Executive Functioning, Weight Trajectories, and Loss of Control Eating in Children with Overweight/Obesity: A Prospective Study

超重/肥胖儿童的执行功能、体重轨迹和饮食失控：一项前瞻性研究

• 批准号: 10458152
• 负责人: Andrea Beth Goldschmidt
• 金额: $ 37.98万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-02 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10458152
• 关键词: Address; Adolescence; Adolescent; Affect; Age; Area; Behavior; Behavioral; Body Weight Changes; Body Weight decreased; Body mass index; Brain; Categories; Child; Childhood; Chronic; Clinical; Cognitive; Communities; Data; Decision Making; Development; Disease; Dorsal; Early Intervention; Eating; Eating Behavior; Eating Disorders; Emotional; Emotions; Etiology; Executive Dysfunction; Food; Functional Magnetic Resonance Imaging; Future; Health; Healthcare Systems; Height; Impairment; Impulsivity; Intervention; Investigation; Knowledge; Maintenance; Measures; Medical; Modeling; Nature; Neural Pathways; Neurocognitive; Neurophysiology - biologic function; Obesity; Outcome; Overweight; Parietal Lobe; Participant; Pathway interactions; Pattern; Performance; Phenotype; Prefrontal Cortex; Principal Investigator; Process; Prospective Studies; Protocols documentation; Public Health; Publishing; Regulation; Remittance; Research; Research Design; Risk; Role; Sampling; Scientific Advances and Accomplishments; Short-Term Memory; Specificity; Structure; Time; Training; Weight; Weight Gain; Weight maintenance regimen; Youth; base; brain pathway; comorbidity; design; dietary; eating pathology; excessive weight gain; executive function; follow-up; healthy weight; improved; inter-individual variation; loss of control over eating; middle childhood; negative affect; neglect; neural correlate; neuroimaging; neuromechanism; obesity in children; prevent; preventive intervention; prospective; psychosocial; relating to nervous system; restraint; therapy development

PROJECT SUMMARY/ABSTRACT Pediatric overweight and obesity continue to be major public health issues. Loss of control (LOC) eating is an obesity-related phenotype that affects approximately 30% of children and adolescents with overweight/obesity and may impede successful weight control. Pediatric overweight/obesity and LOC eating frequently emerge during childhood and adolescence, and tend to follow a chronic and unremitting course if untreated. Both conditions are associated with relative deficiencies in executive functioning (EF), including working memory, planning, inhibitory control, and decision-making. These decrements may impair one’s ability to appropriately regulate weight and eating behavior. A limitation of prior research is that it has been primarily cross-sectional in nature, which inhibits understanding of the timing and direction of influence involved in the associations among EF, weight change, and eating pathology. Moreover, little is known about the domain specificity of relative EF deficits in youth with overweight/obesity and LOC eating, nor about their underlying neural substrates. An improved understanding of the nature and prospective outcomes of EF impairments in youth with overweight/obesity and LOC eating could inform intervention development by indicating whether treatments should focus on improving general and/or food-specific EF, as well as which neural pathways should be targeted to achieve the most robust and sustained effects on eating and weight. The proposed R01 study will examine prospective associations between EF performance and related neural substrates, and child weight change and LOC eating. Community-based children representing a spectrum of risk, including non- overweight/obese (n=60), overweight/obese (n=60), and overweight/obese with comorbid LOC eating (n=60), will provide repeated assessments of height/weight, LOC eating pathology, and general and food-specific EF every 6-12 months over 2 years of follow-up. A subset of participants from each risk category will complete a baseline and 18-month fMRI protocol assessing neural substrates of general and food-specific working memory. Specific aims are to investigate prospective associations between both general and food-specific EF, and their neural substrates, and trajectories of weight change and LOC eating (including remittance and persistence) over 2 years. These data will clarify timing and trajectory of weight change and LOC eating in relation to EF performance and its associated neural activation patterns. This study, which is the first to prospectively examine associations among general and food-specific EF, weight trajectories, and LOC eating, has clear potential to advance scientific and clinical understanding of mechanisms that promote the onset and maintenance of maladaptive eating in youth and inform interventions to alleviate their cumulative personal and societal burden. Furthermore, this application builds on the principal investigator’s programmatic line of research on neurocognitive factors involved in eating- and weight-related problems, and provides a clear pathway to future clinically and scientifically impactful studies.

项目摘要/摘要 小儿超重和肥胖仍然是主要的公共卫生问题。失去控制（LOC）饮食是 肥胖相关的表型影响大约30％的超重/肥胖症儿童和青少年 并可能阻碍成功的体重控制。小儿超重/肥胖和饮食经常出现 在童年和青少年期间，如果没有治疗，并且倾向于遵循慢性和不舒服的过程。两个都 条件与执行功能（EF）的相对缺陷有关，包括工作记忆， 计划，抑制控制和决策。这些减少可能会损害一个人适当的能力 调节体重和饮食行为。先前研究的局限性是它一直是主要的横截面 自然，抑制了对涉及关联涉及的影响的时机和影响方向的理解 EF，体重变化和饮食病理学。此外，对相对EF的域特异性知之甚少 超重/肥胖和LOC饮食的年轻人的缺陷，也没有针对其潜在的神经底物。一个 对年轻人的EF损害的性质和预期结果的理解得以提高 超重/肥胖和LOC饮食可以通过指示是否治疗来为干预开发提供信息 应该专注于改善一般和/或食物特异性的EF，以及哪些神经途径应该是 目标是实现对饮食和体重的最强大，最持续的影响。拟议的R01研究将 检查EF性能与相关神经底物与儿童体重之间的潜在关联 改变和饮食。代表风险范围的社区儿童，包括非 - 超重/肥胖（n = 60），超重/肥胖（n = 60），超重/肥胖与合并症loc（n = 60）， 将重复评估身高/体重，LOC饮食病理学以及一般和食品特异性EF 每6-12个月在2年的随访中。来自每个风险类别的参与者的一部分将完成 基线和18个月的功能磁共振成像协议评估一般和食品特异性工作的神经底物 记忆。具体目的是研究一般和食品特异性EF之间的潜在关联， 及其神经底物以及体重变化和LOC饮食的轨迹（包括汇款和 持久性）超过2年。这些数据将阐明体重变化的时机和轨迹 与EF性能及其相关的神经激活模式有关。这项研究，这是第一个 前瞻性检查一般和食品特异性EF，体重轨迹和LOC饮食之间的关联， 具有明确的潜力来提高对促进发作和发作机制的科学和临床理解 维持青年适应不良的饮食，并告知干预措施以减轻其累积个人和 社会负担。此外，此应用程序建立在首席研究人员的编程线上 研究与饮食和体重有关的问题涉及的神经认知因素，并提供了明确的 通往未来临床和科学影响力研究的途径。