[Evaluation and prognosis of obesity in children].
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Adolescent↗
Biomedical subjects
F Bellisle
Publications and source records attributed to F Bellisle.
Perceptions of and preferences for sweet taste in uremic children.
Uremic children have low energy intakes, with little appetite for sweet foods. Likewise, sucrose-rich diets are poorly accepted by uremic rats, which suggests that uremia causes a relative aversion for sucrose. Hemodialyzed children (no. = 39, mean age = 160 mo) and healthy controls (no. = 25, mean age = 122 mo) were compared for perception of sweet taste intensity in two familiar foods (soft white cheese and apple sauce) and for preference for sweetness. The food stimuli were prepared in five sucrose concentrations: 1%, 5%, 10%, 15%, and 20% for cheese; 10%, 20%, 30%, 40%, and 60% for apple sauce. Children were presented with pairs of stimuli of adjacent concentrations and asked, in a forced choice, to identify the sweeter stimulus and to express their preferences. The hemodialyzed children made more mistakes (19%) than the controls (5%) when asked to rank sweetness in the soft cheese (i.e., with low concentrations). Both groups made an equal number of mistakes when asked to rank sweetness in the apple sauce. Preferences for sweetness were markedly different. In cheese, the highest sucrose concentration was preferred by 21.9% of the hemodialyzed children vs 41% of the controls. The lowest sucrose concentration was selected by 15.6% of the hemodialyzed children vs 4.6% of the controls. Similar preference trends were observed for apple sauce. We conclude that abnormally low preferences for sweet foods can contribute to insufficient caloric intake in uremic children.
Adolescent↗
Influence of body fat distribution during childhood on body fat distribution in adulthood: a two-decade follow-up study.
Development of body fat distribution was assessed in a two-decade follow-up study. The present article describes the development of various trunk/extremity ratios and gives the figures by age and sex between 1 month to 21 years. The relationship between adult and childhood skinfold (SF) ratio measurements is weak in boys and slightly better in girls. From the present and our previous study, we can select adiposity measurements in children which both are associated to pathologies and have the best correlations with adult values, i.e. the body mass index (BMI) in both sexes, trunk SF in boys and the subscapular/arm SF ratio in girls. Consequently, a boy with both high BMI and trunk SF values or a girl with both high BMI and subscapular/arm SF values have an increased risk of centralized obesity at adult age.
Adipose Tissue↗
Eating attitudes and taste responses in young ballerinas.
The Eating Attitude Test 40 (EAT 40) was administered to 23 ballerinas (mean age 18.3 +/- 0.9 years). The scores were high, as they are in anorexic patients. The EAT 40 revealed anorexic-like attitudes in dancers: selective food restrictions, severe dieting, constant preoccupations with food. However, dancers scored low at items screening bulimia, vomiting or laxative abuse. The dancers' perceptions and preferences for sweetness and fat food content were examined and compared to those of 14 sedentary controls. Taste stimuli were 20 semiliquid mixtures of soft-white cheese (0, 3 or 7 grams of fat per 100 grams) or heavy cream (30% fat), and sweetened with 1, 5, 10, 20 or 40% sucrose. The subjects used a 9-point category scale to rate the perceived sweetness, fat content, and hedonic value of the stimuli. There were no significant differences in the perceived sweetness intensity between groups, but the perception of fat appeared to be better in dancers, in particular in very sweet stimuli. Dancers showed a clear aversion for the fattest stimuli. In young female dancers, enhanced sensitivity for alimentary fats is associated with decreased preferred levels.
Adolescent↗
Quantifying palatability in humans.
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Eating↗
The prediction in boys and girls of the weight/height index and various skinfold measurements in adults: a two-decade follow-up study.
