Sugar sweetened beverages: Impact on reward, satiety, and metabolism in children

描述（由申请人提供）：西班牙裔儿童不成比例地受到肥胖和2型糖尿病（T2 D）的影响。越来越多的证据表明，糖的消费，特别是含糖饮料（SSB），是导致肥胖和T2 D的关键可变因素。SSB主要用高果糖玉米糖浆（HFCS）增甜，HFCS由不同比例的葡萄糖和果糖组成，HFCS对代谢健康的生理反应尚未完全了解。研究阐明HFCS如何影响代谢健康的作用机制，特别是在高危西班牙裔儿童中，是必要的。高糖摄入和代谢疾病风险之间的假设联系涉及与成瘾有关的大脑奖励途径。对青少年的新发现表明，经常食用冰淇淋，与身体脂肪无关，与奖励系统活动的减少有关，类似于在药物成瘾中观察到的耐受性。到目前为止，还没有研究探讨SSB摄入如何影响儿童的大脑奖励和成瘾途径，也没有评估这种关系是否因SSB摄入频率而异。因此，本研究的总体目标是检查和比较SSB的图片和实际SSB接收如何影响大脑奖励途径，食物选择，随后的食物/饮料摄入量，以及超重西班牙裔儿童（7-9岁）的代谢途径，频繁和天真的饮酒者之间。我们建议对50名西班牙裔儿童（7-9岁）进行横断面研究，其中一半是经常使用SSB的儿童（即，报告e2 SSB服务器/天; n=50）和一半是天真饮酒者（即，d2例/周; n=50）。受试者将经历两个fMRI范例：食物选择任务，其中他们被呈现食物/饮料的图片，这些食物/饮料的适口性/能量密度不同，并对每个项目的价值进行评级，以及使用SSB（用HFCS增甜）和无味对照的概率奖励范例。扫描后，受试者将立即接触自由进食的食物托盘，其中包括各种健康和不健康的食物/饮料。将在基线（扫描前）、扫描后即刻和自由进食期间每隔10分钟采血一次，以评估葡萄糖、胰岛素和肠肽。将在这些相同的时间点收集饱腹感和饱腹感测量值。具体目标是：1）检查和比较暴露于高能量食物/饮料的图片如何影响选择，价值和奖励途径（纹状体，杏仁核，眶额皮质，杏仁核），并研究如何预期和接收SSB与无味的解决方案eliminated激活大脑奖励通路之间的频繁和天真的饮酒者;以及2）检查和比较暴露于磁体中的SSB摄入如何影响随后的急性随意摄入、葡萄糖、胰岛素、肠肽以及频繁饮酒者和未饮酒者之间的感知饱腹感和饥饿反应。这些发现不仅将确定可能的SSB成瘾的机制，而且还将确定可能需要更有针对性的干预措施的慢性糖摄入风险最高的儿童。

DESCRIPTION (provided by applicant): Hispanic children are disproportionately affected by obesity and type 2 diabetes (T2D). Mounting evidence points to sugar consumption, specifically sugar-sweetened beverages (SSB), as a key modifiable factor contributing to obesity and T2D. SSB are primarily sweetened with high fructose corn syrup (HFCS), which consists of glucose and fructose in varying proportions, and the physiological responses of HFCS on metabolic health are not fully understood. Studies elucidating the mechanism of action of how HFCS impacts metabolic health, particularly in high-risk Hispanic children, are warranted. A hypothesized link between high sugar intake and metabolic disease risk involves brain reward pathways implicated in addiction. New findings with adolescents demonstrate that frequent consumption of ice cream, independent of body fat, is associated with a reduction in reward system activity, similar to the tolerance observed in drug addiction. To date, no study has examined how SSB intake impacts brain reward and addiction pathways in children, nor assessed whether this relationship differs by frequency of SSB intake. Thus, the overall goal of this study is to examine and compare how pictures of SSB and actual SSB receipt impacts brain reward pathways, food choice, subsequent food/beverage intake, and metabolic pathways in overweight Hispanic children (7-9 y), between frequent and naive drinkers. We propose a cross-sectional study of 50 Hispanic children (7-9 y), half who are frequent SSB consumers (i.e., report e 2 SSB serv/day; n=50) and half who are na¿ve drinkers (i.e., report d 2 serv/wk; n=50). Subjects will undergo two fMRI paradigms: a food choice task in which they are presented with pictures of foods/beverages that vary in their palatability/energy density and rate the value of each item, and a probabilistic reward paradigm using SSB (sweetened with HFCS) and a tasteless control. Immediately following the scan, subjects will be exposed to an ad libitum food tray, which will include a variety of healthy and unhealthy foods/beverages. Blood will be drawn at baseline (before scan), immediately after scan, and at 10-minute intervals during ad libitum food exposure to assess glucose, insulin, and gut peptides. Satiety and fullness measures will be collected at those same time points. Specific aims are: 1) to examine and compare how exposure to pictures of energy-dense foods/beverages influence choice, value, and reward pathways (striatum, amygdala, orbitofrontal cortex, insula) and examine how anticipation and receipt of SSB versus tasteless solution elicits activation of brain reward pathways between frequent and naive drinkers; and 2) to examine and compare how exposure to SSB intake in the magnet impacts subsequent acute ad libitum intake, glucose, insulin, gut peptides, and perceived satiety and hunger responses between frequent and naive drinkers. These findings will not only identify mechanisms involved in possible SSB addiction, but will also identify children most at risk for chronic sugar intake who may require more targeted interventions.