Chandlee Laboratory
University Park, Pennsylvania, 16802, United States
NCT Number: NCT05456516
Children from rural communities are at greater risk for obesity than children from more urban communities. However, some children are resilient to obesity despite greater exposure to obesogenic influences in rural communities (e.g., fewer community-level physical activity or healthy eating resources). Identifying factors that promote this resiliency could inform obesity prevention. Eating habits are learned through reinforcement (e.g., hedonic, familial environment), the process through which environmental food cues become valued and influence behavior. Therefore, understanding individual differences in reinforcement learning is essential to uncovering the causes of obesity. Preclinical models have identified two reinforcement learning phenotypes that may have translational importance for understanding excess consumption in humans: 1) goal-tracking-environmental cues have predictive value; and 2) sign-tracking-environmental cues have predictive and hedonic value (i.e., incentive salience). Sign-tracking is associated with poorer attentional control, greater impulsivity, and lower prefrontal cortex (PFC) engagement in response to reward cues. This parallels neurocognitive deficits observed in pediatric obesity (i.e., worse impulsivity, lower PFC food cue reactivity). The proposed research aims to determine if reinforcement learning phenotype (i.e., sign- and goal-tracking) is 1) associated with adiposity due to its influence on neural food cue reactivity, 2) associated with reward-driven overconsumption and meal intake due to its influence on eating behaviors; and 3) associated with changes in adiposity over 1 year. The investigators hypothesize that goal-tracking will promote resiliency to obesity due to: 1) reduced attribution of incentive salience and greater PFC engagement to food cues; and 2) reduced reward-driven overconsumption. Finally, the investigators hypothesize reinforcement learning phenotype will be associated due to its influence on eating behaviors associated with overconsumption (e.g., larger bites, faster bite rat and eating sped). To test this hypothesis, the investigators will enroll 76, 8-10-year-old children, half with healthy weight and half with obesity based on Centers for Disease Control definitions. Methods will include computer tasks to assess reinforcement learning, dual x-ray absorptiometry to assess adiposity, and neural food cue reactivity from functional near-infrared spectroscopy (fNIRS).
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Notify Me8 year–10 year
All sexes
Interventional
Not applicable
University Park, Pennsylvania, 16802, United States
Healthy volunteers accepted: Yes
Only the study team can determine whether someone qualifies for participation.
Child Inclusion Criteria:
Parent Inclusion Criteria:
Exclusion criteria
Parent Exclusion Criteria:
Children will rate foods on taste, health, and desire to eat. The order in which they rate the food characteristics is randomly assigned and counter-balanced across participants
Time frame: baseline and 1 year follow-up
child height and weight will be measured
Time frame: baseline and 1-year follow-up
The BodPod uses air displacement plethysmography to assess body composition including fat mass and fat-free mass in children
Time frame: baseline and 1-year follow-up
Intake in grams from standard meal
Time frame: baseline and 1-year follow-up
Intake in kcal during a standard meal
Time frame: baseline
Intake in grams during a snack buffet using a standard eating in the absence of hunger paradigm (i.e., non-homeostatic intake)
Time frame: baseline
Intake in kcal during a snack buffet using a standard eating in the absence of hunger paradigm (i.e., non-homeostatic intake)
Time frame: baseline
Functional near infrared spectroscopy will measure brain activity through oxy- and deoxyhemoglobin while children rate food images on health, taste and wanting
Time frame: baseline
Functional near infrared spectroscopy will measure brain activity through oxy- and deoxyhemoglobin while children choose which of two foods they would like to eat
Time frame: 1-year follow-up
Functional near infrared spectroscopy (fNIRS) will measure brain activity through oxy- and deoxyhemoglobin in response to consumption of taste-test samples of foods both before and after a standard laboratory meal
Time frame: 1-year follow-up.
Functional near infrared spectroscopy will measure brain activity through oxy- and deoxyhemoglobin while children rate how much they want foods samples and how each sample tasted after consumption. This is completed before and after a standard test meal
Time frame: baseline and 1-year follow-up
Ratings of how much a child likes a food is measured on a computerized visual scale. The scale is from 1 (Hate It) to 5 (Love It).
Time frame: baseline and 1-year follow-up
Child fullness will be measured using a pictorial fullness scale termed a Freddy Fullness scale. Prior to the visit, children will be instructed to fast for at least 3hrs. They are then instructed on use of the scale by trained research personnel. Following this, children will be asked to report current fullness on the scale, which measures a fullness range of 0 to 150 mm. This will be done before and after each meal and taste test. The scale will also be used before and after the fNIRS session.
Time frame: baseline and 1-year follow-up
An ActiGraph watch will be given to the parent with instruction. The child will be wearing the wrist watch for one week in the baseline time period (other than when showering, bathing or in a pool) and will hand it back at their next visit.
Time frame: baseline and 1-year follow-up
An ActiGraph watch will be given to the parent with instruction. The child will be wearing the wrist watch for one week in the baseline time period (other than when showering, bathing or in a pool).
