Understanding eating in the absence of hunger among young children: A systematic review of existing studies

Abstract

Background Eating in the Absence of Hunger (EAH), or consuming highly palatable foods when satiated, is one behavioral pathway that may lead to childhood obesity. EAH is an objective, laboratory-based measure. A more comprehensive understanding of potential determinants of EAH could inform childhood obesity programs outside of a laboratory setting. Objective Systematic review of EAH experiments to identify individual, familial, and societal-level correlates of EAH among children 12 years of age or younger. Design 1,487 studies were retrieved from five electronic databases (Medline [PubMed], Web of Science, Cochrane Library, CINAHL, PsycINFO). Eligible studies were those that measured EAH as initially operationalized in a laboratory setting enrolling children ≤12 years or reporting age-specific results for children ≤12 years. Only articles written in English were included. Results 12 cross-sectional, six prospective, and one behavioral-intervention studies were included in the review. EAH was observable among boys and girls; absolute levels of EAH increased with age; and maternal feeding styles were associated with EAH among girls. The most consistent evidence supported increased levels of EAH among overweight and obese versus normal weight children, both cross-sectionally and prospectively. Two studies supported a genetic component to EAH. Conclusions Studies enrolling independent samples support a positive association between weight status and EAH among children; studies addressing causality are needed. Other various individual, genetic, and familiar characteristics were associated with EAH, yet studies among more heterogeneous sample populations are needed to confirm findings. Studies addressing societal-level factors related to EAH were absent.

Contextual factors associated with eating in the absence of hunger among adults with obesity

“…Therefore, mechanisms driving EAH require further study, especially given associations between EAH and excess weight status. (12) Indeed, time of day may be a more salient factor in the context of eating episodes than EAH in individuals with obesity, suggesting that weight control interventions may benefit from addressing time of day effects on eating behavior (e.g., encouraging mindful eating in the evening, when distractions may be more common).…”

“…(3) Disinhibited eating, characterized by a lack of healthy restraint over eating including eating in the absence of hunger (EAH), (4) may promote excess energy intake, (5) unhealthy weight gain, (6–8) and obesity. (9–11) Contrary to pediatric samples, (12) EAH in adults is underexplored, (5, 13–17) particularly in the natural environment. (18) …”

Role of food preoccupation and current dieting in the associations of parental feeding practices to emotional eating in young adults: A moderated mediation study

“…Feeding practices that reflect coercive control, such as pressuring children to eat, restricting children's access and consumption of unhealthy foods, and using food to influence children's behaviors or regulate their emotions, appear especially detrimental to the development of healthy eating patterns and weight (Lansigan, Emond, & Gilbert-Diamond, 2015;Shloim, Edelson, Martin, & Hetherington, 2015;Vaughn et al, 2016;Ventura & Birch, 2008). Cross-sectional and experimental studies have established associations between these feeding practices and increased child preference for restricted foods, heightened responsiveness to the presence of palatable foods, and eating beyond satiety when restricted foods are made available (Galloway, Fiorito, Francis, & Birch, 2006;Jansen et al, 2012).…”

Randomized Exposure to Food Advertisements and Eating in the Absence of Hunger Among Preschoolers

“…In our other study conducted among 9-to 10-year-olds, 6 current BMI percentile was strongly related to consumption during the EAH phase, suggesting that we were observing an existing behavioral pattern that may have contributed to the children's current BMI percentile. There are known longitudinal associations between EAH behaviors and weight gain, 7,12 even among toddlers. 26 It is critical to next understand how exposures that can prime cued eating might influence the establishment of EAH behaviors prospectively.…”

“…4 Exposure to TV food advertisements prompts cued eating among schoolage children, 5 even after consuming a satiating meal. 6 This is concerning if such excess caloric consumption leads to excess weight gain 7 or primes a preference for energy-dense foods. 8 However, no study to date has tested whether food advertisements cue eating among preschool-age children.…”