Eating Phenotypes for Childhood Obesity in the Context of Familial Obesity Risk

描述（由申请人提供）：预防儿童肥胖对未来健康和富有成效的社会至关重要。很可能在儿童肥胖之前，肥胖饮食表型就已经显现出来。如果是这样的话，早期识别这些表型将使一级预防策略朝着新的方向发展。这项研究将是第一个使用综合方法同时研究饥饿和饱腹状态下的饮食行为，并评估短期食欲和摄入量调节对7至9岁正常体重（NW）和肥胖（OB）儿童长期体重结果的影响，这些儿童处于肥胖的高风险（HR）或低风险（LR）。重要的是要确定HR-NW儿童的饮食行为是否与LR-NW儿童相似，或者他们是否已经采取了与HR-OB儿童更相似的行为，如果是这样，可能会使他们走上过度增重的道路。热量补偿是指根据前负荷能量密度的变化调整摄入量，将在儿童总体食欲控制的背景下通过比较他们的饱腹感商数和进食固定量食物（前负荷）和随意（自由进食）后的餐后食欲评级进行评估。该研究还将确定这些饮食特征是否可以预测儿童BMI Z评分，腰围和体脂百分比的1年变化。此外，这项研究将评估在没有饥饿的情况下进食，这是指儿童在满足时对美味的高能量密度零食的反应，是否延伸到更健康的低能量密度零食（水果）。最后，本研究旨在确定儿童家庭食物环境（即，家庭中低能量和高能量密度食物的可用性）、饮食表型和体重相关结果的1年变化。主要结果将包括儿童的热量补偿指数百分比，食欲控制，每日能量摄入量，以及BMI z评分，腰围和体脂百分比的1年变化。次要结果将包括在没有饥饿和家庭的家庭食物环境的情况下摄入低能量和高能量密度的零食。从这项研究中收集到的知识可以用来为肥胖风险最高的儿童设计个性化的行为干预措施， 行为表型的各个组成部分。

DESCRIPTION (provided by applicant): Prevention of childhood obesity is essential to the future of a healthy and productive society. It is very likely that obesogenic eating phenotypes manifest themselves before children become obese. If so, identifying these phenotypes early will move primary prevention strategies in a new direction. This study will be the first to use an integrative approach to concurrently study select eating behaviors under states of hunger and satiety and to assess the impact of short-term appetite and intake regulation on longer-term weight outcomes in normal-weight (NW) and obese (OB) children, ages 7 to 9, who are at high risk (HR) or low risk (LR) for obesity. It is important to determine whether HR-NW children are similar in their eating behaviors to LR-NW children or if they have already adopted behaviors that resemble more closely those of HR-OB children, which, if so, may put them on the path to excess weight gain. Caloric compensation, which refers to adjustments in intake in response to changes in the energy density of a preload, will be evaluated in the context of children's overall appetite control by comparing their satiety quotient and postprandial ratings of appetite after consuming fixed amounts of foods (preloads) and ad libitum (free-feeding) meals. The study will also determine if these eating traits predict 1-year changes in children's BMI z-score, waist circumference, and percent body fat. Additionally, this study will assess if eating in the absence of hunger, which refers to children's susceptibility to eating when satiated in response to the presence of palatable high energy-dense snacks, extends to healthier low energy-dense snacks (fruit). Lastly, this study aims to determine the relationship between children's home food environment (i.e., availability of low and high energy-dense foods in the home), eating phenotypes, and 1-year changes in weight-related outcomes. Primary outcomes will include children's percentage caloric compensation index, appetite control, daily energy intake, and 1-year changes in BMI z-score, waist circumference, and percent body fat. Secondary outcomes will include intake of low and high energy-dense snacks in the absence of hunger and families' household food environment. The knowledge gleaned from this research can be used to design personalized behavioral interventions for children who are at greatest risk for obesity that target the individual components of the behavioral phenotype.