Psychosocial influences on appetite and eating behavior

Eunice Kennedy Shriver National Institute Of Child Health & Human Development

Investigators

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Abstract

1) Adolescent socioeconomic deprivation and perinatal complications Socioeconomic deprivation experienced objectively (e.g., lack of money/opportunities) or subjectively (perceptions of having less money/opportunities compared to others) are associated with risk factors for cardiometabolic pregnancy complications including diet, physical activity, and obesity. However, experiences of objective and subjective socioeconomic deprivation in adolescence have not been explored as potential risk factors in developing these perinatal complications in adulthood. This study explored independent associations between objective and subjective socioeconomic status (SES) in adolescence and later experiences of gestational diabetes (GDM), preeclampsia-eclampsia (PE) and hypertensive disorders of pregnancy (HDP). Using the National Longitudinal Study of Adolescent to Adult Health (Add Health), we examined the relationships between family poverty during adolescence (Wave I, 1994-1995, ages 12-16), perceptions of familys relative SES while growing up (assessed retrospectively at Wave V, 2016-2018, ages 33-39) and lifetime experiences of GDM, PE, or HDP by Wave V. We found that experiencing low relative SES and poverty during adolescence were independently associated with risk of GDM, but not with PE or HDP. Findings provide insight into potential mechanisms linking early-life SES with GDM, suggesting that interventions to reduce inequities during adolescence may contribute to the reduction of socioeconomic disparities in GDM later in life. This project has been completed; results have been accepted for publication in Annals of Epidemiology. 2) Intergenerational socioeconomic mobility and health Changes in SES between childhood and adulthood, known as socioeconomic mobility, are thought to primarily impact adult health through changes in financial resources. However, changes in psychosocial experiences associated with moving between SES environments (i.e., perceptions of SES advantage/disadvantage) may also impact adult health, independent of childhood or adulthood SES. Using data from Add Health, this study investigated associations between socioeconomic mobility, adult eating behaviors (fast-food FFC and sugar-sweetened beverage SBC consumption) and adult metabolic health (body mass index BMI, metabolic syndrome Mets). We also tested whether these relationships were mediated by subjective SES (perceptions of ones own socioeconomic standing compared to others). Changes in SES quintile between participants parents at Wave I (1994-1995, ages 12-19) and participants at Wave V (2016-2018, ages 33-43) were used to categorize participants into groups based on whether they exhibited upwardly mobile, downward mobile, or immobile SES (with high or low SES immobility). Preliminary findings suggest that compared to low SES immobility, upward mobility was associated with lower BMI and SBC whereas downward mobility was associated with higher SBC among all participants and higher FFC among women. Moreover, associations of SES mobility and FFC were mediated by subjective SES. These findings suggest the relationship between SES mobility and FFC may be due to more than changing financial resources to spend on healthier food choices. Given associations between FFC, poor diet, and later metabolic health, these findings, if replicated, suggest the need to develop policies and interventions to buffer the negative impacts of SES mobility on health. 3) Interactions between objective and subjective socioeconomic status on body composition and eating behaviors of children Prior research has established that low objective SES (OSES) and subjective SES (SSES) are independently associated with poorer health outcomes and higher BMI. Yet it remains unclear how objective and subjective SES may interact to influence the health outcomes of children. This study investigated the independent and interactive contributions between OSES of families and children's SSES (based on perceptions of their family's relative SES standing) on body composition (BMI and fat mass index) and parents report of their childs hyperphagic behaviors (tendencies to be overly preoccupied and motivated by food). The analysis was on data from the Childrens Growth and Behavior Study, a longitudinal cohort study of children and adolescents in the Division of Intramural Research of NICHD. The results revealed that SSES was independently and negatively associated with hyperphagia severity and OSES was independently and negatively associated with both fat mass index and hyperphagia severity. Notably, there was an interaction between SSES and OSES on hyperphagia severity, such that lower SSES was associated with greater hyperphagia severity only at lower levels of OSES. These findings suggest that future research on socioeconomic disparities in childrens body composition and eating behaviors should examine the interaction of SSES and OSES. 4) The role of sensitivity to ostracism on eating behaviors and BMI of children Compared to adults, children may base their perceptions of social disadvantage more on social standing, notably acceptance by peers. Social ostracism (being ignored or excluded by others) is a common experience of both adults and children. Prior research has suggested that experimental exposure to ostracism (versus inclusion by others) promotes increased consumption of palatable, high-calorie snack foods among children. But it remains unclear whether children who consume more energy in response to the stressful effects of ostracism are more vulnerable to future weight gain. We investigated this using a simulated ostracism event in the laboratory within the Growing up In Singapore Towards Healthy Outcomes (GUSTO) Study, a longitudinal birth cohort study. By exposing children (approximately 8.5 years old) to an experimental situation where they believe they are being ostracized by peers, we tested whether sensitivity to ostracism measured physiologically (heart rate variability) and through self-report (ratings of emotions and feelings of threat) predict calories consumed in a subsequent snack and BMI measured at future study visits. Our analyses revealed a moderated mediation. Greater proportional change in heart rate variability in response to ostracism (vs. inclusion) (a measure of stress response) predicted greater energy intake from a snack after ostracism, which predicted higher BMI approximately 1.5 years later. However, this mediation was only observed among children reporting relatively higher levels of social anxiety. These findings suggest that children who experience greater concerns about negative evaluation and rejection by others (social anxiety) may be vulnerable to increased energy intake and ultimately weight gain in response to ostracism. 5) Socioeconomic mobility and perinatal health Using Add Health data, we are examining associations of SES mobility from adolescence to adulthood with womens experiences delivering a child who is preterm (preterm birth; PTB) or has a low birthweight (LBW) and potential psychological pathways that may mediate these relationships. Pregnancy-specific experiences of PTB (delivery before 37 weeks of pregnancy) and LBW (baby weighing less than 5 pounds at birth) between Waves IV and V (2016-2018, ages 33-41) were self-reported at Wave V. Preliminary findings indicate that compared to high SES immobility, short-range (one SES quintile) upward mobility was associated with higher odds of PTB. Odds of PTB were also higher among those experiencing long-range (two or mor quintiles) upward mobility as well as short- and long-range downward mobility, but confidence intervals contained the null. Neither upward nor downward mobility were associated with LBW. Further analyses will try to identify explanations for these results.