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Executive Functioning, Weight Trajectories, and Loss of Control Eating in Children with Overweight/Obesity: A Prospective Study

超重/肥胖儿童的执行功能、体重轨迹和饮食失控：一项前瞻性研究

基本信息

批准号：
10158469
负责人：
Andrea Beth Goldschmidt
金额：
$ 12.78万
依托单位：
MIRIAM HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-05-15 至 2021-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10158469
关键词：
Address Adolescence Adolescent Affect Age Area Behavior Behavioral Body Weight Changes Body Weight decreased Body mass index Brain Categories Child Childhood Chronic Clinical Cognitive Communities Data Decision Making Development Disease Dorsal Early Intervention Eating Eating Behavior Eating Disorders Emotional Emotions Etiology Executive Dysfunction Food Functional Magnetic Resonance Imaging Future Health Healthcare Systems Height Impairment Impulsivity Intervention Investigation Knowledge Maintenance Measures Medical Modeling Nature Neural Pathways Neurocognitive Neurophysiology - biologic function Obesity Outcome Overweight Parietal Lobe Participant Pathway interactions Pattern Performance Phenotype Prefrontal Cortex Principal Investigator Process Prospective Studies Protocols documentation Public Health Publishing Regulation Remittance Research Research Design Risk Role Sampling Scientific Advances and Accomplishments Short-Term Memory Specificity Structure Time Training Weight Weight Gain Weight maintenance regimen Youth base brain pathway comorbidity design dietary eating pathology excessive weight gain executive function follow-up healthy weight improved inter-individual variation loss of control over eating middle childhood negative affect neglect neural correlate neuroimaging neuromechanism obesity in children prevent preventive intervention prospective psychosocial relating to nervous system restraint therapy development

项目摘要

PROJECT SUMMARY/ABSTRACT Pediatric overweight and obesity continue to be major public health issues. Loss of control (LOC) eating is an obesity-related phenotype that affects approximately 30% of children and adolescents with overweight/obesity and may impede successful weight control. Pediatric overweight/obesity and LOC eating frequently emerge during childhood and adolescence, and tend to follow a chronic and unremitting course if untreated. Both conditions are associated with relative deficiencies in executive functioning (EF), including working memory, planning, inhibitory control, and decision-making. These decrements may impair one’s ability to appropriately regulate weight and eating behavior. A limitation of prior research is that it has been primarily cross-sectional in nature, which inhibits understanding of the timing and direction of influence involved in the associations among EF, weight change, and eating pathology. Moreover, little is known about the domain specificity of relative EF deficits in youth with overweight/obesity and LOC eating, nor about their underlying neural substrates. An improved understanding of the nature and prospective outcomes of EF impairments in youth with overweight/obesity and LOC eating could inform intervention development by indicating whether treatments should focus on improving general and/or food-specific EF, as well as which neural pathways should be targeted to achieve the most robust and sustained effects on eating and weight. The proposed R01 study will examine prospective associations between EF performance and related neural substrates, and child weight change and LOC eating. Community-based children representing a spectrum of risk, including non- overweight/obese (n=60), overweight/obese (n=60), and overweight/obese with comorbid LOC eating (n=60), will provide repeated assessments of height/weight, LOC eating pathology, and general and food-specific EF every 6-12 months over 2 years of follow-up. A subset of participants from each risk category will complete a baseline and 18-month fMRI protocol assessing neural substrates of general and food-specific working memory. Specific aims are to investigate prospective associations between both general and food-specific EF, and their neural substrates, and trajectories of weight change and LOC eating (including remittance and persistence) over 2 years. These data will clarify timing and trajectory of weight change and LOC eating in relation to EF performance and its associated neural activation patterns. This study, which is the first to prospectively examine associations among general and food-specific EF, weight trajectories, and LOC eating, has clear potential to advance scientific and clinical understanding of mechanisms that promote the onset and maintenance of maladaptive eating in youth and inform interventions to alleviate their cumulative personal and societal burden. Furthermore, this application builds on the principal investigator’s programmatic line of research on neurocognitive factors involved in eating- and weight-related problems, and provides a clear pathway to future clinically and scientifically impactful studies.

项目总结/文摘