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.

Public Health Relevance

Given the high prevalence of childhood obesity, there is a pressing need to identify modifiable risk factors and behavioral phenotypes for overeating and increased weight gain in children. Using an integrated approach, the proposed research aims to study multiple eating traits concurrently under states of hunger and satiety. It will examine the impact of short-term appetite and intake regulation on longer-term energy intake control and weight development in a cohort of ethnically diverse normal-weight and obese boys and girls with different familial predispositions to obesity.

National Institute of Health (NIH)
Research Project (R01)
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Psychosocial Risk and Disease Prevention Study Section (PRDP)
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Horlick, Mary
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University of Pennsylvania
Other Health Professions
Schools of Nursing
United States
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