Time frame: baseline and 1-year follow-up
Self-report questionnaire for child: The Children's Anxiety Meter Scale measures state anxiety before and after the fNRIS session
Time frame: baseline
Self-report questionnaire for child: The Perceived Stress Scale asks the child about feelings over the last month to assess perceived stress
Time frame: baseline and 1-year follow-up
Self-report questionnaire for child: The loss of control eating questionnaire asks children if they have recently experienced and episode of loss of control eating
Time frame: baseline and 1-year follow-up
Parental report questionnaire: information describing the cultural, social and financial characteristics of the family.
Time frame: baseline and 1-year follow-up
Parental report questionnaire: Child Puberty and Tanner Questionnaire is score in the following way: Male genitals are scored on a scale of 1 to 5 maturity, female breasts on a scale of 1 to 5 and both males and females on a scale of 1 to 5 for pubic hair quality and extension. Higher values indicate more pubertal development
Time frame: baseline and 1-year follow-up
Parental report questionnaire: Child Feeding Questionnaire (CFQ) is scored on a scale of 1-5 with lower values being better (score is the average of items for each subscale).
Time frame: baseline
Parental report questionnaire: The Child Eating Behavior Questionnaire (CEBQ) was designed to assess children's eating scale styles. It is a parent-report measure comprised of 35 items, each rated on a five-point likert scale that ranges from never to always. It is made up of eight scales: Food responsiveness, Emotional over-eating, Enjoyment of food, Desire to drink, Satiety responsiveness, Slowness in eating, Emotional under-eating, and Food fussiness.
Time frame: baseline
Parental report questionnaire: The Child Behavior questionnaire (CBQ) is an assessment of temperament.Children are assessed on 15 primary temperament characteristics using a 7 point Likert scale.
Time frame: baseline
Parental report report questionnaire: The Behavior Rating Inventory of Executive Function (BRIEF-2) assesses executive function and self-regulation. Questions are answered on a 3-point scale (never, sometimes, often). This rating is scored by taking a sum of all items and referencing and age- and sex-normalized tables to get T-scores and percentiles; Higher T-scores indicate less Executive Function.
Time frame: baseline and 1-year follow-up
Parental report questionnaire: The Binge Eating Scale asks parents about children's eating behaviors related to binge eating and overeating. Response are from 1 - 4 which scales from the least to most severe
Time frame: baseline and 1-year follow-up
Parental report questionnaire: The Child Sleep Habits Questionnaire contains 8 questions describing a child's sleep habits. The answers are on a 3 point scale with an opportunity to note if the answer indicates a problem.
Time frame: baseline and 1-year follow-up
Parental report questionnaire: The External Food Cue Responsiveness Scale Questionnaire asks nine questions related to external food cues, answered in a 1 (never) -5 (always) scale. Higher scores indicate an increased responsiveness to external food cues.
Time frame: baseline
Parental report questionnaire: The Family Food Behavior Survey asks parents about the food and feeding behaviors in the home and has the following sub scales: and provides subscale scores for the following behaviors: Maternal Control, Maternal Presences, Child Choice, and Organization. Questions are scored from 0 - Never True, 1 - Rarely True, 2 - Sometimes, 3 - Often True, 4 - Always True
Time frame: baseline
Parental report questionnaire: The Sensitivity to Punishment and Reward Questionnaire asks about child behaviors and has the follow sub scales: Fear/Shyness, Anxiety, Conflict Avoidance, Sensory Reward, Drive, Responsiveness to Social Approval, Impulsivity/Fun Seeking. The original 4 subscales (2004; 34 item subscales): Sensitivity to Punishment, Impulsivity/Fun Seeking, Drive, and Reward Responsiveness. Parents respond from 1 - Strongly Disagree, 2 - Disagree, 3 - Neither Agree nor Disagree, 4 - Agree, 5 - Strongly Agree
Time frame: baseline
Self-report questionnaire for the parent: The Three Factor Eating Questionnaire asks the parents about their own eating behaviors and has the following subscales - Cognitive Control of Eating Behaviors, Disinhibition of Control, and Susceptibility to Hunger.
Time frame: baseline and 1-year follow-up
Self-report questionnaire for the parent: The Parent Weight Loss Behavior Questionnaire asks parents about their use of healthy and unhealthy weight loss behaviors
Time frame: baseline
The child will be given the Wechsler Abbreviated Scale of Intelligence to estimate cognitive ability. It is a battery of four subtests: Vocabulary (31-item), Block Design (13-item), Similarities (24-item) and Matrix Reasoning (30-item). Each of the 4 subtests is scored by taking a sum of all items and referencing and age- and sex- normed tables to get standardized scores; these standardized scores are then added to get the 3 subscale scores, their associated IQ scores percentiles; Higher scores indicate a higher IQ.
