Eating in the Absence of Hunger Is a Stable Predictor of Adiposity Gains in Middle Childhood

Yashaswini R Bhat; Barbara J Rolls; Stephen J Wilson; Emma Rose; Charles F Geier; Bari Fuchs; Hugh Garavan; Kathleen L Keller

doi:10.1016/j.tjnut.2024.10.008

Eating in the Absence of Hunger Is a Stable Predictor of Adiposity Gains in Middle Childhood

J Nutr. 2024 Oct 10:S0022-3166(24)01075-7. doi: 10.1016/j.tjnut.2024.10.008. Online ahead of print.

Authors

Yashaswini R Bhat¹, Barbara J Rolls¹, Stephen J Wilson², Emma Rose², Charles F Geier³, Bari Fuchs¹, Hugh Garavan⁴, Kathleen L Keller⁵

Affiliations

¹ Department of Nutritional Sciences, the Pennsylvania State University, University Park, PA, United States.
² Department of Psychology, the Pennsylvania State University, University Park, PA, United States.
³ Department of Psychology, University of Georgia, Athens, GA, United States.
⁴ Department of Psychological Sciences, University of Vermont, Burlington, VT, United States.
⁵ Department of Nutritional Sciences, the Pennsylvania State University, University Park, PA, United States; Department of Food Science, The Pennsylvania State University, University Park, PA, United States. Electronic address: klk37@psu.edu.

PMID: 39393498
DOI: 10.1016/j.tjnut.2024.10.008

Abstract

Background: 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.

Objectives: 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.

Methods: 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 m²). Seven days of wrist-worn Actigraphy quantified moderate-to-vigorous-physical activity (MVPA) and sedentary time.

Results: 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.

Conclusions: 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.

Trial registration number: The data was obtained from the Food and Brain study with registration number: NCT03341247.

Keywords: Eating in the Absence of Hunger (EAH); adiposity; childhood obesity; middle childhood; physical activity; sedentary behavior; stability.

Associated data

ClinicalTrials.gov/NCT03341247