Proceedings of the Nutrition Society

Research Article

Appetitive traits and child obesity: measurement, origins and implications for intervention

Symposium on ‘Behavioural nutrition and energy balance in the young’

on 27 and 28 March 2008, A Meeting of the Nutrition Society, was held at the West Park Conference Centre, Dundee, hosted by the Scottish Section.

Susan Carnella1 c1 and Jane Wardlea2

a1 New York Obesity Research Center, St Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY, USA

a2 Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology & Public Health, University College London, London, UK

Abstract

Childhood obesity has multiple causes, most of them capable of explaining only one part of the problem. The population-wide impact of sedentary lifestyles and availability of energy-dense food is undeniable, but substantial individual differences in body weight persist, suggesting that individuals respond differently to the ‘obesogenic’ environment. One plausible mechanism for this variation is the early expression of appetitive traits, including low responsiveness to internal satiety signals, high responsiveness to external food cues, high subjective reward experienced when eating liked foods and preferences for energy-dense foods. Case–control studies support the existence of abnormalities in these traits among obese children compared with normal-weight children, and correlations between psychometric measures of child appetite and child weight suggest that appetitive trait profiles may not only promote obesity but also protect against it. The origins of appetitive traits are as yet uncharted, but will include both genetic and environmental influences. Parental feeding style may affect the development of appetite but the exact nature of the relevant behaviours is unclear and many studies are cross-sectional or begin late in childhood, obscuring causal relationships. Future research should explore determinants and biological mechanisms by using prospective designs beginning early in life, measuring relevant biomarkers such as gut hormones and incorporating neuroimaging and genotyping technologies. Potential clinical applications include the identification of ‘at risk’ children early in life and interventions to modify appetitive traits or ameliorate their impact on intake and weight.

(Online publication August 20 2008)

Correspondence:

c1 Corresponding author: Susan Carnell, fax +1 212 523 4830, email susan.carnell@gmail.com