Observed Mealtime Satiety Signaling and Childhood Obesity Risk

Project Title: Observed Mealtime Satiety Signaling and Childhood Obesity Risk
PI name(s): Alison L. Miller,
Co-I name(s): Julie Lumeng Funding (sponsor): Eunice Kennedy Shriver National Institute of Child Health and Human Development

Summary

Identify observable behavioral indicators of satiety signaling at mealtimes and differences in these indicators across childhood.

Abstract

The prevalence of childhood obesity remains high, and low-income children are at high risk. Children’s abilities to self-regulate their intake of foo based on internal cues of hunger and satiety are a focus of interventions that encourage parents to recognize child satiety cues, with the idea that failure to respond appropriately to such cues may override children’s ability to self-regulate intake. Yet, the specific child satiety signaling behaviors that may prompt parents to recognize satiety during naturalistic mealtimes are not well-articulated, as prior research on child satiety has primarily utilized either parents’ reportsof children’s general satiety responsiveness or experimental techniques to assess satiety in laboratory settings. Tools to help parents detect mealtime satiety signals are needed. Despite significant work on observed behavioral indicators of hunger and satiety during infancy, little is known about satiety signaling in older children. Drawing from diverse literatures, we know that children engage in a range of eating behaviors during meals (e.g., slowness in eating, (lack of) food enjoyment, disgust expressions) that could signal satiety. The proposed work seeks to fill the gap in the literature on child satiety and childhood obesity by identifying behavioral indicators of child satiety signaling in the context of naturalistic mealtimes across early to midde childhood (i.e., toddler-age, preschool- age and school-age). We know that parents play an important role in preventing childhood obesity, yet not all parents recognize child satiety responsiveness. Child risk for obesity may be increased when parents are unable to recognize child satiety signals, and children who do not display clear satiety signaling may be at even greater risk. By identifying behavioral indicators of satiety signaling during mealtimes in association with child adiposity, this work has the potential to inform interventions that seek to enhance parents’ abilities to identify and respond appropriately to child’s satiety signaling durin mealtimes. Leveraging data from multiple longitudinal studies with videotaped naturalistic mealtimes in low-income families, we propose to code theoretically-driven features of child eating behavior that could signal satiety in toddlers (27 months; n=161), preschoolers (M age 5 years; n=271), and school-age children (M age 8 years; n=273). The aims are: Aim 1. To identify observable behavioral indicators of satiety signaling at mealtimes and differences in these indicators across childhood. Aim 2. To test the hypothesis that less observed behavioral satiety signaling is associated with greater concurrent adiposity and prospective increases in child adiposity across a 2-year period. Aim 3. To test the hypothesis that parent-reported child satiety responsiveness moderates the association of observed behavioral satiety signaling and child adiposity such that children at highest risk for excess adiposity are those with either less clear observable behavioral satiety signaling, or those with clear satiety signaling whose parents do not report recognizing the signals.