Metabolic profile of healthy, normal-weight adults with low satiety responsiveness.

Eating behaviour traits mediate the association between satiety responsiveness and energy intake among individuals with overweight and obesity

BackgroundBehavioral mechanisms that contribute to the association between breastfeeding and reduced obesity risk are poorly understood. The purpose of this study was to evaluate the hypothesis that feeding human milk from the breast (direct breastfeeding) has a more optimal association with subsequent child appetite regulation behaviors and growth, when compared to bottle-feeding.MethodsChildren (n = 109) aged 3- to 6- years were retrospectively classified as directly breastfed (fed exclusively at the breast), bottle-fed human milk, or bottle-fed formula in the first three months of life. Young children's appetite regulation was examined by measuring three constructs (satiety response, food responsiveness, enjoyment of food) associated with obesity risk, using the Child Eating Behavior Questionnaire. Multinomial logistic regression analyses were used to test whether children bottle-fed either human milk or formula had reduced odds of high satiety and increased odds of high food responsiveness and high enjoyment of food compared to children fed directly from the breast. Current child weight status and growth trends from 6-36 months were also examined for their relation to direct breastfeeding and appetite regulation behaviors in early childhood.ResultsChildren fed human milk in a bottle were 67% less likely to have high satiety responsiveness compared to directly breastfed children, after controlling for child age, child weight status, maternal race/ethnicity, and maternal education. There was no association of bottle-feeding (either human milk or formula) with young children's food responsiveness and enjoyment of food. There was neither an association of direct breastfeeding with current child weight status, nor was there a clear difference between directly breastfed and bottle-fed children in growth trajectories from 6- to 36-months. More rapid infant changes in weight-for-age score were associated with lower satiety responsiveness, higher food responsiveness and higher enjoyment of food in later childhoodConclusionWhile direct breastfeeding was not found to differentially affect growth trajectories from infancy to childhood compared to bottle-feeding, results suggest direct breastfeeding during early infancy is associated with greater appetite regulation later in childhood. A better understanding of such behavioral distinctions between direct breastfeeding and bottle-feeding may identify new pathways to reduce the pediatric obesity epidemic.

Studies have shown that individuals with low satiety efficiency may be more susceptible to weight gain, but little is known about the effect of weight loss intervention outcomes in these individuals. This study aimed to evaluate the impact of an energy-restricted weight loss intervention on eating behavior traits and psychobehavioral factors in individuals differing in their satiety responsiveness. A pooled cohort of individuals who were overweight or obese (n = 100; aged 39 ± 9 years) participating in a 12- to 15-week weight loss program targeting an energy deficit of 500–700 kcal/day were included in this study. Satiety responsiveness was determined by a median split of the mean satiety quotient based on appetite sensations measured in response to a test meal at baseline (low satiety responsiveness (LSR) vs. high satiety responsiveness (HSR)). Anthropometric variables, eating behavior traits, psychobehavioral factors, and ad libitum energy intake were assessed before and after the intervention. Although similar weight loss was observed between the LSR and HSR groups (−3.5 ± 3.2 vs. −3.8 ± 2.8 kg, p = 0.64) in response to an energy-restricted weight loss intervention, changes in eating behavior traits were different between groups. Individuals with LSR had a higher increase in cognitive restraint (+5.5 ± 4.1 vs. +3.5 ± 3.5, p = 0.02) and some of its subscales and a lower decrease in situational susceptibility to disinhibition (−0.6 ± 1.1 vs. −1.2 ± 1.3, p = 0.02) in response to the intervention compared to the HSR group. In conclusion, energy-restricted weight loss intervention seems to trigger undesirable changes in some eating behavior traits in individuals more vulnerable to overeating, which could increase their susceptibility to weight regain.

Some individuals exhibit a weak satiety response to food and may be susceptible to overconsumption. The current study identified women showing consistently low or high satiety responses to standardised servings of food across four separate days and compared them on behavioural, psychological and physiological risk factors for overeating and future weight gain. In a crossover design, 30 female participants (age: 28.0 ± 10.6; body mass index (BMI): 23.1 ± 3.0) recorded sensations of hunger in the post-prandial period following four graded energy level breakfasts. Satiety quotients were calculated to compare individuals on satiety responsiveness across conditions. Body composition, resting metabolic rate (RMR), energy intake, food reward and craving, and eating behaviour traits were assessed under controlled laboratory conditions. A distinct low satiety phenotype (LSP) was identified with good consistency across separate study days. These individuals had a higher RMR, greater levels of disinhibition and reported feeling lower control over food cravings. Further, they consumed more energy and exhibited greater wanting for high-fat food. The inverse pattern of characteristics was observed in those exhibiting a consistently high satiety phenotype (HSP). Weak satiety responsiveness is a reliable trait identifiable using the satiety quotient. The LSP was characterised by distinct behavioural and psychological characteristics indicating a risk for overeating, compared to HSP.

