Comparing Child Eating Patterns in Controlled and Home Environments

Project Summary Increased availability of high-energy dense foods has contributed to a pediatric obesity epidemic, with 23% of United States children currently presenting with the disease.11 Recently, laboratory studies identified an ‘obesogenic’ style of eating marked by larger bites, and faster eating and bite rates.12,13 This highlights that how children eat contributes to both overconsumption12,14 and greater adiposity.13,14 These components of ‘eating microstructure’ have been proposed as modifiable behavioral targets for obesity prevention.15,16 However, it is unclear if laboratory measures of children’s eating style generalize to the home environment, where children consume two thirds of their total energy.17–19 NICHD’s Pediatric Growth and Nutrition Branch emphasizes the importance of identifying early risk factors for childhood obesity, therefore, the proposed study will use a smart-phone based research platform to 1) test if child eating styles observed in the lab generalize to more ecologically valid home environments and 2) identify aspects of home food environment that amplify obesogenic eating behaviors. We will assess laboratory and home eating styles (e.g., bite rate) in 100 prepubertal 6-9-year-old children to constrain variability in energy requirements.20 Children will be video-recorded while consuming identical study-provided meals at home and in the laboratory (counter-balanced order) in addition to a ‘typical’ meal at home. Parents will use smart-phone devices and the Wear-IT app10 to video-record children at home. To study how adiposity relates to “obesogenic” styles of eating, gold standard dual x-ray absorptiometry49 will be used. We hypothesize children will have a consistent eating style in the laboratory and at home and that regardless of meal environment or composition, children with higher adiposity will have more obesogenic styles of eating (e.g., faster bite rate, larger bites) compared to children with lower adiposity. Parents will also report social (e.g., feeding practices21) and physical (e.g., foods available22) characteristics of the home food environment, as these can influence child eating behaviors. We hypothesize that home food environments characterized by greater availability of energy dense foods, greater access to technology during meals, and less frequent family meals will be associated with a more obesogenic eating style in the home than the laboratory. The ability to target eating behaviors that drive overconsumption is critical for the prevention of pediatric obesity, a primary goal of NICHD’s Pediatric Growth and Nutrition Branch. Assessing eating behaviors in ecologically valid home settings is a critical step in the prevention overconsumption and obesity. The proposed virtual platform will also lay the foundation for other areas of child health that rely on manual coding of behaviors (e.g., communication, human development, and clinical psychology), setting the stage for longer-term impacts. The use of smart-phone devices also reduces barriers to research and clinical participation for rural and underserved populations (e.g., proximity to research/care centers, transportation) by providing a virtual platform to engage families in their home.