Abstract
Background/ObjectivesCharacterizing behavioral phenotypes that predict increased zBMI gain during adolescence could identify novel intervention targets and prevent the development of obesity. The purpose of this study was to determine if sensitization of the relative reinforcing value (RRV) of high (HED) or low energy density (LED) foods predicts adolescent weight gain trajectories. A secondary aim was to test the hypothesis that relationships between sensitization of the RRV of food and weight change are moderated by delay discounting (DD).Subjects/MethodsWe conducted a prospective, longitudinal cohort study in 201 boys and girls with an average zBMI of 0.4, who began the study between the ages of 12 and 14 years and completed the study 2 years later. Participants completed five laboratory visits where the RRV of HED and LED, and DD were assessed at a baseline (visits 1, 2, and 4) and then RRV was measured again after participants consumed a portion of the same HED and LED food for 2 weeks (visits 3 and 5; order counterbalanced). Increases (>1) in the RRV from baseline to post-daily intake were categorized as “sensitization” and decreases (≤1) were categorized as “satiation.” Participants returned to the laboratory for follow-up visits at 6, 15, and 24 months to have height and weight taken and to complete additional assessments.ResultsSensitization to HED food was associated with a greater zBMI change over time (β = 0.0070; p = 0.035). There was no impact of sensitization to LED food or interaction between sensitization to HED and LED food on zBMI change and no moderation of DD on the relationship between HED sensitization and zBMI change (all p > 0.05).ConclusionOur prior work showed that sensitization to HED food is cross-sectionally associated with greater zBMI. This study extends this work by demonstrating that sensitization to HED food prospectively predicts increased zBMI gain over time in adolescents without obesity. Future studies should determine if sensitization can be modified or reduced through behavioral intervention.Trial registrationClinicaltrials.gov: NCT04027608.
Highlights
Adolescence is a critical time period for establishing weightrelated behaviors that track to adulthood [1]
We have demonstrated that the sensitization of the reinforcing value (RRV) of high energy density (HED) food is associated with greater BMI and weight gain over time in adults [17] and is cross-sectionally associated with greater zBMI in adolescents [19]
Exclusion to low energy density (LED) food could offset the impact of sensitization to HED food on zBMI change, so we explored that interaction in this study
Summary
Adolescence is a critical time period for establishing weightrelated behaviors that track to adulthood [1]. This period is marked by rapid physical, psychosocial, and neurological development that favors reward responses that are often not countered by a relatively immature inhibitory control system [2,3,4]. Higher RRV of food is associated with greater BMI and weight gain over time [5]. This relationship is moderated by delay discounting (DD), or the tendency to select smaller, more immediate rewards as opposed to larger, delayed rewards [6]. Adolescence is an understudied developmental time period with respect to reinforcement pathology and may be an important time for establishing this behavioral phenotype
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