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.

Public Health Relevance

Given the link between sugar-sweetened beverages (SSB), childhood obesity, and the growing evidence of sugar addiction, more research is needed to elucidate how SSB in liquid form impacts neural and metabolic pathways. This study is relevant to public health because it will help elucidate the mechanism by which SSB impacts neural pathways and metabolic parameters in Hispanic children and could help identify children most at risk for chronic sugar intake who may require more targeted interventions. The results can also shed light on how the brain's valuation system responds to SSBs and provide a useful neuroimaging paradigm for future intervention studies.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Exploratory/Developmental Grants (R21)
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Psychosocial Risk and Disease Prevention Study Section (PRDP)
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Laughlin, Maren R
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University of Texas Austin
Social Sciences
Schools of Arts and Sciences
United States
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Shearrer, Grace E; O'Reilly, Gillian A; Belcher, Britini R et al. (2016) The impact of sugar sweetened beverage intake on hunger and satiety in minority adolescents. Appetite 97:43-8