ObjectiveTo determine patterns of satiety responsiveness and its relationship to eating in the absence of hunger (EAH), in a cohort of adolescents. We also assessed whether sex, BMI and duration of breastfeeding, during infancy, predicted satiety responsiveness and eating behavior at 16 years.MethodsAdolescents (n=576) from a longitudinal cohort, that began as an iron deficiency anemia preventive trial, participated in an unlimited breakfast after an overnight fast, and reported satiety response on a visual analogue scale after the meal, followed by an EAH procedure. Height, weight and body composition were measured before breakfast. Latent profile analysis generated profiles that captured individual differences in satiety responsiveness. Multivariable regressions, adjusted for potential confounders, evaluated the association between: 1) satiety responsiveness and EAH, and 2) breastfeeding in infancy, satiety responsiveness and EAH in adolescence.ResultsParticipants were on average 16.7-years-old, 48% female, 37% overweight/obese and 76% were breastfed as the sole source of milk for < 6 months. We found three latent profiles of satiety responsiveness: 1. “responsive” (49%); 2. “not responsive” (41%); 3. “still hungry” (10%). Participants in the “not responsive” or “still hungry” profile were more likely to eat during the EAH procedure (OR=2.5, 95%CI 1.8–3.6). Being breastfed for < 6 months was related to higher odds of being in the “not responsive” or “still hungry” profile (OR 1.8, 95%CI 1.2–2.6) and EAH (OR=2.2, 95% CI 1.4–3.3). Satiety responsiveness was not influenced by sex and overweight/obesity.ConclusionAfter an ad libitum meal, we found varied satiety responses, which related to EAH. Furthermore, shorter breastfeeding duration was associated with poorer satiety response and higher consumption during an EAH procedure. Understanding if breastfeeding influences the development of satiety responsiveness and eating behavior may be important in an era characterized by abundant calorie-dense foods and a plethora of environmental cues promoting consumption.

A better understanding of the cause of obesity is a clinical priority. Obesity is highly heritable, and specific genes are being identified. Discovering the mechanisms through which obesity-related genes influence weight would help pinpoint novel targets for intervention. One potential mechanism is satiety responsiveness. Lack of satiety characterizes many monogenic obesity disorders, and lower satiety responsiveness is linked with weight gain in population samples. To test the hypothesis that satiety responsiveness is an intermediate behavioral phenotype associated with genetic predisposition to obesity in children. Cross-sectional observational study of a population-based cohort of twins born January 1, 1994, to December 31, 1996 (Twins Early Development Study). Participants included 2258 unrelated children (53.3% female; mean [SD] age, 9.9 [0.8] years), one randomly selected from each twin pair. Genetic predisposition to obesity. We created a polygenic risk score (PRS) comprising 28 common obesity-related single-nucleotide polymorphisms identified in a meta-analysis of obesity-related genome-wide association studies. Satiety responsiveness was indexed with a standard psychometric scale (Child Eating Behavior Questionnaire). Using 1990 United Kingdom reference data, body mass index SD scores and waist SD scores were calculated from parent-reported anthropometric data for each child. Information on satiety responsiveness, anthropometrics, and genotype was available for 2258 children. We examined associations among the PRS, adiposity, and satiety responsiveness. The PRS was negatively related to satiety responsiveness (β coefficient, -0.060; 95% CI, -0.019 to -0.101) and positively related to adiposity (β coefficient, 0.177; 95% CI, 0.136-0.218 for body mass index SD scores and β coefficient, 0.167; 95% CI, 0.126-0.208 for waist SD scores). More children in the top 25% of the PRS were overweight than in the lowest 25% (18.5% vs 7.2%; odds ratio, 2.90; 95% CI, 1.98-4.25). Associations between the PRS and adiposity were significantly mediated by satiety responsiveness (P = .006 for body mass index SD scores and P = .005 for waist SD scores). These results support the hypothesis that low satiety responsiveness is one of the mechanisms through which genetic predisposition leads to weight gain in an environment rich with food. Strategies to enhance satiety responsiveness could help prevent weight gain in genetically at-risk children.

