Food cravings and loss-of-control eating in youth: Associations with gonadal hormone concentrations

Abstract

Objective: Among youth with overweight, food cravings (FC) are associated with loss-of-control (LOC)-eating, but the impact of sex-associated biological characteristics on this relationship is unknown. We examined whether sex and gonadal hormone concentrations moderated the relationships between FC and LOC-eating severity among healthy boys and girls across the weight strata in natural and laboratory environments.

Method: Using ecological momentary assessment (EMA), FC, and LOC-eating severity were reported 3-5 times a day for 2 weeks. In the laboratory, participants reported FC, consumed lunch from a buffet test meal designed to simulate LOC-eating, and rated LOC-eating severity during the meal.

Results: Eighty-seven youth (13.0 ± 2.7 years, 58.6% female, 32.2% with overweight/obesity) participated. EMA measured general and momentary FC were positively associated with LOC-eating severity (ps < .01), with no differences by sex (ps = .21-.93). Estradiol and progesterone significantly moderated the relationships between FC and LOC-eating such that general FC and LOC-eating severity were only positively associated among girls with greater (vs. lower) estradiol (p = .01), and momentary FC and LOC-eating severity were only positively associated among girls with greater (vs. lower) progesterone (p = .01). Boys' testosterone did not significantly moderate the associations between FC and LOC-eating severity (ps = .36-.97). At the test meal, pre-meal FC were positively related to LOC-eating severity (p < .01), without sex or hormonal moderation (ps = .20-.64).

Discussion: FC were related to LOC-eating severity in boys and girls. In the natural environment, gonadal hormones moderated this relationship in girls, but not boys. The mechanisms through which gonadal hormones might affect the relationship between FC and LOC-eating warrant investigation.

Keywords: adolescents; children; ecological momentary assessment; estradiol; food cravings; gonadal hormones; laboratory intake; loss-of-control eating; sex; testosterone.

Figure 1.. Estradiol and Progesterone Concentrations by Day Since Last Menstruation

A. Estradiol Concentrations by Day Since Last Menstruation. B: Progesterone Concentrations by Day Since Last Menstruation. In all graphs, 28-day menstrual cycles were assumed.

Figure 2.. Associations Between Food Cravings and LOC-eating Severity

A. General Food Cravings and LOC-eating Severity in the Natural Environment. Low and high general cravings represent food craving ratings one standard deviation below and above the sample’s general level of craving. B: Momentary Food Cravings and LOC-eating Severity in the Natural Environment. Low and high momentary cravings represent food cravings ratings one standard deviation below and above an individual’s afference level of craving. Beta coefficients from the GLMM were used to approximate LOC-eating severity at low and high levels of craving, these are graphed on the Y-axis. C: Food Cravings and LOC-eating Severity in the Laboratory. Test meal data were standardized for pre-meal hunger prior to graphing and beta coefficients from regressions were used to approximate LOC-eating severity. In all graphs, High indicates higher reported food cravings; Low, lower food cravings; LOC-eating, loss-of-control eating. To facilitate visualization of EMA data, level of cravings was dichotomized as one standard deviation below and above the mean.

Figure 3.. Moderation by Gonadal Hormones of Associations Between Food Cravings and LOC-eating Severity in the Natural Environment

A: Moderation effects of estradiol for the association of general food cravings and LOC-eating severity. Estradiol was mean centered then dichotomized into low and high which were defined as one standard deviation below and above the mean. Beta coefficients from the GLMM were used to approximate LOC-eating severity at low and high levels of craving and at low and high levels of estradiol were graphed on the Y-axis. B: Moderation effects of progesterone for the association of Momentary Food Cravings and LOC-eating Severity. Progesterone was mean centered then dichotomized into low and high which were defined as one standard deviation below and above the mean. Beta coefficients from the GLMM were used to approximate LOC-eating severity at low and high levels of craving and at low and high levels of progesterone were graphed on the Y-axis. In all graphs, High indicates higher food cravings; Low, lower food cravings; LOC-eating, loss-of-control eating. To facilitate visualization, level of cravings was dichotomized into low and high which were defined as one standard deviation below and above the mean.