Sheila M. Brady

Objective: Resource‐based models of self‐regulation posit that cognitive fatigue, or the depletion of cognitive resources, may be an impetus for self‐regulatory difficulties, including overeating. Studies of adults indicate that cognitive fatigue may increase energy intake only among adults who report engaging in dietary restraint (DR). The current study examined if DR similarly moderates the effects of cognitive fatigue on energy intake in youth.Method: Using a randomized crossover design, participants completed a two‐hour cognitive fatigue and a non‐fatigue control (i.e., watched movies) condition, on separate days within a 31‐day period. Energy intake (kcal) was evaluated using a ~10,000 kcal buffet‐style meal presented after each condition with the instructions to “Please eat until you are no longer hungry.” DR was assessed via the Eating Disorder Examination.Results: Participants included 98 youth (13.0 ± 2.56 years; BMI%ile 60.06 ± 29.01; 46.9% Female; 46.9% non‐Hispanic White, 20.4% non‐Hispanic Black, 12.2% non‐Hispanic Asian; 20.4% endorsed engaging in any DR within the prior 28 days). After adjusting for height, fat mass (%), lean mass (kg), sex, race/ethnicity, visit order, and days between visits, the interaction of DR and experimental condition was associated with energy intake, F(1, 88) = 8.60, p = 0.004, η²_p = 0.089. Youth with DR had greater intake following the fatigue (vs. control) condition, but intake did not differ by condition among youth without DR.Discussion: DR may weaken youth's efforts to regulate energy intake when cognitively fatigued. Studies utilizing more comprehensive measures of DR are needed to elucidate whether this association differs across DR phenotypes and in naturalistic environments.Trial Registration: This study was pre‐registered (https://clinicaltrials.gov/ct2/show/NCT02390765)

Background/Objectives: Attention bias (AB) toward food is associated with obesity, but it is unclear if programs designed to reduce AB can impact adolescents’ eating behavior. We investigated whether a two-week, smartphone-delivered attention retraining (AR) program (vs a control program) altered food AB in adolescent girls with overweight. Methods: Participants completed three food-cue visual-probe trainings/day. The AR and control programs directed attention away from food stimuli during 100% and 50% of trainings, respectively. Before and after completion of the programs, girls completed a food-cue visual-probe task while undergoing magnetoencephalography (MEG), and then a laboratory test meal. Results: Sixty-eight adolescents were randomized; 58 completed post-program visits. There was minimal effect of condition on AB scores (β [95%CI] = −1.9 [−20.8, 16.9]; d = −0.06). There was a small effect of condition on energy intake (EMM_control = 1017 kcal, EMM_AR = 1088 kcal, d = 0.29). Within the AR group, there was slightly blunted initial engagement in brain areas associated with reward response and subsequent increased goal-directed attention and action control. Conclusions: We found preliminary support for efficacy of an intensive smartphone-delivered AR program to alter neural correlates of attention processing in adolescent girls with overweight or obesity. Studies with larger sample sizes are needed to elucidate if AR trainings disrupt the link between food AB and eating behavior.

Multisystem inflammatory syndrome in children (MIS-C) is a rare but life-threatening hyperinflammatory condition induced by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes pediatric COVID-19 (pCOVID-19). The relationship of the systemic tissue injury to the pathophysiology of MIS-C is poorly defined. We leveraged the high sensitivity of epigenomics analyses of plasma cell-free DNA (cfDNA) and plasma cytokine measurements to identify the spectrum of tissue injury and glean mechanistic insights. Compared with pediatric healthy controls (pHCs) and patients with pCOVID-19, patients with MIS-C had higher levels of cfDNA primarily derived from innate immune cells, megakaryocyte-erythroid precursor cells, and nonhematopoietic tissues such as hepatocytes, cardiac myocytes, and kidney cells. Nonhematopoietic tissue cfDNA levels demonstrated significant interindividual variability, consistent with the heterogenous clinical presentation of MIS-C. In contrast, adaptive immune cell–derived cfDNA levels were comparable in MIS-C and pCOVID-19 patients. Indeed, the cfDNA of innate immune cells in patients with MIS-C correlated with the levels of innate immune inflammatory cytokines and nonhematopoietic tissue–derived cfDNA, suggesting a primarily innate immunity–mediated response to account for the multisystem pathology. These data provide insight into the pathogenesis of MIS-C and support the value of cfDNA as a sensitive biomarker to map tissue injury in MIS-C and likely other multiorgan inflammatory conditions.

