Caloric compensation and appetite control in children of different weight status and predisposition to obesity

Abstract

To prevent childhood obesity it is critical to identify behavioral phenotypes for overeating, especially among children who are predisposed to obesity. We examined caloric compensation and appetite control in 212 normal-weight (NW) and obese (OB) children, ages 7 to 9, who were at high risk (HR) or low risk (LR) for obesity based on maternal obesity. In a within-subjects crossover design, children ate breakfast, lunch, dinner, and snacks in the laboratory once a week for two weeks. Children's percentage compensation index (%COMPX) was computed at breakfast. Twenty-five minutes before breakfast, children received one of two compulsory preloads, which varied in energy density (ED) and caloric content [Low ED (LED): 1.00 kcal/g; 100 kcal; High ED (HED): 1.60 kcal/g; 160 kcal]. Children's appetite was measured hourly using Visual Analog Scales, which were used to compute 3-h post-prandial area under the curve (AUCs) after breakfast and the satiety quotient (SQ), which allows between-group comparisons of a fixed amount of a food's potency to reduce appetite sensations per unit of intake. There were no significant differences in %COMPX, SQ, or AUC among LR-NW, HR-NW, and HR-OB children (P > 0.10). SQs for Hunger and Prospective Consumption were higher and SQ for Fullness lower after consuming the LED compared to the HED preload (P < 0.009). Further, the SQ and AUC for Desire to Eat and AUC for Prospective Consumption significantly predicted energy intake during the remainder of the day (P < 0.03). In this study, HR-NW children did not differ from LR-NW or HR-OB children in their caloric compensation or appetite control. Foods with a high satiating effect may facilitate appetite control and help to moderate daily energy intake in all children, including at-risk children.

Trial registration: ClinicalTrials.gov NCT02928874.

Copyright © 2020 Elsevier Ltd. All rights reserved.

Figures

Figure 1:

Timeline of assessments during full-day test visit.

Figure 2:

Model-based means (± SEM) of energy intake during Preload – Test Meal Paradigm for LR-NW (n = 60), HR-NW (n = 77), and HR-OB (n = 75) children. LED, low energy density; HED, high energy density. The models for these means were adjusted for time and preload condition. Main effects were significant for risk group (P = 0.0021), preload condition (P = 0.0009), and test visit (P = 0.02). The risk group-by-preload condition interaction was not significant (P = 0.95).

Figure 3:

Model-based means (± SEM) of daily energy intake for LR-NW (n = 60), HR-NW (n = 77), and HR-OB (n = 75) children.

Figure 4:

Model-based means (± SEM) for the visual analog scale (VAS) appetite ratings, post-preload satiety quotient (SQ), and post-breakfast 3-hour area under the curve (AUC) for LR-NW, HR-NW, and HR-OB children. *Pairwise comparisons for significant risk group-by-time interaction (P < 0.04); a HR-NW > HR-OB; b HR-NW > LR-NW; c HR-OB > LR-NW