The impact of a music enrichment program during infancy and early toddlerhood on effortful control at age 3: A preliminary investigation

Effortful control (EC), a self-regulation skill, is associated with long-term developmental outcomes. Music has been associated with infant self-regulation and may be an intervention strategy for enhancing EC during toddlerhood. This investigation included 32 parent-child dyads from a previously conducted randomized controlled trial (RCT). Participants (9-15-months old at baseline) attended either a music enrichment program or a playdate control once a week for 1 year and monthly for an additional year. At age 3, participants completed snack and gift delay effortful control tasks. Groups were compared using one-way ANOVA. We found that participants in the music group had a significantly higher score during snack delay (music mean = 3.47 ± 0.94; control mean = 2.45 ± 1.51; p = 0.03; Cohen's d = 0.84). We did not find a significant group difference for latency to peek (music mean = 39.10 ± 20.10; control mean = 30.90 ± 19.88; p = 0.25; d = 0.57) or latency to touch (music mean = 105.73 ± 417.69; control mean = 98.35 ± 28.84; p = 0.38; d = 0.29) for the gift task. This study provides initial evidence that early participation in a music enrichment program may benefit later development of EC. This study is registered at ClinicalTrials.gov (NCT02936284).

Maternal Sugar-Sweetened Beverage Intakes Are Predictive of Infant Added Sugar Intakes

Objectives

To understand how a mother's dietary intakes are related to an infant's added sugar intakes.

Methods

A cross-sectional analysis on data obtained from food frequency questionnaires and three 24-h dietary recalls, respectively, pertaining to the dietary intakes of 101 mothers (age 32.6 ± 4.3 years) and their infants (age 11.8 ± 1.8 years, 44.6% male) was conducted. Pearson correlations were used to evaluate associations between a mother's total energy, macronutrient, and sugar intakes, and infant added sugar intakes. Hierarchical stepwise regressions evaluated whether maternal intakes accounted for additional variance in predicting infant added sugar intakes beyond an infant's gestational age, birthweight, breastfeeding duration, and introduction of solid foods, and a mother's education, income, BMI, parity, and age.

Results

Positive correlations were observed between infant added sugar intakes and maternal total sugar intakes (r = 0.276, p = 0.005) and sugar-sweetened beverage (SSB) intakes (r = 0.352, p < 0.001). The association between infant added sugar intakes and maternal SSB intakes remained significant after accounting for known obesity-related covariates (p = 0.005). The model with all covariates accounted for 39% of the variance in predicting infant added sugar intakes. When maternal SSB intakes were added to the model, the association remained significant and accounted for an additional 5% of variance in predicting infant added sugar intakes (F_inc (1,90) = 8.23, p = 0.01). Maternal total sugar intakes lost significance when added to the model (p = 0.06) and only accounted for 2% of additional variance.

Conclusions

Women who consume high amounts of sugar, especially from SSBs, might feed their children more added sugars during infancy.

Funding Sources

National Institute on Child Health and Human Development of the National Institutes of Health.

Reinforcer pathology: Common neural substrates for delay discounting and snack purchasing in prediabetics

Reinforcer pathology theory stipulates that individuals with both (a) high preference for smaller, immediate over larger, delayed rewards; and (b) high demand for unhealthy commodities are uniquely susceptible to poor health outcomes. Specifically, two behavioral economic tasks (delay discounting, assessing preference for smaller, immediate or larger, delayed rewards; and purchasing, assessing purchases of commodities over changes in price) have been independently associated with conditions such as overweight/obesity and problem substance use. In the present study, we examined possible shared neural regions involved in the processes of delay discounting and demand for snack foods in a prediabetic sample. Fifty-four participants completed both of these tasks. Conjunction between delay discounting and purchasing task results indicates substantial common neural substrates recruited during these two tasks, consistent with interpretations of executive control, interoception, and attention, in the prefrontal cortex, insula, and frontoparietal cortex (superior/middle frontal cortex and superior/inferior parietal lobules), respectively. Collectively, these results suggest possible neural substrates in which the two behavioral risk factors of reinforcer pathology may interact during real-world decision-making in prediabetes.

No food for thought: moderating effects of delay discounting and future time perspective on the relation between income and food insecurity

BACKGROUND

Low income is related to food insecurity, and research has suggested that a scarcity of resources associated with low income can shift attention to the present, thereby discounting the future.

OBJECTIVE

We tested whether attending to the present and discounting the future may moderate the influence of income on food insecurity.