Prediction of adiposity in adults from anthropometric measurements (arm and trunk skinfolds, weight/height) made during childhood and adolescence was assessed in a two-decade follow-up study. Weight/height showed the best correlation between childhood and adulthood values in both sexes. The child-adult correlations for skinfolds were better in males than in females and their value varied according to body site. In males, trunk skinfolds showed slightly better correlations than arm sites, and the weakest correlations were observed for the biceps. In females arm skinfolds, especially the biceps, showed a better predictive value than trunk skinfolds for which the child-adult correlation was almost nil. Trunk skinfolds, which are more often associated with metabolic complications of obesity than limb skinfolds, are predictable from childhood measurements in males and not in females. The prediction of adiposity development in different body sites may help identify children most susceptible to various pathologies in later life.
Adolescent↗
Adiposity and food intake in young children: the environmental challenge to individual susceptibility.
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Anthropometry↗
Obesity and food intake in children: evidence for a role of metabolic and/or behavioral daily rhythms.
Food intake was studied in 339 French children, aged 7-12 years. Daily energy consumption and distribution of intake over the waking hours estimated from dietary histories were compared in children of five corpulence categories. The categories (lean, slim, average, fat, obese) were defined on the basis of the weight/height2 index. No difference in estimated daily energy intake was observed between corpulence groups; however, the reported distribution of intake over the waking hours varied. Obese and fat children ate less at breakfast and more at dinner than leaner peers. The traditionally larger meals of the day (lunch and dinner) represented higher proportions of daily intake in fat and obese children; the energy value of breakfast and afternoon snack was inversely related to corpulence. Although these effects do not rule out hyperphagia or increased 'externality' in some overweight subjects, the results suggest a possible contribution of disturbed metabolic and/or behavioral daily cycles in the development of overweight. This hypothesis, which should be investigated further, suggests prevention strategies.
Child↗
Spontaneous insulin fluctuations and the preabsorptive insulin response to food ingestion in humans.
Insulin secretion occurs in response to cephalic stimulation by foods; in humans, the response is quite variable and its importance in meal situations is difficult to assess. Insulinemia also varies spontaneously in the absence of food stimulation. In the present work, a comparative study of spontaneous and food-associated insulinemia changes was performed. Spontaneous preprandial fluctuations of glycemia and insulinemia were recorded and the presence of significant oscillations or trends was investigated. Premeal changes in insulinemia then served as a basis for evaluating the preabsorptive insulin response (PIR) during food ingestion. A sinewave fitted to preprandial insulin oscillations did not appear satisfactory as a basis for the assessment of the PIR. Significant PIRs were then defined in terms of deviation from a confidence interval (mean of the preprandial values +/- 2 SD). Significant PIRs were more frequent when the food presented was more palatable. Individual differences in responsiveness appeared. The physiological significance of a PIR over a background of spontaneous fluctuations is discussed.
Adult↗
The measurement of food preferences in humans: do taste-and-spit tests predict consumption?
Hedonic ratings of foods, obtained by laboratory taste-and-spit tests, are often used to determine the optimal concentration of sugar in a commercial food. However, the predictive value of these tests on actual consumption has not been demonstrated. Does the optimal sugar concentration in a specific food, as determined by a short exposure taste test, induce maximum intake of that food? In the present experiment, a standard food (yogurt) was presented in five sucrose concentrations (from 2% to 29%) to 18 subjects. The five types of yogurts were first tasted and rated for pleasantness. Secondly, they were presented in ad lib consumption tests. Discrepancies appeared between taste test ratings and ingestive responses, e.g., in subjects who preferred medium to high sucrose concentrations, the optimal concentration (in terms of intake) was lower than the "preferred" one (as determined by taste-and-spit tests). The results of taste-and-spit should be taken cautiously when trying to predict ingestion.
Adult↗
Taste and bulimia.
Binge-eating episodes in bulimia often involve sweet or fat-containing foods. Sensory perceptions and preferences for sweetness and fat content were examined in 16 normal-weight women with a diagnosis of DSM IIIR bulimia and in 16 normal-weight volunteer controls. Taste stimuli were 15 semi-liquid mixtures of dessert-type soft white cheese ("fromage blanc") containing 0, 3 or 7 grams of fat per 100 g, and sweetened with 1, 5, 10, 20, or 40% sucrose (wt./wt.). The subjects used 9-point category scales to rate the perceived sweetness and fat content of the stimuli, and assigned a pleasantness (hedonic) rating to each sample. Taste preferences were modelled using the Response Surface Method (RSM). Mean estimates of sweetness intensity and fat content were generally similar for bulimic patients and controls. In contrast, profiles of taste preference differed significantly between groups. Optimal stimulus sweetness was 15% sucrose wt./wt. for bulimic patients and only 9% for controls, while optimal fat levels were lower for bulimic patients relative to controls. The present data are consistent with previous reports that patients with eating disorders crave sweetness but show reduced sensory preferences for fat-containing foods.
