Columbia University Irving Medical Center, New York, NY, USA.
New York State Psychiatric Institute, New York, NY, USA.
Psychol Med. 2023 Jul;53(10):4742-4750. doi: 10.1017/S0033291722001684. Epub 2022 Aug 3.
Loss-of-control (LOC) eating commonly develops during adolescence, and it predicts full-syndrome eating disorders and excess weight gain. Although negative emotions and emotion dysregulation are hypothesized to precede and predict LOC eating, they are rarely examined outside the self-report domain. Autonomic indices, including heart rate (HR) and heart rate variability (HRV), may provide information about stress and capacity for emotion regulation in response to stress.
We studied whether autonomic indices predict LOC eating in real-time in adolescents with LOC eating and body mass index (BMI) ⩾70th percentile. Twenty-four adolescents aged 12-18 (67% female; BMI percentile mean ± standard deviation = 92.6 ± 9.4) who reported at least twice-monthly LOC episodes wore biosensors to monitor HR, HRV, and physical activity for 1 week. They reported their degree of LOC after all eating episodes on a visual analog scale (0-100) using a smartphone.
Adjusting for physical activity and time of day, higher HR and lower HRV predicted higher self-reported LOC after eating. Parsing between- and within-subjects effects, there was a significant, positive, within-subjects association between pre-meal HR and post-meal LOC rating. However, there was no significant within-subjects effect for HRV, nor were there between-subjects effects for either electrophysiologic variable.
Findings suggest that autonomic indices may either be a marker of risk for subsequent LOC eating or contribute to LOC eating. Linking physiological markers with behavior in the natural environment can improve knowledge of illness mechanisms and provide new avenues for intervention.
失控（LOC）进食在青少年中较为常见，并且它可预测全面综合征进食障碍和体重过度增加。尽管负面情绪和情绪调节障碍被假设为 LOC 进食的前兆和预测因素，但它们很少在自我报告领域之外进行研究。自主神经指数，包括心率（HR）和心率变异性（HRV），可能会提供有关压力和应对压力的情绪调节能力的信息。
我们研究了自主神经指数是否可以实时预测具有 LOC 进食和 BMI ⩾70 百分位的青少年的 LOC 进食。24 名年龄在 12-18 岁的青少年（67%为女性；BMI 百分位平均值±标准差=92.6±9.4）至少每月报告两次 LOC 发作，他们佩戴生物传感器来监测 HR、HRV 和身体活动 1 周。他们使用智能手机在视觉模拟量表（0-100）上报告每次进食后 LOC 的严重程度。
调整活动量和时间因素后，较高的 HR 和较低的 HRV 预测进食后自我报告的 LOC 更高。在个体内和个体间效应之间进行解析，发现餐前 HR 与餐后 LOC 评分之间存在显著的正个体内关联。然而，对于 HRV 没有显著的个体内效应，对于这两个电生理变量都没有个体间效应。
这些发现表明自主神经指数可能是随后 LOC 进食风险的标志物，或者可能导致 LOC 进食。将生理标志物与自然环境中的行为联系起来可以提高对疾病机制的认识，并为干预提供新的途径。
