The hypothalamic-pituitary-adrenal (HPA) axis and its byproduct, cortisol, have been hypothesized to be the mediators that links chronic stress to adverse health outcomes, including increased obesity risk. This mediation is hypothesized to occur via several mechanisms, including stress-related cortisol secretion leading to both increased caloric consumption and a shift in preference to comfort foods (i.e., foods high in fat and/or added sugars). Under conditions of chronic stress, aberrations in the normal diurnal pattern of cortisol secretion occur, and obese, compared to non-obese, adults have been reported to demonstrate these aberrations more frequently. Although it is vital to understand the origins of these associations and the mechanisms through which they are established, few studies have examined links between HPA axis functioning and obesity in childhood. Furthermore, no studies have examined potential links between stress, cortisol, eating behavior, and obesity among low-income preschool children, though this population carries the greatest burden of the childhood obesity epidemic, and disparities in obesity prevalence emerge in this age range. This application, therefore, proposes 3 specific aims:
Aim 1 : To examine the association between diurnal cortisol patterns and weight status within a population of low-income preschool-aged children. Hypothesis 1: Children with alteration of the normal diurnal pattern of cortisol secretion will demonstrate a higher prevalence of obesity compared to children with the typical diurnal pattern. This alteration of the diurnal pattern will most commonly present as hypercortisolism, but may also present as hypocortisolism.
Aim 2 : To examine the association between diurnal cortisol patterns and eating behaviors within a population of low-income preschool-aged children. Hypothesis 2: Children with alteration of the normal diurnal pattern of cortisol secretion will demonstrate a higher prevalence of food-related tantrums, emotional eating, and eating in the absence of hunger compared to children with the typical diurnal pattern.
Aim 3 : To examine the association between diurnal cortisol patterns and dietary composition within a population of low-income preschool-aged children. Hypothesis 3: Children with alteration of the normal diurnal pattern of cortisol secretion will consume more comfort foods (foods high in fat and/or added sugars) compared to children with the typical diurnal pattern.

Public Health Relevance

Childhood obesity is a significant public health problem, particularly for low-income populations. Obesity, once established in childhood, is very likely to track into adulthood. More effective approaches to preventing and treating childhood obesity are needed. A focus on the intersection of stress, eating behavior, and obesity may inform the development of more effective intervention and prevention programs.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
NIH Challenge Grants and Partnerships Program (RC1)
Project #
1RC1DK086376-01
Application #
7815838
Study Section
Special Emphasis Panel (ZRG1-EMNR-C (58))
Program Officer
Horlick, Mary
Project Start
2009-09-30
Project End
2011-08-31
Budget Start
2009-09-30
Budget End
2010-08-31
Support Year
1
Fiscal Year
2009
Total Cost
$500,000
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Pediatrics
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Doom, Jenalee R; Cook, Stephanie H; Sturza, Julie et al. (2018) Family conflict, chaos, and negative life events predict cortisol activity in low-income children. Dev Psychobiol 60:364-379
Miller, Alison L; Gearhardt, Ashley N; Retzloff, Lauren et al. (2018) Early Childhood Stress and Child Age Predict Longitudinal Increases in Obesogenic Eating Among Low-Income Children. Acad Pediatr 18:685-691
Miller, Alison L; Song, Ju-Hyun; Sturza, Julie et al. (2017) Child cortisol moderates the association between family routines and emotion regulation in low-income children. Dev Psychobiol 59:99-110
Domoff, Sarah E; Lumeng, Julie C; Kaciroti, Niko et al. (2017) Early Childhood Risk Factors for Mealtime TV Exposure and Engagement in Low-Income Families. Acad Pediatr 17:411-415
Fernandez, Carmen; Kasper, Nicole M; Miller, Alison L et al. (2016) Association of Dietary Variety and Diversity With Body Mass Index in US Preschool Children. Pediatrics 137:e20152307
Leung, C Y Y; Miller, A L; Kaciroti, N A et al. (2016) Low-income pre-schoolers with higher temperamental surgency enjoy and respond more to food, mediating the path to higher body mass index. Pediatr Obes 11:181-6
Miller, Alison L; Lee, Hannah J; Lumeng, Julie C (2015) Obesity-associated biomarkers and executive function in children. Pediatr Res 77:143-7
Miller, Alison L; Sturza, Julie; Rosenblum, Katherine et al. (2015) Salivary alpha amylase diurnal pattern and stress response are associated with body mass index in low-income preschool-aged children. Psychoneuroendocrinology 53:40-8
Wilson, Katherine E; Lumeng, Julie C; Kaciroti, Niko et al. (2015) Sleep Hygiene Practices and Bedtime Resistance in Low-Income Preschoolers: Does Temperament Matter? Behav Sleep Med 13:412-23
Miller, Alison L; Lumeng, Julie C; LeBourgeois, Monique K (2015) Sleep patterns and obesity in childhood. Curr Opin Endocrinol Diabetes Obes 22:41-7

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