Abstract
The prevalence of obesity and eating disorders varies by sex, but the extent to which sex influences eating behaviors, especially in childhood, has received less attention. The purpose of this paper is to critically discuss the literature on sex differences in eating behavior in children and present new findings supporting the role of sex in child appetitive traits and neural responses to food cues. In children, the literature shows sex differences in food acceptance, food intake, appetitive traits, eating-related compensation, and eating speed. New analyses demonstrate that sex interacts with child weight status to differentially influence appetitive traits. Further, results from neuroimaging suggest that obesity in female children is positively related to neural reactivity to higher-energy-dense food cues in regions involved with contextual processing and object recognition, while the opposite was found in males. In addition to differences in how the brain processes information about food, other factors that may contribute to sex differences include parental feeding practices, societal emphasis on dieting, and peer influences. Future studies are needed to confirm these findings, as they may have implications for the development of effective intervention programs to improve dietary behaviors and prevent obesity.
Highlights
Sex and gender are important characteristics that contribute to individual variability in the development of disordered eating and obesity, but the extent to which they impact eating behaviors in children is less clear
To support the argument that sex differences in childhood eating behavior are relevant to the development of eating and weight-disorders, we have selectively focused on some aspects of eating behavior (i.e., food acceptance, food intake, picky eating, appetitive traits, eating compensation, eating in the absence of hunger, and meal-specific microstructural patterns)
These results suggest that increased weight status in female children is positively related to neural engagement to high- relative to low-energy density (ED) food cues in regions typically associated with contextual processing and visual object recognition, while in male children the opposite pattern was observed
Summary
Sex and gender are important characteristics that contribute to individual variability in the development of disordered eating and obesity, but the extent to which they impact eating behaviors in children is less clear. Sex-based influences on eating behavior have been thought to be minimal There are both biological (e.g., sexual dimorphic patterns of in utero neural development and genetics) and psychosocial (e.g., parental feeding practices and societal body ideals) factors that may affect the way children eat prior to puberty. Data from the National Health and Nutrition Examination Survey (NHANES) show across all age groups a higher prevalence of obesity among male children compared to females [7] These striking statistics provide support for studying the role of sex in eating behaviors because they are integral to the development of these conditions. Another criterion outlined in this report is if there are known sex differences in disease severity, progression, or outcome. 1–2 years, preschool children as 3–5 years, and middle childhood as 6–11 years
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