Central Nervous System and Peripheral Hormone Responses to a Meal in Children

Abstract

Context Behavioral studies suggest that responses to food consumption are altered in children with obesity (OB). Objective To test central nervous system and peripheral hormone response by functional MRI and satiety-regulating hormone levels before and after a meal. Design and Setting Cross-sectional study comparing children with OB and children of healthy weight (HW) recruited from across the Puget Sound region of Washington. Participants Children (9 to 11 years old; OB, n = 54; HW, n = 22), matched for age and sex. Intervention and Outcome Measures Neural activation to images of high- and low-calorie food and objects was evaluated across a set of a priori appetite-processing regions that included the ventral and dorsal striatum, amygdala, substantia nigra/ventral tegmental area, insula, and medial orbitofrontal cortex. Premeal and postmeal hormones (insulin, peptide YY, glucagon-like peptide-1, active ghrelin) were measured. Results In response to a meal, average brain activation by high-calorie food cues vs objects in a priori regions was reduced after meals in children of HW (Z = −3.5, P < 0.0001), but not in children with OB (z = 0.28, P = 0.78) despite appropriate meal responses by gut hormones. Although premeal average brain activation by high-calorie food cues was lower in children with OB vs children of HW, postmeal activation was higher in children with OB (Z = −2.1, P = 0.04 and Z = 2.3, P = 0.02, respectively). An attenuated central response to a meal was associated with greater degree of insulin resistance. Conclusions Our data suggest that children with OB exhibit an attenuated central, as opposed to gut hormone, response to a meal, which may predispose them to overconsumption of food or difficulty with weight loss.

An Exploration of the Role of Sugar-Sweetened Beverage in Promoting Obesity and Health Disparities

“…Compared with healthy weight adults, adults with obesity do not exhibit decreased reward responses to food cues after meal consumption [ 57 ]. Likewise, compared with healthy weight children, children with obesity failed to exhibit reduced reward response to palatable food cues following meal consumption, even though both groups exhibited appropriate circulating satiety hormone responses to the meal [ 67 •]. Additionally, children who failed to exhibit reduced reward response to palatable food cues following meal consumption exhibited the least body weight loss during a family-based behavioral treatment for obesity [ 68 ••].…”

Modulation of neural fMRI responses to visual food cues by overeating and fasting interventions: A preliminary study

“…For each ROI, figures show SPM maps of BOLD activation at p FWE < 0.05 in response to Food > Objects from Pre-to Post-Fast, overlaid on the avg152T1 template. Bar graphs on the right of each figure visually present the mean BOLD response to the Food > Object contrast within clusters meeting statistical thresholds (defined in the Methods; see Table 2 for MNI coordinates) in the pathogenesis of obesity (Roth et al, 2019;Thaler et al, 2012). More specifically, rodent studies show that caloric excess triggers an inflammatory hypothalamic response altering the intricate neuroendocrine hypothalamic network regulating appetite and energy balance (Razolli et al, 2019).…”

Child neurobiology impacts success in family-based behavioral treatment for children with obesity

“…Figure 1B details pre-treatment study visit procedures as previously described ( 25 ). Briefly, participants had a fasting blood draw, consumed a standardized breakfast (milk, toast with butter and jam) representing 10% of their estimated daily caloric requirements (by the Mifflin-St Jeor equation with a standard activity factor of 1.3) ( 33 ) and underwent body composition measurements (Bioelectrical Impedance Analysis (BIA; Quantum II.…”

“…A growing literature ( 19 ) derived from functional magnetic resonance imaging (fMRI) studies demonstrates that adults ( 20 – 22 ) and children ( 23 – 25 ) with obesity exhibit alterations in appetitive processing within brain regions regulating attentional, reward, salience, and motivational aspects of food consumption. Among children with obesity, relative to healthy weight controls, phenotypic responses include enhanced activation to food cues when fasted (or pre-meal) within reward regions ( 23 , 24 ) and reduced ability of food intake to suppress reward-related activation by food cues ( 23 ).…”

“…The degree of response to high-calorie food cues within these regions is a marker of subjective satiety and, critically, also predicts food choice and caloric intake ( 26 , 30 ). We have previously shown that 9–11 year old children with obesity exhibit an attenuated satiety response averaged across these appetite-processing regions compared to children of healthy weight ( 25 ). We therefore tested if activation by food images among children with obesity--measured pre-treatment--predicted weight or behavioral outcomes during a 6-mo.…”