Appetite Self-Regulation in Childhood: A Narrative Review and Conceptual Model of Processes and Mechanisms With Implications for Research and Practice.

The purpose of the present narrative review was to propose a unifying generalized conceptual model of mechanisms and processes in appetite self-regulation (ASR) in childhood. Appetite self-regulation, along with other domains of self-regulation, develops across childhood and contributes to energy intake and balance, diet quality, weight, and therefore long-term health outcomes. There have been efforts to conceptualize and measure components of ASR and associated processes/mechanisms, but, at present, there is no unifying conceptualization of ASR in childhood. A search of key databases supplemented by snowballing was undertaken for definitions/conceptions and theoretical models of ASR with a focus on children. An interpretive synthesis approach was used to identify themes from the definitions and models. The themes formed the basis of the proposed unifying generalized model of ASR in childhood, which is the main contribution of the article. At the center of the model is bottom-up reactivity to food, food cues and hunger, satiation and satiety signals, together with top-down regulatory control. An additional contribution is the proposed 5 interacting and overlapping domains (biological, hedonics, cognitive, behavioral, and traits) that function in and influence both bottom-up reactivity and top-down regulation. The domains also contribute to ASR outcomes of enactment and competence. External contextual and intrapersonal factors are conceived as impacting the domains and the bottom-up, top-down processes. The relevance of the model for explanations of ASR phenomena in childhood and children's food choice and diet quality, as well as its implications for research directions and approaches to preventive intervention, including food parenting practices, are discussed. The model provides a framework for researchers and practitioners to support and interpret children's problems and competence in self-directing food choices, energy intake, and nutrition.