DESIGN

Delay discounting and measures of future time perspective (Zimbardo Time Perspective Inventory, Consideration of Future Consequences Scale, time period of financial planning, and subjective probability of living to age 75 y) were studied as moderators of the relation between income and food insecurity in a diverse sample of 975 adults, 31.8% of whom experienced some degree of food insecurity.

RESULTS

Income, financial planning, subjective probability of living to age 75 y, and delay discounting predicted food insecurity as well as individuals who were high in food insecurity. Three-way interactions showed that delay discounting interacted with financial planning and income to predict food insecurity (P = 0.003). At lower levels of income, food insecurity was lowest for subjects who had good financial planning skills and did not discount the future, whereas having good financial skills and discounting the future had minimal influence on food insecurity. The same 3-way interaction was observed when high food insecurity was predicted (P = 0.008).

CONCLUSION

Because of the role of scarce resources on narrowing attention and reducing prospective thinking, research should address whether modifying future orientation may reduce food insecurity even in the face of diminishing financial resources.

Treatment outcomes of overweight children and parents in the medical home

OBJECTIVE

To test in the primary care setting the short- and long-term efficacy of a behavioral intervention that simultaneously targeted an overweight child and parent versus an information control (IC) targeting weight control only in the child.

METHODS

Two- to 5-year-old children who had BMI ≥85th percentile and an overweight parent (BMI >25 kg/m2) were randomized to Intervention or IC, both receiving diet and activity education over 12 months (13 sessions) followed by 12-month follow-up (3 sessions). Parents in the Intervention group were also targeted for weight control and received behavioral intervention. Pediatricians in 4 practices enrolled their patients with the assistance of embedded recruiters (Practice Enhancement Assistants) who assisted with treatment too.

RESULTS

A total of 96 of the 105 children randomized (Intervention n = 46; IC n = 50) started the program and had data at baseline. Children in the Intervention experienced greater reductions in percent over BMI (group × months; P = .002) and z-BMI (group × months; P < 0.001) compared with IC throughout treatment and follow-up. Greater BMI reduction was observed over time for parents in the Intervention compared with IC (P < .001) throughout treatment and follow-up. Child weight changes were correlated with parent weight changes at 12 and 24 months (r = 0.38 and 0.26; P < .001 and P = .03).

CONCLUSIONS

Concurrently targeting preschool-aged overweight and obese youth and their parents in primary care with behavioral intervention results in greater decreases in child percent over BMI, z-BMI, and parent BMI compared with IC. The difference between Intervention and IC persists after 12 months of follow-up.

Efficacy of family-based weight control program for preschool children in primary care

OBJECTIVE

To test the efficacy of an innovative family-based intervention for overweight preschool-aged children and overweight parents conducted in the primary care setting.

METHODS

Children with BMI ≥ 85th percentile and an overweight parent were randomized to intervention or information control (IC). Trained staff delivered dietary and physical/sedentary activities education to parents over 6 months (10 group meetings and 8 calls). Parents in the intervention received also behavioral modification. An intention-to-treat analysis was performed by using mixed analysis of variance models to test changes in child percent over BMI (%OBMI) and z-BMI and to explore potential moderators of group differences in treatment response.

RESULTS

Ninety-six of 105 randomized families started the program: 46 children (31 girls/15 boys) in the intervention and 50 (33 girls/17 boys) in the IC, with 33 and 39 mothers and 13 and 11 fathers in intervention and IC, respectively. Baseline characteristics did not differ between groups. Children in the intervention group had greater %OBMI and z-BMI decreases at 3 and 6 months compared with those assigned to IC (P < .0021). A greater BMI reduction over time was also observed in parents in the intervention compared with parents assigned to IC (P < .0001). Child %OBMI and parent BMI changes were correlated (r = .31; P = .003). Children with greater baseline %OBMI were more likely to have a greater %OBMI decrease over time (P = .02).

CONCLUSIONS

Concurrently targeting preschool-aged overweight youth and their overweight parents for behavioral weight control in a primary care setting reduced child %OBMI and parent BMI, with parent and child weight changes correlating.

