肥胖青少年的肥胖严重程度与食物奖励之间的关联：一项单阶段个体参与者数据荟萃分析。
The association between obesity severity and food reward in adolescents with obesity: a one-stage individual participant data meta-analysis.
作者信息
Moore Halim, Pereira Bruno, Fillon Alicia, Miguet Maud, Masurier Julie, Beaulieu Kristine, Finlayson Graham, Thivel David
机构信息
EA 3533, Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), CRNH Auvergne, Clermont Auvergne University, 3 Rue de La Chebarde, 63170, Clermont-Ferrand, Aubière, France.
Unit of Biostatistics (DRCI), Clermont-Ferrand University Hospital, Clermont-Ferrand, France.
出版信息
Eur J Nutr. 2024 Jun;63(4):1241-1255. doi: 10.1007/s00394-024-03348-4. Epub 2024 Feb 20.
BACKGROUND
Food reward and cue reactivity have been linked prospectively to problematic eating behaviours and excess weight gain in adults and children. However, evidence to date in support of an association between degree of adiposity and food reward is tenuous. A non-linear relationship between reward sensitivity and obesity degree has been previously proposed, suggesting a peak is reached in mild obesity and decreases in more severe obesity in a quadratic fashion.
OBJECTIVE
To investigate and characterise in detail the relationship between obesity severity, body composition, and explicit and implicit food reward in adolescents with obesity.
METHODS
Data from seven clinical trials in adolescents with obesity were aggregated and analysed in an independent participant data meta-analysis. Linear and curvilinear relationships between the degree of obesity and explicit and implicit reward for sweet and high fat foods were tested in fasted and fed states with BMI-z score as a continuous and discrete predictor using clinically recognised partitions.
RESULTS
Although positive associations between obesity severity and preference for high-fat (i.e. energy dense) foods were observed when fasted, none reached significance in either analysis. Conversely, adiposity was reliably associated with lower reward for sweet, particularly when measured as implicit wanting (p = 0.012, ηp = 0.06), independent of metabolic state. However, this significant association was only observed in the linear model. Fat distribution was consistently associated with explicit and implicit preference for high-fat foods.
CONCLUSIONS
A limited relationship was demonstrated between obesity severity and food reward in adolescents, although a lower preference for sweet could be a signal of severe obesity in a linear trend. Obesity is likely a heterogenous condition associated with multiple potential phenotypes, which metrics of body composition may help define.
CLINICAL TRIAL REGISTRATIONS
NCT02925572: https://classic.
CLINICALTRIALS
gov/ct2/show/NCT02925572 . NCT03807609: https://classic.
CLINICALTRIALS
gov/ct2/show/NCT03807609 . NCT03742622: https://classic.
CLINICALTRIALS
gov/ct2/show/NCT03742622 . NCT03967782: https://classic.
CLINICALTRIALS
gov/ct2/show/NCT03967782 . NCT03968458: https://classic.
CLINICALTRIALS
gov/ct2/show/NCT03968458 . NCT04739189: https://classic.
CLINICALTRIALS
gov/ct2/show/NCT04739189 . NCT05365685: https://www.
CLINICALTRIALS
gov/study/NCT05365685?tab=history .
背景
食物奖励和线索反应性已被前瞻性地与成人和儿童的问题饮食行为及体重过度增加联系起来。然而，迄今为止，支持肥胖程度与食物奖励之间存在关联的证据并不确凿。此前曾提出奖励敏感性与肥胖程度之间存在非线性关系，表明在轻度肥胖时达到峰值，而在更严重肥胖时呈二次方下降。
目的
详细研究肥胖青少年的肥胖严重程度、身体成分与显性和隐性食物奖励之间的关系。
方法
汇总并分析了来自七项肥胖青少年临床试验的数据，进行独立参与者数据荟萃分析。以BMI-z评分作为连续和离散预测因子，使用临床认可的划分方法，在禁食和进食状态下测试肥胖程度与甜食和高脂肪食物的显性和隐性奖励之间的线性和曲线关系。
结果
尽管在禁食时观察到肥胖严重程度与对高脂肪（即能量密集型）食物的偏好之间存在正相关，但在任何一项分析中均未达到显著水平。相反，肥胖与对甜食的较低奖励可靠相关，尤其是以隐性欲望衡量时（p = 0.012，ηp = 0.06），且与代谢状态无关。然而，这种显著关联仅在线性模型中观察到。脂肪分布始终与对高脂肪食物的显性和隐性偏好相关。
结论
肥胖青少年的肥胖严重程度与食物奖励之间的关系有限，尽管对甜食的较低偏好可能是严重肥胖呈线性趋势的一个信号。肥胖可能是一种与多种潜在表型相关的异质性疾病，身体成分指标可能有助于定义这些表型。
临床试验注册
NCT02925572：https://classic.
CLINICALTRIALS
gov/ct2/show/NCT02925572 。NCT03807609：https://classic.
CLINICALTRIALS
gov/ct2/show/NCT03807609 。NCT 03742622：https://classic.
CLINICALTRIALS
gov/ct2/show/NCT03742622 。NCT03967782：https://classic.
CLINICALTRIALS
gov/ct2/show/NCT03967782 。NCT03968458：https://classic.
CLINICALTRIALS
gov/ct2/show/NCT03968458 。NCT0473918 9：https://classic.
CLINICALTRIALS
gov/ct2/show/NCT04739189 。NCT05365685：https://www.
CLINICALTRIALS
gov/study/NCT05365685?tab=history 。
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