Time frame: baseline
The Dellis-Kaplan Executive Function System Trail Making Test, Design Fluency, and Verbal Fluency will be used to assess motor processing speed, cognitive processing speed, fluency, and switching
Time frame: baseline
The Flanker is a measure of interference. Scoring is based on a combination of accuracy and reaction time. A 2-vector scoring method is employed that uses accuracy and reaction time, where each of these "vectors" ranges in value between 0 and 5, and the computed score, combining each vector score, ranges in value from 0-10. For any given individual, accuracy is considered first. If accuracy levels for the participant are less than or equal to 80%, the final "total" computed score is equal to the accuracy score. If accuracy levels for the participant reach more than 80%, the reaction time score and accuracy score are combined. Higher scores indicate higher levels of ability to attend to relevant stimuli and inhibit attention from irrelevant stimuli.
Time frame: baseline
The List Sorting Working memory test assesses working memory. The List Sorting test requires immediate recall and sequencing of different visually and orally presented stimuli (i.e., "working memory"). Pictures of different foods and animals are displayed with accompanying audio recording and written text (e.g., "elephant"), and the participant is asked to say the items back in size order from smallest to largest, first within a single dimension (either animals or foods, called 1-List) and then on two dimensions (foods, then animals, called 2-List). The test takes approximately seven minutes to administer. List Sorting is scored by summing the total number of items correctly recalled and sequenced on 1-List and 2-List, which can range from 0-26.Higher scores on each of these indicate higher levels of working memory within the normative standard being applied.
Time frame: baseline
The Dimensional Change Card Sort Test is used to measure cognitive flexibility. Two target pictures are presented that vary along two dimensions (e.g., shape and color). Scoring is based on a combination of accuracy and reaction time. A 2-vector scoring method is employed that uses accuracy and reaction time, scores ranging from 0-10. For any given individual, accuracy is considered first. If accuracy levels for the participant are less than or equal to 80%, the final "total" computed score is equal to the accuracy score. If accuracy levels for the participant reach more than 80%, the reaction time score and accuracy score are combined. Higher scores indicate higher levels of cognitive flexibility.
Time frame: baseline and 1-year follow-up
An air displacement plethysmograph (BodPod) will be used to measure child body composition
Time frame: baseline and 1-year follow-up
The parent who primarily makes food related decisions in the house will accompany the child to the visit and will have their height and weight measured. They will also report on the height and weight of the other parent
Time frame: baseline and 1-year follow-up
Parental report questionnaire: The Home Food Inventory is a pre-specified list of foods that parents mark as present or not in the home. This is completed by the parent while at home.
Time frame: baseline and 1-year follow-up
Parental report questionnaire: The HELIX study short, quantitative food frequency questionnaire asks parents to report the frequency with which their child consumes various foods.
Time frame: baseline and 1-year follow-up
Parental report questionnaire: Parents report on various aspect of the home and neighborhood environment
Time frame: baseline
Parental report questionnaire: The Structure and Control in Parent Feeding is an assessment of parental feeding practices
Time frame: baseline
Parental report questionnaire: the Feeding to Manage Child Behavior Questionnaire is an assessment of parental use of food to manage or control their child's behaviors
Time frame: 1-year follow-up
Child report questionnaire: The Body Image Scale assesses children's own perception of their body size and their ideal body size
Time frame: 1-year follow-up
Child report questionnaire: The Weight Concerns Scale assesses the extent to which children are concerned about their weight
Time frame: baseline and 1-year follow-up
Child report questionnaire: The Stress in Children Questionnaire assesses child stress
Time frame: baseline
Parental report questionnaire: The Lifestyle Behavior Checklist is a list of problematic food- and eating-related behaviors that parents rate the frequency of and indicate if they consider it problematic
Time frame: baseline and 1-year follow-up
Metabolites from first-void child urine samples
Time frame: baseline and followup
Children will be video recorded and eating behaviors will be coded including bites, meal duration, latency to first bite, and distraction behaviors. Other microstructure behaviors will be computed such as bite size and eating rate.
Time frame: baseline
Children will be video recorded and eating behaviors will be coded including bites, meal duration, latency to first bite, and distraction behaviors. Other microstructure behaviors will be computed such as bite size and eating rate. Additionally, approach and self-control behaviors will be codes from videos (e.g., smelling food, distraction from food).
Time frame: Baseline
This is a two-stage reward-related decision making tasks that will be assessed with a computational model of reinforcement learning that estimates parameters such as weighting, reward decay, choice and response 'stickiness' and tendency to switch.
Time frame: baseline
This is a visual attention task that measures response speed when there is a presence of a rewarded or non-rewarded visual distraction. Key outcome is response speed difference between trials with rewarded visual cue versus not.
Time frame: followup
The pavlovian instrumental transfer task for children measures extent to which stimuli previously associated with reward (or other outcomes) enhance or bias independently learned goal-directed actions. Outcomes will assess general and specific PIT scores
Time frame: baseline and followup
The population density of primary home address and school address will be assessed using the National Center for Education Statistics locale definitions.
Penn State University
Other
Neurocognitive and Behavioral Factors That Promote Resiliency to Pediatric Obesity
Acronym: BRAKE
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