Caloric compensation and eating in the absence of hunger in 5- to 12-y-old weight-discordant siblings

Abstract

Background: An impaired ability to compensate for calories and increased eating in the absence of hunger (EAH) has been associated with increased energy intake and weight gain in unrelated children.

Objective: The aims of this study were to compare caloric compensation [the percentage compensation index (%COMPX)] and EAH in weight-discordant siblings aged 5-12 y.

Design: In a crossover, behavioral genetics design, 47 same-sex sibling pairs (53% female, 55% full siblings) were served dinner once a week for 3 wk. Across conditions, siblings were served the same dinner, but 25 min before dinner, they either consumed in full or did not consume 1 of 2 preloads that varied in energy density (ED; 0.57 or 0.97 kcal/g). On the day when no preload was consumed, EAH was assessed after dinner and defined as the number of calories consumed from snacks.

Results: Overweight/obese siblings undercompensated [%COMPX: -48.8 ± 56.3 (mean ± SEM)] and therefore overate after the high-ED preload, whereas normal-weight siblings showed accurate compensation (%COMPX: 101.3 ± 51.9; P = 0.03). Furthermore, overweight/obese siblings consumed 34% more calories (93 kcal) in the absence of hunger than did normal-weight siblings (P = 0.01). Within-pair resemblances for %COMPX and EAH were stronger for full siblings (P < 0.049) than for half siblings (P > 0.23).

Conclusions: An impaired ability to regulate short-term energy intake, which includes incomplete adjustment for calorie differences in a preload and eating when satiated, may represent a behavioral phenotype for obesity in children. Future studies should test whether teaching children to focus on internal satiety cues may prevent at-risk children from overeating.

Trial registration: ClinicalTrials.gov NCT01598389.

FIGURE 1.

Sequence of experimental intake assessments for eating in the absence of hunger and %COMPX. ED, energy density; %COMPX, percentage compensation index.

FIGURE 2.

Mean (±SEM) energy intake at the meal (A) and total energy intake (meal + preload; B) consumed by normal-weight (n = 47) and overweight/obese (n = 47) siblings across preload conditions. The analyses indicated a nonsignificant trend for a condition-by-weight status interaction for meal energy intake (P = 0.09). Values are model-based means with preload condition and child weight status included in the linear mixed model. ED, energy density.

FIGURE 3.

Histograms of individual responses for EAH and %COMPX by sibling weight status. EAH, eating in the absence of hunger; %COMPX, percentage compensation index.