The Role of Food Insecurity and Sensitization in Excess Weight Gain in Adolescents from Low to Moderate Income Households

翻译后摘要：肥胖的病因是复杂的，是由不同的因素在不同的人群， 包括在不同的发展阶段，在不同的种族和族裔社区， 社会经济地位（SES）。重要的是要确定的因素，促进过量的能量摄入， 高风险人群制定循证有效的肥胖预防和治疗策略。 在过去的十年里，研究预测超重的行为表型已经变得很明显， 肥胖和整个生命周期的体重变化对于制定个性化干预策略至关重要 具有高度的功效和有效性。一种新的表型已被确定， 其特征在于对食品的相对强化值（RRV）进行敏化。这被定义为增加 在重复、每日食用高能量密度（HED）食物两周后食物的RRV。在 在成年人中，致敏与BMI呈正相关，并前瞻性地预测体重随时间的增加。的 zBMI和致敏性之间的横断面关系已在青少年队列中得到证实 入组UBSNAK研究，最近的数据表明，与成人一样， 预测青少年的zBMI变化。从初步工作中还知道， 食物不安全和zBMI与其他个人，行为和环境因素有关，如 延迟折扣，感知压力和健康饮食的自我效能。拟议研究的目标是 1)调查粮食不安全与提高认识之间的关系; 2）确定 在中低收入青少年人群中确定zBMI和zBMI变化的敏感性 和3）确定青少年粮食不安全与家庭粮食不安全如何相互作用，以缓解 致敏与zBMI变化之间的关系。第一个目标将检验粮食不安全的假设， 与敏感化有关，这种关系由个体、行为和环境介导。 因素第二个目标将检验家庭粮食不安全缓和这种关系的假设 在青少年中，致敏与zBMI随时间变化之间的关系。第三个目标将检验以下假设： 青少年粮食不安全与家庭粮食不安全相互作用，以缓和 敏感性和zBMI的变化，影响这种关系的一个因素是青少年的饮食 自治综合考虑，这项研究将有助于确定和表征新的干预目标， 青少年超重和肥胖风险较高。

Abstract: The etiology of obesity is complex and is driven by different factors in different populations, including across developmental stages, in different racial and ethnic communities, and at different levels of socioeconomic status (SES). It is important to identify the factors that promote excess energy intake in the highest risk populations to develop evidence-based, effective obesity prevention and treatment strategies. Over the past decade, it has become apparent that studying behavioral phenotypes that predict overweight, obesity, and weight change across the lifespan is critical for developing individualized intervention strategies with a high degree of efficacy and effectiveness. One novel phenotype that has been identified and characterized is sensitization of the relative reinforcing value (RRV) of food. This is defined as an increase in the RRV of a food after repeated, daily consumption of high energy density (HED) food for two weeks. In adults, sensitization is positively associated with BMI and prospectively predicts weight gain over time. The cross-sectional relationship between zBMI and sensitization has been replicated in a cohort of adolescents enrolled in the UBSNAK study and recent data have shown that, as in adults, sensitization prospectively predicts zBMI change in adolescents. It is also known, from preliminary work, that the relationship between food insecurity and zBMI is associated with other individual, behavioral, and environmental factors, such as delay discounting, perceived stress, and self-efficacy for healthy eating. The goals of the proposed study are 1) to investigate the relationship between food insecurity and sensitization 2) to determine the role of sensitization in determining zBMI and zBMI change in a population of moderate to low-income adolescents and 3) to determine how adolescent food insecurity interacts with household food insecurity to moderate the relationship between sensitization and zBMI change. The first aim will test the hypothesis that food insecurity is related to sensitization and that this relationship is mediated by individual, behavioral, and environmental factors. The second aim will test the hypothesis that household food insecurity moderates the relationship between sensitization and zBMI change over time in adolescents. The third aim will test the hypothesis that adolescent food insecurity interacts with household food insecurity to moderate the relationship between sensitization and zBMI change and that one factor that impacts this relationship is adolescent eating autonomy. When taken together, this study will help to identify and characterize novel intervention targets in a population of adolescents at higher risk for overweight and obesity.