Background: High food responsiveness (FR) and low satiety responsiveness (SR) are 2 appetitive traits that have been associated longitudinally with risk of excessive weight gain; however, to our knowledge, no studies have examined the associations between these traits and eating patterns in daily life in young children.Objective: We tested the hypothesis that higher FR is independently associated with a higher meal frequency and that lower SR is associated with a larger meal size.Design: Data were from 1102 families (2203 children) from the Gemini twin birth cohort. Appetite was assessed with the use of the Child Eating Behavior Questionnaire when the children were 16 mo old (mean ± SD: 15.73 ± 1.08 mo old), and meal frequency (eating occasions per day) and meal size (kilojoules per eating occasion) were determined from 3-d diet diaries completed by parents when the children were 21 mo old (mean ± SD: 20.65 ± 1.10 mo old). Complex samples general linear models were used to explore cross-sectional associations between appetitive traits and meal variables.Results: After adjustment for the covariates gestational age, birth weight, sex, difference in age at diet-diary completion, and appetite measurement, higher FR was associated with more-frequent meals (B ± SE: 0.13 ± 0.04; P = 0.001) but not with meal size (P = 0.41), and lower SR was associated with a larger meal size (B ± SE: −47.61 ± 8.79; P < 0.001) but not with meal frequency (P = 0.15).Conclusions: FR and SR predict different eating variables with more food-responsive children eating more frequently, whereas less–satiety-responsive children eat more food on each eating occasion. Different strategies may be required to reduce the potential effects of FR and SR on weight gain.

Appetite and adiposity in children: evidence for a behavioral susceptibility theory of obesity

The satiating efficiency of food has been increasingly quantified using the Satiety Quotient (SQ). The SQ integrates both the energy content of food ingested during a meal and the associated change in appetite sensations. This systematic review examines the available evidence regarding its methodological use and clinical utility. A literature search was conducted in six databases considering studies from 1900 to April 2020 that used SQ in adults, adolescents and children. All study designs were included. From the initial 495 references found, fifty-two were included. Of the studies included, thirty-three were acute studies (twenty-nine in adults and four in adolescents) and nineteen were longitudinal studies in adults. A high methodological heterogeneity in the application of the SQ was observed between studies. Five main utilisations of the SQ were identified: its association with (i) energy intake; (ii) anthropometric variables; (iii) energy expenditure/physical activity; (iv) sleep quality and quantity and (v) to classify individuals by their satiety responsiveness (i.e. low and high satiety phenotypes). Altogether, the studies suggest the SQ as an interesting clinical tool regarding the satiety responsiveness to a meal and its changes in responses to weight loss in adults. The SQ might be a reliable clinical indicator in adults when it comes to both obesity prevention and treatment. There is a need for more standardised use of the SQ in addition to further studies to investigate its validity in different contexts and populations, especially among children and adolescents.

Appetitive traits as targets for weight loss: The role of food cue responsiveness and satiety responsiveness

Association Between State-Based and Trait-Based Responsiveness to Satiety Cues Differs by Child Risk for Overweight/Obesity

The goal was to conduct exploratory analysis to determine if executive functions (EFs) and food responsiveness/satiety responsiveness (appetitive behaviours that describe one's tendency to eat in the presence of food or food cues) interact to influence weight status among preschool children participating in a trial promoting self-regulation around energy-dense foods. At baseline, parents completed the Behaviour Rating Inventory of Executive Function-Preschool and the Child Eating Behaviour Questionnaire. Children completed anthropometric measurements at the preschool. Spearman's correlation, linear regression, and tests of interaction were conducted. The relationship between weight status and EFs among those who were high vs low in food responsiveness and satiety responsiveness was examined. Children (n = 92) had a mean age of 5.1 years and body mass index (BMI) percentile of 57.6; half (54%) were male. There were significant correlations between food responsiveness and several EFs (emotional control, inhibitory control, working memory, and plan/organize). In the stratified analysis, children with high food responsiveness or low satiety responsiveness had higher BMI percentiles as emotional control skills worsened. BMI percentiles were not elevated among children with low food responsiveness and poor emotional control. These results suggest that EFs may be more relevant to weight status if preschool children had high levels of food responsiveness or low levels of satiety responsiveness (ie, increased tendency to be influenced by environmental food cues). This analysis should be replicated with direct measures of executive function and appetitive behaviours in larger samples of young children to examine longitudinal impact on weight status.

