Parental Feeding Practices for Childhood Obesity

Overseen By Jennifer Emond, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Trustees of Dartmouth College

Must not be taking: Appetite medications

Disqualifiers: Food allergies, Dietary restrictions, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

330 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to understand how different parental feeding practices affect childhood obesity, especially in children who may be genetically predisposed to obesity. Researchers examine how parents use control feeding methods, such as restricting foods or using food to soothe emotions, and how these methods might increase overeating tendencies in children. They will study children aged 2.5 to 5 years over time to observe how these practices impact weight gain. Additionally, the trial will explore attentional bias to food cues, which refers to how children's attention is drawn to food-related stimuli, potentially influencing their eating behaviors. Families with children aged 2.25 to 2.99 years, living in Vermont or New Hampshire, and without food allergies or medical conditions affecting appetite are a good fit for this study. As an unphased trial, this study offers families the opportunity to contribute to valuable research that could shape future childhood obesity prevention strategies.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but children taking medication that affects appetite or attention are excluded from participating.

What prior data suggests that these parental feeding practices are safe for children?

Research has shown that paying extra attention to food might be linked to obesity. Some people may focus more on food, which can lead to overeating. However, limited information exists on the safety of studying these attention patterns in young children.

This study does not involve a drug or medical procedure. Instead, it examines how paying attention to food affects eating habits. No direct evidence of physical harm or side effects has been found in this study. It aims to understand how children react to food and how that might relate to their weight over time.

In summary, the study observes behaviors, and no clear data indicates safety issues. It focuses on measuring and understanding behaviors, not introducing new medical treatments. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the trial on parental feeding practices for childhood obesity because it explores how attentional bias to food cues can influence eating behaviors. Unlike traditional approaches that focus on diet and exercise, this method investigates how parents' attentional focus on food might impact their children's weight. The trial aims to uncover whether these cognitive processes can be modified to help manage or reduce childhood obesity, potentially offering a new angle for intervention. By understanding and possibly altering these biases, researchers hope to develop more effective strategies for preventing and treating obesity in children.

What evidence suggests that this trial's treatments could be effective for childhood obesity?

This trial will compare attentional bias to food cues with control cues to understand their impact on childhood obesity. Research has shown that excessive attention to food can increase the risk of childhood obesity. Children who focus more on food might be more likely to gain weight. Studies have found that individuals who pay significant attention to food often exhibit traits that lead to increased eating, especially those already at genetic risk. A review of research suggests that managing this focus on food could help control weight in overweight or obese individuals. Therefore, understanding and addressing this focus in young children might be crucial for preventing obesity. ^{1 2 3 4 6}

Who Is on the Research Team?

Jennifer Emond, PhD

Principal Investigator

Dartmouth College

Diane Gilbert-Diamond, ScD

Principal Investigator

Dartmouth College

Are You a Good Fit for This Trial?

This trial is for children aged 2.5 to 5 years who may be at risk of obesity due to genetic factors and certain eating behaviors. It focuses on understanding how parents' feeding practices influence their child's weight gain over time, especially in those with a high genetic predisposition for obesity.

Inclusion Criteria

My child is between 2 years 3 months and 2 years 11 months old with normal or corrected vision.

Exclusion Criteria

I do not have food allergies, dietary restrictions, take medication that affects my appetite or attention, and no relatives are in this study.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Initial assessment of children's genetic risk for obesity and baseline measurement of appetitive traits and adiposity

1 visit

1 visit (in-person)

Longitudinal Assessment

Repeated assessments of coercive parental food practices, eating in the absence of hunger, appetitive traits, and adiposity every 6 months

2.5 years

5 visits (in-person)

Follow-up

Participants are monitored for changes in appetitive traits and adiposity after the main assessment period

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Attentional bias to food cues

Trial Overview The study examines the relationship between parental feeding methods, like restricting food or using it as an emotional tool, and children's appetitive traits that can lead to overeating. The goal is to see how these factors contribute to childhood obesity, particularly in genetically susceptible kids.

How Is the Trial Designed?

Group I: Food Cues Active Control 1 Intervention

Attentional bias to Food cues experimental measurement

Group II: Control Cues Active Control 1 Intervention

Attentional bias to food cues control measurement

Who Is Running the Clinical Trial?

Trustees of Dartmouth College

Lead Sponsor

Trials

32

Recruited

14,500+

Dartmouth-Hitchcock Medical Center

Collaborator

Trials

548

Recruited

2,545,000+

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Collaborator

Trials

2,513

Recruited

4,366,000+

Dartmouth College

Collaborator

Trials

93

Recruited

1,415,000+

Published Research Related to This Trial

A study involving 50 children (25 overweight and 25 healthy-weight) aged 8-12 years found that both groups initially orient towards food stimuli, but overweight children continue to show a preference for food images during longer attention spans (500 ms and 1500 ms).

This suggests that while all children may initially notice food cues, overweight children have a sustained attentional bias towards food, indicating a potential mechanism that could contribute to the risk of obesity later in life.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The role of attentional biases to appetitive stimuli in childhood overweight. Rojo-Bofill, LM., Ortiz-Roldán, A., Moreno-Giménez, A., et al.[2020]

A study involving 58 obese women revealed a significant attentional bias towards food cues compared to normal weight controls, indicating that obesity is associated with heightened focus on food-related stimuli.

In a follow-up experiment with 96 obese women, training to avoid food pictures successfully reduced this attentional bias, suggesting that modifying attentional processing could be a promising strategy for addressing overeating behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Biased attentional processing of food cues and modification in obese individuals. Kemps, E., Tiggemann, M., Hollitt, S.[2018]

A study involving 60 adolescents (30 obese and 30 controls) found that obese adolescents showed different patterns of visual attention to food cues, particularly high-calorie foods, compared to their non-obese peers, especially in later stages of viewing.

