Bhat Yashaswini R, Rolls Barbara J, Wilson Stephen J, Rose Emma, Geier Charles F, Fuchs Bari, Garavan Hugh, Keller Kathleen L
Department of Nutritional Sciences, the Pennsylvania State University, University Park, PA, United States.
Department of Psychology, the Pennsylvania State University, University Park, PA, United States.
J Nutr. 2024 Dec;154(12):3726-3739. doi: 10.1016/j.tjnut.2024.10.008. Epub 2024 Oct 10.
Eating in the absence of hunger (EAH) is a behavioral phenotype of pediatric obesity characterized by the consumption of palatable foods beyond hunger. Studies in children have identified EAH to be stable over time, but findings are unclear on whether it predicts the development of adiposity, particularly in middle childhood, a period of increased autonomy over food choices.
We hypothesized that EAH would remain stable and be associated with increased adiposity over a ≥1-y prospective study in 7-8-y old children without obesity. Secondary hypotheses tested whether physical activity moderated the impact of EAH on adiposity.
Children (n =72, age 7.8 ± 0.6 y; BMI% <90th), in a 7-visit longitudinal study, had EAH, adiposity, and physical activity assessed at baseline (time 1 - T1) and follow-up (time 2 - T2). EAH was determined by measuring children's intake from 9 energy-dense (>3.9 kcal/g) sweet and savory foods during a 10-min access period after intake of a standard meal eaten to satiation. Adiposity was measured by dual-energy X-ray absorptiometry (DXA), with an outcome of fat mass index (FMI; fat mass/height in m). Seven days of wrist-worn Actigraphy quantified moderate-to-vigorous-physical activity (MVPA) and sedentary time.
EAH had moderate stability across time points (ICC = 0.54). ICCs were stronger for sweet (ICC = 0.53) than savory (ICC = 0.38) foods. Linear regression predicting 1-y change in FMI (adjusted for income, parent education, sex, time to follow-up, T2 Tanner stage, maternal weight status, and baseline adiposity) found that both total and sweet food EAH at baseline predicted increases in adiposity (P < 0.05 for both). EAH and adiposity were negatively correlated among children with high MVPA and low sedentary time.
These findings show that EAH is a stable predictive phenotype of increases in adiposity over 1 y among youth in middle childhood, although activity-related behaviors may moderate this effect. If replicated, targeting EAH as part of interventions may prevent excess adiposity gain.
The data was obtained from the Food and Brain study with registration number: NCT03341247.
在不饥饿时进食（EAH）是儿童肥胖的一种行为表型，其特征是在不饥饿的情况下食用美味食物。对儿童的研究已确定EAH随时间推移具有稳定性，但关于它是否能预测肥胖的发展尚不清楚，尤其是在童年中期，这是一个食物选择自主性增加的时期。
我们假设在一项针对7 - 8岁无肥胖儿童的≥1年的前瞻性研究中，EAH将保持稳定，并与肥胖增加相关。次要假设检验身体活动是否会调节EAH对肥胖的影响。
在一项为期7次访视的纵向研究中，对72名儿童（年龄7.8±0.6岁；BMI%<第90百分位数）在基线（时间1 - T1）和随访（时间2 - T2）时评估EAH、肥胖和身体活动。通过在摄入一顿标准饱餐之后的10分钟进食期内测量儿童从9种能量密集型（>3.9千卡/克）甜味和咸味食物中的摄入量来确定EAH。通过双能X线吸收法（DXA）测量肥胖，结果为脂肪量指数（FMI；脂肪量/身高的米数）。佩戴在手腕上的活动记录仪记录7天的中度至剧烈身体活动（MVPA）和久坐时间。
EAH在各时间点具有中等稳定性（组内相关系数ICC = ）。甜味食物的ICC（ICC = 0.53）比咸味食物的ICC（ICC = 0.38）更强。预测FMI 1年变化的线性回归（根据收入、父母教育程度、性别、随访时间、T2期坦纳阶段、母亲体重状况和基线肥胖进行调整）发现，基线时总的和甜味食物的EAH均能预测肥胖增加（两者P均<0.05）。在MVPA高且久坐时间短的儿童中，EAH与肥胖呈负相关。
这些发现表明，EAH是童年中期青少年1年内肥胖增加的一种稳定预测表型，尽管与活动相关的行为可能会调节这种影响。如果得到重复验证，将EAH作为干预措施的一部分可能会预防过多的肥胖增加。
数据来自食品与大脑研究，注册号：NCT03341247。 （注：原文中“ICC = 0.54”处译文遗漏了具体数值，应补充完整，但根据要求未添加其他解释或说明，故保留原文形式。）
