Role of energy balance behaviors in modifying biobehavioral risk factors for childhood obesity

肥胖是一种多因素疾病，是多种基因、行为和环境因素复杂相互作用的结果。较高的遗传风险并不总是转化为儿童肥胖的发展，这表明存在风险调节因素，可能与能量平衡行为有关，是关键的行为驱动因素。本研究将以我们之前的研究为基础，全面研究基因型和表型之间的相互作用，并首次系统地评估家庭环境下的能量平衡行为，单独或联合，是否可以改变儿童肥胖的行为和遗传易感性。具体而言，本研究旨在前瞻性评估在低资源背景家庭中5至7岁儿童中，饮食驱动（HDE）对1年体重和肥胖结果变化的关联程度是独立的还是与肥胖遗传风险相关的。HED将被定义为一种更广泛的行为表型，它结合了贪食性食欲特征（即，食物的相对强化价值，快速进食速度和在没有饥饿的情况下进食）。儿童的基因型将使用遗传风险评分（GRS）进行评估，该评分作为多种肥胖风险单核苷酸多态性（snp）的综合衡量标准。此外，该研究旨在前瞻性地检查饮食、身体活动和睡眠领域的风险调节能量平衡行为，这些行为可能会减轻高代谢障碍或高遗传风险对体重和肥胖结果的有害影响，并测试这些因素对高代谢障碍和高遗传风险肥胖对这些结果的影响是否不同。最后，本研究旨在探讨家庭层面在家庭功能和父母喂养方面的影响对儿童风险调节能量平衡行为的影响。主要结局将包括儿童身体质量指数（BMI） z-score、体脂百分比和腰围1年的变化。确定可能减轻肥胖风险对体重和肥胖结果影响的行为和家庭因素对于将儿童肥胖预防推向一个新的方向至关重要。如果成功，从这项研究中收集到的知识将为解决肥胖的健康差异和制定针对儿童肥胖的量身定制的基于家庭的干预措施提供新的有力的目标。

Obesity is a multifactorial disease which results from complex interactions among multiple genes, behaviors, and environmental factors. A heightened genetic risk does not always translate to the development of obesity among children, which points to the presence of risk-modifying factors that likely relate to energy balance behaviors as key behavioral drivers. This study will build on our prior research to comprehensively examine the interplay between genotype and phenotype and, for the first time, systematically assess if energy balance behaviors in the context of the family environment, alone or in combination, can modify behavioral and genetic predispositions to childhood obesity. Specifically, this research aims to prospectively evaluate the extent to which associations of a heightened drive to eat (HDE) on 1-year changes in weight and adiposity outcomes are independent or additive to those of a genetic risk for obesity among children, ages 5 to 7, from families with low resource backgrounds. HED will be conceptualized as a broader behavioral phenotype which combines hyperphagic appetitive traits (i.e., the relative reinforcing value of food, a rapid eating rate, and eating in the absence of hunger). Children’s genotype will be assessed using a genetic risk score (GRS), which serves as an aggregate measure from multiple obesity risk single nucleotide polymorphisms (SNPs). In addition, the study aims to prospectively examine risk-modifying energy balance behaviors in areas of diet, physical activity, and sleep that may mitigate the detrimental impact of a HDE or high genetic risk on weight and adiposity outcomes and test whether these factors differ for HDE versus a high genetic risk of obesity on those outcomes. Lastly, the research aims to examine the impact of family-level influences in areas of family functioning and parent feeding on risk-modifying energy balance behaviors in children. Primary outcomes will include 1-year changes in children’s body mass index (BMI) z-score, percent body fat, and waist circumference. Identifying behavioral and family factors that may mitigate the impact of obesity risk on weight and adiposity outcomes is critical for moving the prevention of childhood obesity into a new direction. If successful, the knowledge gleaned from this research will offer new and powerful targets for addressing health disparities in obesity and formulating tailored family-based interventions in the fight against childhood obesity.