High fluid shear stress and spatial shear stress gradients affect endothelial proliferation, survival, and alignment

Cerebral aneurysms develop near bifurcation apices, where complex hemodynamics occur: Flow impinges on the apex, accelerates into branches, then slows again distally, creating high wall shear stress (WSS) and positive and negative spatial gradients in WSS (WSSG). Endothelial responses to these kinds of high WSS hemodynamic environments are not well characterized. We examined endothelial cells (ECs) under elevated WSS and positive and negative WSSG using a flow chamber with constant-height channels to create regions of uniform WSS and converging and diverging channels to create positive and negative WSSG, respectively. Cultured bovine aortic ECs were subjected to 3.5 and 28.4 Pa with and without WSSG for 24 and 36 h. High WSS inhibited EC alignment to flow, increased EC proliferation assessed by bromodeoxyuridine incorporation, and increased apoptosis determined by terminal deoxynucleotidyl transferase dUTP-mediated nick-end labeling. These responses to high WSS were either accentuated or ameliorated by WSSG: Positive WSSG (+980 Pa/m) inhibited alignment and stimulated proliferation and apoptosis, whereas negative WSSG (-1120 Pa/m) promoted alignment and suppressed proliferation and apoptosis. These results demonstrate that ECs discriminate between positive and negative WSSG under high WSS conditions. EC responses to positive WSSG may contribute to pathogenic remodeling that occurs at bifurcations preceding aneurysm formation.

Energy intake, parental control of children's eating, and physical activity in siblings discordant for adiposity

Studying siblings discordant for adiposity allows for identifying risk factors for obesity by testing whether there is low familiality or resemblance of energy balance behaviors and then whether sibling differences in these behaviors are associated with differences in their adiposity. Nineteen sibling pairs discordant for overweight were assessed for physical activity, laboratory-based food consumption (single food, variety of foods), and parental control of child feeding behaviors. There was virtually no familiality for physical activity and energy intake during a single food meal. Sibling differences in moderate-to-vigorous physical activity (MVPA) and energy intake independently predicted differences in their adiposity. There was high familiality for increased energy intake (responsivity) when presented with a meal composed of a variety of foods, and sibling differences in responsivity did not predict sibling differences in adiposity. Parent concern and monitoring of child eating had only slight familiality and were associated with sibling differences in adiposity. In conclusion, sibling differences in MVPA and energy intake and parent concern and monitoring of child eating may promote differences in adiposity. Increased responsivity to dietary variety by overweight siblings does not appear to promoting sibling discordance in overweight as normal weight and overweight siblings responded similarly to dietary variety.

Peer influence on children's physical activity: an experience sampling study

OBJECTIVE

The primary objective was to examine the associations between social context (the presence of peers, friends, and family members) and physical activity intensity for overweight and lean girls and boys.

METHODS

Participants for this study included 10 boys (M = 13.4 years; SD = .8) and 10 girls (M = 13.8 years; SD =. 8). Twelve participants were between the 15th and the 85th BMI percentile (eight girls, four boys) and eight youth were at or above the 85th BMI percentile (six boys, two girls). Participants reported on their activity intensity and whether the activity was solitary or with others for seven consecutive days.

RESULTS

Children were more likely to report more intense physical activity when in the company of peers or close friends. Overweight children reported greater physical activity when in the presence of peers than did lean children; however, overweight children also reported more time spent alone.

CONCLUSIONS

Taken together, findings highlight the importance of considering peer relationships in studies of physical activity and childhood "obesity".

Peer influence on pre-adolescent girls’ snack intake: Effects of weight status

Although most eating occurs in a social context, the effects of peer influence on child eating have not been the object of systematic experimental study. The present study assesses the effects of peer influence on lean and overweight pre-adolescent girls' snack intake as a function of the co-eaters' weight status. The weight status of the participants was varied by studying weight discordant dyads (i.e., one lean and one overweight participant) and weight concordant dyads (i.e., both members of the dyads were either lean or overweight). Results from the random regression model indicate that overweight girls eating with an overweight peer consumed more kilocalories than overweight participants eating with a normal-weight peer. Normal-weight participants eating with overweight peers ate similar amounts as those eating with lean eating companions. The regression model improved when the partners' food intake was entered in the model, indicating that the peers' intake was a significant predictor of participants' snack consumption. This study underscores differences in responses to the social environment between overweight and non-overweight youths.

Effects of social influence on eating in couples, friends and strangers

Previous research indicates that both males and females eat less in the presence of a stranger of the opposite sex than in the presence of a same sex. Another literature shows that people tend to model or matching the amount eaten by others. The extent to which people are eager to inhibit their food consumption or match other's intake is likely to vary as a function of the characteristics of the co-eater. The present study examines how males and females adjust their level of eating as a function of their familiarity with and the gender of their eating companion, using a free-eating paradigm. Findings indicated that both the familiarity between co-eaters and the participants' gender predicted food consumption. Although unfamiliarity suppressed both men's and women's food intakes, the matching effect operated only when a female co-eater was involved. We conclude that the overarching motive (i.e., producing a positive impression) does not necessarily vary substantially across the various gender-familiarity combinations, but that the means or strategies (eating lightly and or matching of intake) by which the person accomplishes it and the strength of the motive vary as a function of the audience. In other words, in some social contexts self-enhancing motives can be served by restricting intake as well as through ingratiatory strategies such as attitudinal or behavioral conformity.

