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

摘要：肥胖的病因很复杂，由不同人群中的不同因素驱动， 包括在不同的发展阶段、不同的种族和民族社区以及在不同的 社会经济地位(SES)。重要的是要找出促进过多能量摄入的因素。 为高危人群制定循证、有效的肥胖防治策略。 在过去的十年里，很明显，研究预测超重的行为表型， 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 具有高度的疗效和有效性。一种新的表型，已经被鉴定和 其特征是对食物的相对强化值(RRV)的敏化。这被定义为增加 每天重复食用高能量密度(HED)食物两周后食物的RRV。在……里面 在成人中，敏感化与BMI呈正相关，并预测随着时间的推移体重增加。这个 ZBMI和致敏之间的横截面关系在一群青少年中重复出现 参加UBSNAK研究和最近的数据表明，与成年人一样，预期的敏感化 预测青少年的zBMI变化。从初步工作中还知道， 粮食不安全和zBMI与其他个人、行为和环境因素有关，例如 延迟折扣、感知压力和健康饮食的自我效能感。拟议研究的目标是 1)调查粮食不安全和致敏之间的关系2)确定 敏感度测定中低收入青少年人群的zBMI和zBMI变化 以及3)确定青少年食物不安全与家庭食物不安全如何相互作用，以缓解 增敏作用与zBMI变化的关系。第一个目标将检验这样一个假设，即粮食不安全 与敏感化有关，这种关系是由个人、行为和环境调节的 各种因素。第二个目标将检验家庭粮食不安全缓和关系的假设。 在青少年中，敏感化和zBMI之间的变化随时间而变化。第三个目标将检验这一假设 青少年食物不安全与家庭食物不安全相互作用以缓和两者之间的关系 敏感化和zBMI改变，影响这种关系的一个因素是青少年饮食 自主。综合起来，这项研究将有助于识别和表征新的干预靶点 超重和肥胖风险较高的青少年群体。

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.