevel logistic regression models were fit to test the association controlling for child age, sex, school region, and parental education. The majority of adolescents reported their parents were highly responsive in terms of emotional support and involvement (high: 64.1% vs. low: 9.2%), although more parents were not perceived as highly demanding (high: 21.4% vs. low: 35.5%). Children were more likely to be overweight or obese if their parents were highly responsive (OR=1.4 [95%CI: 1.2,1.6]) and demanding (OR=1.1 [95%CI: 1.0,1.3]) compared to those with medium parenting scores. Older children, boys, children with highly educated parents, or in urban schools had greater odds of being overweight or obese by receiving highly responsive parenting compared to their counterparts. Children with highly demanding or responsive parenting had longer physical activity duration and higher physical activity participation rates than their counterparts. High responsiveness and demandingness among Chinese parents were associated with the risk of child overweight and obesity. Further research is needed to examine the causal relationship between parenting practices and childhood obesity in China.

Interrelationships of child appetite, weight and snacking among Hispanic preschoolers

BACKGROUND

Snacking among US preschoolers has increased in recent decades, raising questions about whether snacking contributes to dietary excess.

OBJECTIVES

This research aimed to characterize snacking contributions to dietary excess and to evaluate associations with appetite and weight among preschool-aged children.

METHODS

This study is a cross-sectional, observational study of 187 Hispanic low-income preschoolers. Three 24-h dietary recalls were used to assess snacking frequency and parameters of dietary excess including energy, saturated fat, trans fats and added sugars. Parental reports of child satiety responsiveness, food responsiveness, and enjoyment of food were obtained. Child height and weight were measured.

RESULTS

Children consumed 28% (395 kcal) of daily energy from snacks eaten at 2.3 ± 1.0 occasions per day. Greater snacking frequency was associated with greater daily intakes of energy (p < 0.05) and added sugars (p < 0.001). Among overweight/obese children, higher enjoyment of food was associated with more frequent snacking and greater energy intake from snacks (p = 0.01). Inverse associations of enjoyment of food with snacking frequency and energy intake were seen among normal weight children (p < 0.05).

CONCLUSIONS

More frequent snacking among low-income Hispanic preschoolers may contribute to excessive intakes of energy and added sugars, particularly among overweight/obese children with greater motivation to eat.

Early executive control and risk for overweight and obesity in elementary school

An emerging literature suggests that poor executive control (EC) may be associated with clinical weight problems, e.g., body mass index (BMI) for age percentile ≥85 in children. However, our understanding of the impact of EC on overweight and obesity in childhood is limited by the lack of longitudinal studies spanning critical developmental periods and assessing EC using comprehensive performance-based batteries. The current study addresses these limitations in a longitudinal examination of 212 children who completed an extensive laboratory-based EC task battery in preschool (age 4 years and 6 months) and were followed through elementary school (Grades 1 through 4) with objective measures of weight status. The logistic regression results indicate that poorer EC in preschool is associated with significantly greater risk for clinical weight problems (either overweight or obese status, as defined by BMI-for-age percentile ≥ 85) in elementary school, controlling for maternal education. EC in preschool was not significantly associated with risk for obese status, specifically (defined by BMI-for-age percentile ≥ 95), but the trend was in the expected direction. The results suggest that early executive abilities are relevant for children's subsequent health status, with deficits in EC in the critical period of preschool conferring risk for later problems with weight. Based on these findings, early interventions to promote stronger EC may be a promising, yet currently overlooked, component in pediatric obesity prevention efforts.

Sensitivity for Cues Predicting Reward and Punishment in Young Women with Eating Disorders

Increasing evidence shows that sensitivity to reward (SR) and punishment (SP) may be involved in eating disorders (EDs). Most studies used self-reported positive/negative effect in rewarding/punishing situations, whereas the implied proneness to detect signals of reward/punishment is largely ignored. This pilot study used a spatial orientation task to examine transdiagnostic and interdiagnostic differences in SR/SP. Participants (14-29 years) were patients with anorexia nervosa of restricting type (AN-R, n = 20), binge/purge ED group [AN of binge/purge type and bulimia nervosa (n = 16)] and non-symptomatic individuals (n = 23). Results revealed stronger difficulties to redirect attention away from signals of rewards in AN-R compared with binge/purge EDs, and binge/purge EDs showed stronger difficulties to direct attention away from signals of punishment compared with AN-R. Findings demonstrate interdiagnostic differences and show that the spatial orientation task is sensitive for individual differences in SP/SR within the context of EDs, thereby sustaining its usefulness as behavioural measure of reinforcement sensitivity. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Mothers' self-reported grocery shopping behaviours with their 2- to 7-year-old children: relationship between feeding practices and mothers' willingness to purchase child-requested nutrient-poor, marketed foods, and fruits and vegetables

OBJECTIVE

To assess relationships between mothers' feeding practices (food as a reward, food for emotion regulation, modelling of healthy eating) and mothers' willingness to purchase child-marketed foods and fruits/vegetables (F&V) requested by their children during grocery co-shopping.