Effects of breastfeeding on weight changes in family-based pediatric obesity treatment

Research indicates that breastfeeding may provide protective effects against the development of obesity; however, breastfed children may still become obese because of the obesogenic environment. This study is designed to examine the effects of retrospective recall of breastfeeding on weight changes in children participating in a 6-month behavioral treatment program for childhood obesity. The independent variable of breastfeeding was defined as children who were exclusively breastfed for 4 weeks (excluding water or medication) versus those who were never breastfed. Child percent overweight and body mass index changes during 6 and 12 months were evaluated for 94 families based on mother report of breastfeeding status using analysis of covariance, controlling for socioeconomic status and initial child weight status. Data were compiled for secondary analysis from pediatric obesity randomized controlled outcome studies evaluating core components of family-based treatments. Results showed that, compared with nonbreastfed (formula) children (n = 28), breastfed children (n = 66) showed significantly larger reductions in (mean +/- SEM) percent overweight at 6 months (-15.2 +/- 1.1 vs -10.2 +/- 1.7, p <.05) and 1 year (-10.3 +/- 1.3 vs -5.9 +/- 1.8, p <.05). Similarly, breastfed children showed greater reductions in body mass index at 6 months (-2.1 +/- 0.19 vs -1.1 +/- 0.28) and 1 year (-0.8 +/- 0.23 vs +0.1 +/- 0.32). Findings suggest the beneficial effects of breastfeeding may extend beyond obesity prevention to include improved outcome in family-based pediatric obesity treatment. Potential mechanisms relating breastfeeding, obesity prevention, and enhanced outcome in pediatric obesity treatment are discussed.

Increasing fruit and vegetable intake and decreasing fat and sugar intake in families at risk for childhood obesity

OBJECTIVE

The goal of this study was to evaluate the effect of a parent-focused behavioral intervention on parent and child eating changes and on percentage of overweight changes in families that contain at least one obese parent and a non-obese child.

RESEARCH METHODS AND PROCEDURES

Families with obese parents and non-obese children were randomized to groups in which parents were provided a comprehensive behavioral weight-control program and were encouraged to increase fruit and vegetable intake or decrease intake of high-fat/high-sugar foods. Child materials targeted the same dietary changes as their parents without caloric restriction.

RESULTS

Changes over 1 year showed that treatment influenced targeted parent and child fruit and vegetable intake and high-fat/high-sugar intake, with the Increase Fruit and Vegetable group also decreasing their consumption of high-fat/high-sugar foods. Parents in the increased fruit and vegetable group showed significantly greater decreases in percentage of overweight than parents in the decreased high-fat/high-sugar group.

DISCUSSION

These results suggest that focusing on increasing intake of healthy foods may be a useful approach for nutritional change in obese parents and their children.

Allocation of attentional resources during habituation to food cues

Two experiments were designed to test the hypothesis that habituation to repeated food cues can be inhibited by allocating processing resources to nonfood cues. In two experiments, the salivary response to 10 presentations of lemon yogurt was assessed while subjects engaged in a controlled cognitive search task (demanding attentional resources), an automatic search task (needing fewer attentional resources), or no task. In Experiment 1, the controlled and automatic search tasks differed in the number of memory set items. In Experiment 2, the size of the memory sets was held constant, and individuals were provided practice to stabilize the different search strategies in the task. The automatic search and no task groups habituated to the repeated presentation of food cues in both experiments, but the controlled search group did not. These results support the hypothesis that allocation of attentional resources to external cues can influence the processing of food cues.

Differences in salivation to repeated food cues in obese and nonobese women

In a series of studies we have shown that salivation, a cephalic phase preingestive response, habituates to repeated presentations of olfactory or gustatory cues in nonobese subjects. Previous research has studied the differences in anticipatory response to food cues in obese vs. nonobese subjects. This study was designed to assess if obese and nonobese females differed in their patterns of salivary response to repeated presentation of palatable food cues. The salivary response to 10 gustatory presentations of lemon yogurt was studied in 10 obese and 10 nonobese nonrestrained women. Results showed significant differences in the pattern of salivary responding, with obese subjects showing a significantly slower decline in salivation than nonobese subjects. These results are consistent with the hypothesis that obese women differ from nonobese women in their pattern of response to repeated food cues. The results are discussed in relationship to models of intake that focus on differences in satiety or differences in the reinforcing value of food between obese and nonobese subjects.