Higher cognitive abilities, as measured by the Perceptual Reasoning Index, were associated with reduced attention to high-calorie food images over time in the obese group, suggesting that cognitive factors may influence how food cues are processed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dynamic changes in the food-cue processing of obese adolescents: A controlled eye-tracking study from a dual-system perspective. Akcay, E., Oztop, DB., Aydın, Ö., et al.[2022]

The human attentional system is naturally more responsive to food items compared to nonfood items, as shown in two visual search experiments where participants detected food targets faster.

Individuals with lower Body Mass Index (BMI) exhibited a stronger attentional bias towards food, suggesting that this bias may influence energy consumption and could be a risk factor for weight gain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Food catches the eye but not for everyone: a BMI-contingent attentional bias in rapid detection of nutriments. Nummenmaa, L., Hietanen, JK., Calvo, MG., et al.[2021]

Obese children do not show a greater attention bias for food compared to healthy-weight children, suggesting that the ability to focus on food cues is similar across weight statuses.

However, an initial orientation bias towards food is linked to less weight loss in obese children after 6 months of a weight loss intervention, indicating that this automatic attention to food may hinder their weight loss efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Food through the child's eye: An eye-tracking study on attentional bias for food in healthy-weight children and children with obesity. Werthmann, J., Jansen, A., Vreugdenhil, AC., et al.[2018]

In a study of 222 children, maternal feeding styles did not show significant associations with child overweight at ages 21, 27, and 33 months, suggesting that feeding practices may not be a strong causal factor in early childhood obesity.

Despite various maternal feeding styles being tracked throughout toddlerhood, the research indicates that other factors may play a more critical role in influencing childhood overweight, highlighting the need for future studies to explore different conceptualizations and measurement methods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Longitudinal associations between maternal feeding and overweight in low-income toddlers. Lumeng, JC., Kaciroti, N., Retzloff, L., et al.[2019]

In a study of 69 participants, the pictorial visual probe task revealed a greater food-related attentional bias compared to the lexical task, indicating that the type of stimuli used can significantly affect the measurement of attentional bias.

The study found poor test-retest reliability for the pictorial task, suggesting that attentional bias may not be stable over time and highlighting the need for standardized measurement methods in future research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Measuring Food-Related Attentional Bias. Franja, S., McCrae, AE., Jahnel, T., et al.[2021]

A study involving 31 healthy young adults showed that food labels, particularly low-calorie labels, can significantly influence implicit motivation to approach or avoid caloric rewards, even when the actual taste of the beverages is identical.

fMRI results indicated that low-calorie labels increased brain activity in areas related to motor control during the approach phase, while high-calorie labels activated regions associated with aversion, suggesting that labeling can shape our eating behaviors and preferences without any sensory differences.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Top-down expectation effects of food labels on motivation. Wegman, J., van Loon, I., Smeets, PAM., et al.[2019]

A meta-analysis of studies on attentional bias to food stimuli found no significant differences between individuals with overweight/obesity and those with a healthy weight, suggesting that attentional bias may not be a key factor in the maintenance of obesity.

The review highlighted limitations in existing research, such as unreliable measures and the need to consider factors like binge eating, indicating that more rigorous methods are needed to accurately assess attentional bias in relation to obesity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A systematic review and meta-analysis of attentional bias toward food in individuals with overweight and obesity. Hagan, KE., Alasmar, A., Exum, A., et al.[2021]

A study involving interviews and diaries from 22 mothers of healthy weight children aged 3-5 revealed that parental feeding behaviors are primarily motivated by practical and health considerations rather than concerns about weight.

Parents demonstrated a variety of feeding strategies, including promoting or restricting food intake and responding to their children's individual appetitive traits, suggesting that obesity prevention efforts should align with parents' motivations and focus on their children's unique characteristics.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parental feeding behaviours and motivations. A qualitative study in mothers of UK pre-schoolers. Carnell, S., Cooke, L., Cheng, R., et al.[2021]

A training program aimed at improving cognitive control over unhealthy food choices was found to be feasible and acceptable for 36 obese youngsters aged 9-15 years in an inpatient treatment program.

However, the preliminary results indicated that the cognitive training tasks did not effectively help these children in maintaining weight loss after treatment, suggesting a need for further research to improve intervention strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Computer training of attention and inhibition for youngsters with obesity: A pilot study. Verbeken, S., Braet, C., Naets, T., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7995328/

Measuring attentional bias to food cues in young children ... Attentional bias to food cues may be a risk factor for childhood obesity, yet there are few paradigms to measure such biases in young children.

2. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1471015324000333

The associations between attentional bias to food cues ... Individuals with high attentional bias to food cues and obesogenic appetitive traits may be particularly susceptible to weight gain.

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11144077/

The associations between attentional bias to food cues ... Individuals with high attentional bias to food cues and obesogenic appetitive traits may be particularly susceptible to weight gain.

4. esmed.org esmed.org/MRA/mra/article/download/3918/99193546944/

Late-stage Attentional Bias towards Food Cues Varies ... Overconsumption of energy dense foods is a main contributing factor in the rising number of individuals classified as overweight to obese 1,4,5.

5. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/10.1111/obr.13745

A systematic review of the effectiveness of attentional bias ... This systematic review explored the efficacy of ABM as a tool to support weight management for individuals who are overweight or obese.

6. frontiersin.org frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.629115/full

Measuring Food-Related Attentional Bias Attentional bias is of interest as studies have found that increased attentional bias is associated with obesity; others, however, have not. A ...