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（T2D）的影响。越来越多的证据表明，糖的摄入，特别是含糖饮料（SSB），是导致肥胖和糖尿病的一个关键可改变因素。SSB主要是用高果糖玉米糖浆（HFCS）来增甜的，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不完全清楚。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，是有必要的。高糖摄入与代谢性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。针对青少年的新发现表明，频繁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，还没有研究检查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摄入频率而不同。因此，本研究的总体目标是检查和比较超重西班牙裔儿童（7-9岁）在频繁饮酒者和幼稚饮酒者之间，SSB图片和实际接收SSB是如何影响大脑奖励途径、食物选择、随后的食物/饮料摄入量和代谢途径的。我们建议对50名西班牙裔儿童（7-9岁）进行横断面研究，其中一半是频繁食用SSB的儿童（即每天报告2份SSB， n=50），一半是不经常饮用SSB的儿童（即每周报告2份SSB， n=50）。受试者将接受两种功能磁共振成像范式：一种是食物选择任务，在这个任务中，他们会看到不同口味/能量密度的食物/饮料的图片，并对每个项目的价值进行评级；另一种是概率奖励范式，使用SSB（用HFCS加糖）和无味对照。扫描结束后，受试者将立即接触到一个随意的食物托盘，其中包括各种健康和不健康的食品/饮料。将在基线（扫描前）、扫描后立即和随意进食期间每隔10分钟抽血，以评估葡萄糖、胰岛素和肠道肽。在同一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、价值和奖励通路（纹状体、杏仁核、眼窝额叶皮层、脑岛），并检查对SSB和无味溶液的预期和接收如何引发频繁饮酒者和初次饮酒者之间大脑奖励通路的激活；2)检查和比较在磁铁中摄入SSB对频繁饮酒者和初次饮酒者随后的急性随意摄入量、葡萄糖、胰岛素、肠道肽以及感知饱腹感和饥饿感的影响。这些发现不仅将确定SSB成瘾的可能机制，还将确定慢性糖摄入风险最大的儿童，这些儿童可能需要更有针对性的干预。

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.