Children's satiety responsiveness moderates the association between food reinforcement and eating in the absence of hunger.

BackgroundPrevious studies have reported eating and sleep issues in children with attention deficit hyperactivity disorder (ADHD), but few have focused on those comorbid with overweight/obesity. This study aimed to investigate eating behavior and sleep habit problems in children with ADHD and comorbid overweight/obesity, and their relationship with ADHD core symptoms in such children.MethodsThe study included 124 children with ADHD and overweight/obesity and 145 children with ADHD and normal weight. The Children’s Eating Behavior Questionnaire, Children’s Sleep Habit Questionnaire, and Vanderbilt ADHD Diagnostic Parent Rating Scale were used to assess eating behavior problems, sleep habit problems, and core ADHD symptoms, respectively.ResultsCompared to the normal-weight children with ADHD, those with overweight/obesity scored higher in food responsiveness, enjoyment of food, night waking, sleep-disordered breathing, and daytime sleepiness, while lower in satiety responsiveness, slowness in eating, and emotional undereating. Lower scores of satiety responsiveness and slowness in eating were associated with the presence of overweight or obesity among children with ADHD. In the ADHD overweight/obesity group, shorter sleep duration was correlated with higher body mass index (BMI), and higher food responsiveness was associated with more severe attention deficit symptoms.ConclusionsChildren with ADHD and overweight/obesity reported more eating and sleep problems than those with normal weight. Lower satiety response and faster eating rate may be potential risk factors for overweight/obesity in children with ADHD. Among those with comorbid overweight/obesity, shorter sleep duration associates with higher BMI, and greater food responsiveness relates to more severe attention deficit symptoms. These findings suggest eating and sleep behaviors should be considered in ADHD management, with further research needed on targeted interventions.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13034-025-00954-w.

Introduction Poor sleep health is associated with increased risk for childhood obesity, but the underlying mechanisms are unclear. Eating behaviors may play a role. We examined the association between appetitive traits and objectively-measured sleep variables in 6-year-old children. We hypothesized that poorer or more variable sleep health measures would be associated with higher levels of food approach traits (food responsiveness, enjoyment of food, emotional overeating, and desire to drink), and lower levels of satiety responsiveness. Methods Participants were from an observational long-term follow-up of INSIGHT, an RCT of a responsive parenting intervention for first-time mothers compared to a safety control intervention. At age 6 years, children wore wrist actigraphy (Spectrum Plus) for 7 days to assess sleep. Children with ≥3 valid days were included in analyses (n=167). Mothers completed the Children’s Eating Behavior Questionnaire to assess appetitive traits. Separate regression models examined the association between appetitive traits and sleep variables (M/SD of nighttime total sleep time (TST), onset, offset, and midpoint of sleep timing, and sleep maintenance efficiency), controlling for intervention group, child age, sex, and overweight status. Results Mean TST was unrelated to appetitive traits; greater variability (SD) in TST was associated with higher food responsiveness (B=0.008, p=0.03) and desire to drink (B=0.010, p=0.04). Mean sleep onset time was unrelated to appetitive traits, but greater variability in sleep onset time was associated with higher desire to drink (B=0.686, p=0.004). Higher mean sleep maintenance efficiency was associated with higher satiety responsiveness (B=0.035, p=0.04) and lower enjoyment of food (B=-0.053, p=0.008). Greater variability in sleep maintenance efficiency was associated with higher enjoyment of food (B=0.092, p=0.03) and lower satiety responsiveness (B=-0.089, p=0.01). Emotional overeating was unrelated to sleep variables, and sleep offset and midpoint were unrelated to appetitive traits. Conclusion Other than sleep efficiency, mean levels of sleep health appear unrelated to appetitive traits, but greater variability in sleep health measures were associated with higher levels of potentially obesogenic traits and lower levels of protective traits. Future studies should examine whether promotion of sleep regularity can improve regulation of eating behavior and reduce childhood obesity risk. Support (if any) R01DK088244, KL2TR002015