Rates of childhood overweight/obesity have risen for decades; however, data show the prevalence increased at a faster rate during the COVID-19 pandemic. Pandemic-associated increases in youth’s body mass index (BMI; kg/m²) have been attributed to decreases in reported physical activity; few studies have examined changes in food intake. We therefore examined changes in total energy, nutrient consumption, BMI, BMIz, and adiposity longitudinally over 3 years, comparing healthy youth aged 8–17 years assessed twice prior to the pandemic, to youth seen once before and once during the pandemic. The total energy intake and percent macronutrient consumption were assessed using a standardized, laboratory-based, buffet-style meal. Height and weight were measured and adiposity was collected via dual energy X-ray absorptiometry. Generalized linear model univariate analyses investigated differences between groups. One-hundred-fifteen youth (15.6 + 2.8 years 47.8% female; 54.8% White) from the Washington D.C., Maryland, and Virginia greater metropolitan area participated. In this secondary analysis, neither changes in total energy intake (p = 0.52) nor changes in nutrient consumption were significantly different between the two groups (ps = 0.23–0.83). Likewise, changes in BMI, BMIz, and adiposity (ps = 0.95–0.25) did not differ by group. Further research should investigate food intake and body composition, comparing youth with and without overweight/obesity to better identify those at greatest risk of excess weight gain during the pandemic.

Among youth, greater heart rate (HR) and lesser HR variability (HRV) are precursors to loss-of-control (LOC) eating episodes in the natural environment. However, there are limited data examining whether pre-meal HR and HRV are associated with greater LOC-eating in the laboratory setting. We therefore examined temporal relationships between pre-meal HR, frequency- and time-based metrics of pre-meal HRV, perceived LOC-eating, and energy intake during a meal designed to simulate a LOC-eating episode. Among 209 participants (54.5% female, 12.58 ± 2.72 years, 0.52 ± 1.02 BMIz), 19 reported LOC-eating in the prior month. Perceived LOC-eating during the laboratory meal was not significantly linked to pre-meal HR (p = 0.37), but was positively related to pre-meal HRV (ps = 0.02–0.04). This finding was driven by youth with recent LOC-eating, as these associations were not significant when analyses were run only among participants without recent reported LOC-eating (p = 0.15–0.99). Pre-meal HR and HRV were not significantly related to total energy intake (ps = 0.27–0.81). Additional research is required to determine whether early-stage pediatric LOC-eating is preceded by a healthy pre-meal stress response. Longitudinal studies could help clarify whether this pattern becomes less functional over time among youth who develop recurrent LOC-eating episodes.

Objective: The aim of this study was to examine whether colchicine’s anti‐inflammatory effects would improve measures of lipolysis and distribution of leukocyte populations in subcutaneous adipose tissue (SAT).Methods: A secondary analysis was conducted for a double‐blind, randomized, placebo‐controlled pilot study in which 40 adults with obesity and metabolic syndrome (MetS) were randomized to colchicine 0.6 mg or placebo twice daily for 3 months. Non‐insulin‐suppressible (l₀), insulin‐suppressible (l₂), and maximal (l₀+l₂) lipolysis rates were calculated by minimal model analysis. Body composition was determined by dual‐energy x‐ray absorptiometry. SAT leukocyte populations were characterized by flow cytometry analysis from biopsied samples obtained before and after the intervention.Results: Colchicine treatment significantly decreased l₂ and l₀+l₂ versus placebo (p < 0.05). These changes were associated with a significant reduction in markers of systemic inflammation, including high‐sensitivity C‐reactive protein, resistin, and circulating monocytes and neutrophils (p < 0.01). Colchicine did not significantly alter SAT leukocyte population distributions (p > 0.05).Conclusions: In adults with obesity and MetS, colchicine appears to improve insulin regulation of lipolysis and reduce markers of systemic inflammation independent of an effect on local leukocyte distributions in SAT. Further studies are needed to better understand the mechanisms by which colchicine affects adipose tissue metabolic pathways in adults with obesity and MetS.

Background Children whose parents have type 2 diabetes (T2D) are at high-risk for developing T2D. In youth, negative affect has been shown to predict insulin resistance (IR), and disinhibited-eating behaviors have been linked to IR. It is unknown if youth with a parent with T2D (P-T2D) report greater psychological and behavioral symptoms than those without a P-T2D. Objective To compare youth with and without a P-T2D on symptoms of negative affect and disinhibited-eating. Methods Nine-hundred-thirty-two youth (13.3±2.6 y; BMIz 1.06±1.06; 67.8% female; 53.6% People of Color; 10.7% with a P-T2D) completed questionnaires of anxiety and depressive symptoms, eating in the absence of hunger, and emotional-eating. Loss-of-control (LOC)-eating was assessed by interview. In two separate sub-samples, energy intake was explored using laboratory test meals simulating eating in the absence of hunger and LOC-eating, respectively. Analyses were adjusted for age, sex, race/ethnicity. In follow-up analyses, fat mass (kg) and height, and IR were included as covariates, respectively. Results Adjusting for all covariates including adiposity and IR, compared to youth without a P-T2D, youth with a P-T2D reported more anxiety and depression symptoms, greater eating in the absence of hunger, and emotional-eating (ps<.05). No significant differences were found for LOC-eating, or in exploratory analyses of energy intake for either test meal (ps>.16). Conclusions Self-reported negative affect and disinhibited-eating may be higher among youth with P-T2D compared to those without P-T2D. Prospective studies should examine whether, among those with a P-T2D, what role such symptoms may play for their subsequent risk for T2D.