DESIGN

Cross-sectional. Mothers completed an online survey that included questions about feeding practices and willingness (i.e. intentions) to purchase child-requested foods during grocery co-shopping. Feeding practices scores were dichotomized at the median. Foods were grouped as nutrient-poor or nutrient-dense (F&V) based on national nutrition guidelines. Regression models compared mothers with above-the-median v. at-or-below-the-median feeding practices scores on their willingness to purchase child-requested food groupings, adjusting for demographic covariates.

SETTING

Participants completed an online survey generated at a public university in the USA.

SUBJECTS

Mothers (n 318) of 2- to 7-year-old children.

RESULTS

Mothers who scored above-the-median on using food as a reward were more willing to purchase nutrient-poor foods (β=0·60, P<0·0001), mothers who scored above-the-median on use of food for emotion regulation were more willing to purchase nutrient-poor foods (β=0·29, P<0·0031) and mothers who scored above-the-median on modelling of healthy eating were more willing to purchase nutrient-dense foods (β=0·22, P<0·001) than were mothers with at-or-below-the-median scores, adjusting for demographic covariates.

CONCLUSIONS

Mothers who reported using food to control children's behaviour were more willing to purchase child-requested, nutrient-poor foods. Parental feeding practices may facilitate or limit children's foods requested in grocery stores. Parent-child food consumer behaviours should be investigated as a route that may contribute to children's eating patterns.

Association between Impulsivity and Weight Status in a General Population

The objective of this study is to examine the association between impulsivity and weight status in a large sample of the adult general population in France, and the influence of gender on this relationship. A total of 11,929 men and 39,114 women participating in the NutriNet-Santé cohort were selected in this cross-sectional analysis. The Barratt Impulsiveness Scale (BIS-11) was used to assess impulsivity. Weight and height were self-reported. The association between impulsivity and BMI was estimated using logistic regressions adjusted for socio-demographic and lifestyle factors. Individuals with high impulsivity levels (BIS-11 total score >71) were more likely to be obese (Odds Ratio (OR) = 1.80, 95% Confidence Interval (CI): 1.39, 2.33 in men; OR = 1.30, 95% CI: 1.15, 1.48 in women) compared to individuals in the average range of impulsivity. The strongest associations between impulsivity and obesity were observed in men, where highly impulsive participants were more likely to be class III obese (BMI > 40 kg/m²) (OR = 3.57, 95% CI: 1.86, 6.85). This large sample analysis supports the existence of a relationship between impulsivity and weight status and the importance of psychological factors in the prevention of obesity.

Do maternal perceptions of child eating and feeding help to explain the disconnect between reported and observed feeding practices?: A follow-up study

Research demonstrates a mismatch between reported and observed maternal feeding practices. This mismatch may be explained by maternal cognitions, attitudes, and motivations relating to dyadic parent-child feeding interactions. These complex constructs may not be apparent during observations nor evidenced in self-report questionnaire. Therefore, the aim of this study was to use a qualitative approach to gain a more nuanced and contextualized understanding of (a) maternal perceptions of children's food intake control; (b) how parent-child mealtime interactions influence maternal feeding practices; and (c) ways in which mothers may promote healthy child eating and weight outcomes. Semistructured telephone interviews were conducted with 23 mothers (M = 38.4 ± 3.7 years of age) of preschool-aged children (M = 3.8 ± 0.6 years of age, 19 were normal weight, 14 were girls), who had previously completed child feeding questionnaire and participated in two home-based mealtime observations, 12 months apart. Interviews were recorded, transcribed, and themes extracted to create the database. Four major themes emerged: (a) Maternal confidence in children's ability to regulate food intake is variable; (b) Implementing strategies for nurturing healthy relationships with food beyond the dining table; (c) Fostering positive mealtime interactions is valued above the content of what children eat; and (d) Situation-specific practices and inconsistencies. Findings indicate that maternal feeding practices are shaped by both parent and child influences, and child feeding is mostly guided by controlling the family food environment, rather than by directly pressuring or restricting their child's eating. Results also highlighted the need for research to consider both parent and child influences on child feeding.