Eating behaviors in childhood obesity

Worldwide, childhood obesity is a growing health issue. The World Health Organization (WHO) argues that children should do more physical activity and eat less energy-dense, nutrient-poor foods. What can we do to improve children’s eating behaviors?

In this blog post, we tell you a little more about a study by researcher Ella Lundquist of the Pennsylvania State University and her colleagues at the University of Kansas Medical Center and Children’s Mercy Hospital. As part of a larger study on the effects of commercials on food intake, they studied the relationship between children’s behaviors during a delay of gratification task and eating behaviors during test meals.

Self-control and obesity

One of the factors that is important in both the cause and potential treatment of obesity is self-control. Self-control is the ability to regulate one’s own emotions, thoughts, and behaviors. It consists of multiple facets, including delay of gratification. Delay of gratification is the process of resisting an immediate reward in favor of a later, more valuable reward.

When studying the ability to delay gratification, researchers typically present children with a rewarding food and tell them that they can get more if they are willing to wait for an undisclosed amount of time. For example, a child may choose to get one marshmallow immediately, or to get two if he or she waits (usually for five to twenty minutes). The idea is that the length of time a child can wait for the reward is indicative of self-control, particularly in relation to food.

Looking at food = attentional bias?

Indeed, studies have shown that poorer performance on a delayed gratification task is related to the development of obesity. However, other researchers argue that waiting times may simply reflect how valuable the food item is to the child. Moreover, there is no clear guidance for how long children should wait, possibly limiting the validity of the task.

An alternative to observing waiting time is to identify behaviors during the task that are more generally related to overeating. Specifically, coping strategies such as looking away from food can help extend waiting time. On the other hand, greater time spent looking at food may reflect an attentional bias and present a potential risk factor for obesity.

Lundquist and her team observed these behaviors during a delayed gratification task, in a group of children aged seven to nine years old. They predicted that children who spent more time focused on food, sitting still, and staying silent would have a higher energy intake at subsequent meals. They also hypothesized that these behaviors would be associated with a greater intake of high energy-dense foods.

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Observing looking behaviors

The researchers included a sample of 40 children in their study, of which 24 had a healthy weight and 16 were overweight or obese. They were studied during three laboratory visits. On the first visit, children ate a meal and then completed a delayed gratification task about 30 minutes later. On visits two and three, children viewed a commercial (about food or toys) prior to eating a meal. At each test meal, children could eat as much as they wanted.

During the delayed gratification task, children’s behaviors were videotaped and coded using The Observer XT. Researchers observed looking behaviors, verbal distractions, and movement.

Looking behaviors and food intake

Results showed that children who spent more time looking at food during the delayed gratification task ate more during the subsequent meals. They also ate more energy-dense foods. Furthermore, the researchers found that children who spent more time diverting their attention away from food tended to eat less at laboratory meals. No significant results were found for verbal distractions or movement.

These results are in line with the study’s predictions and provide valuable insights into children’s reactions to food cues. The researchers suggest that future research could also include observations of behaviors during meals, or study behaviors in a delayed gratification task with non-food items.

Understanding more about how eating behaviors are influenced remains important in preventing and treating childhood obesity.

Reference

Lundquist, E.; Austen, M.; Bermudez, M.; Rubin, C.; Bruce, A.; Masterson, T.; Keller, K. (2019). Time spent looking at food during a delay of gratification task is positively associated with children’s consumption at at libitum laboratory meals. Appetite, 141, doi: 10.1016/j.appet.2019.104341.