Adult↗
[The cephalic phase of insulin secretion in man].
In human subjects, a reflex secretion of insulin has been observed following the stimulation of cephalic sensory receptors by food. In animals, such a response is recognised and appears to contribute to energy regulation. In man, its amplitude is very variable and "negative responses" have been reported. Negative responses can be interpreted as, the descending phase of the spontaneous oscillations of insulinaemia which have been described in animals and humans. This observation shows that spontaneous oscillations should be taken into consideration when evaluating or describing the responses to meal stimulation. It thus becomes possible to attribute a significant part of the variability to the subjects' individual sensitivity and to the hedonic value of meals. The response can be conditioned to arbitrary stimuli and then be evoked without exposure to food. Its role in energy regulation has not been demonstrated in man, although certain studies suggest that it may augment the metabolic rate. Large responses are associated with large, palatable meals, but it is not known whether the insulin response is merely a reflection of the sensory characteristics of food or whether it contributes to the stimulation to eat.
Animals↗
[Spontaneous oscillations in basal blood insulin].
Many studies show that basal insulinemia is not stable over time, but oscillates significantly. The period and amplitude of oscillations appear species-specific. Studies on living animals have established that neither central autonomic command nor liver-pancreas feedback play a determining role on these cycles. Work on the isolated, perfused, canine pancreas has demonstrated the existence of an intrinsic pancreatic oscillator. Studies on human subjects confirm and complete animal data. The amplitude of insulinemia cycles is less in humans than in animals. In obese humans, insulin cycles are normal. In non-insulin-dependent diabetics, insulin oscillations are very irregular; after partial pancreatectomy (removal of the head of the pancreas), the normal insulin cycles disappear. The insulinemia cycles thus seem to reflect the behavior of an intrinsic pancreatic oscillator which synchronizes the activity of beta cells. Spontaneous oscillations in plasma insulin could play a role in the regulation of receptor affinity in target-tissues.
Animals↗
No correlation between adiposity and food intake: why are working class children fatter?
Many studies have failed to show a correlation between individual energy intake and obesity. However, the prevalence of overweight is higher in populations with higher caloric intake. In this study on a population of French children, no correlation was found between energy intake and individual corpulence (wt/ht2 index or skinfold thickness), but a higher proportion of overweight children was found in lower social classes where energy intake is traditionally higher. A hypothesis is proposed to account for this apparent contradiction: the typical lifestyle or diet in a given population challenges individual adaptive capacities; the more caloric the socially accepted diet, the higher the proportion of individuals who are challenged beyond their adaptive threshold. Socially determined factors such as a high calorie diet act in a permissive way in the development of obesity although the caloric intake of obese individuals may be no different from that of nonobese peers.
Body Height↗
Cephalic phase of insulin secretion and food stimulation in humans: a new perspective.
Insulinemia and glycemia were measured at a 1-min interval at the hour of a lunch meal in human subjects. When no food was presented to naive subjects (n = 4), cyclic oscillations of insulinemia were found (period, 12-20 min; amplitude, 2.8-10.3 microU/ml). It is proposed that these spontaneous oscillations must be taken into consideration when evaluating the insulin response on cephalic contact with food stimuli; they might otherwise constitute a source of artifacts. Four subjects were then submitted to a series of four test meals scheduled at a 1-wk interval. Although their prandial glycemia remained comparable with preprandial values for the first 16 min of the meals, insulinemia often exhibited early peaks (within a few min after meal onset) whose amplitude appeared related to palatability conditions. Evidence suggests that the insulin peaks triggered by cephalic stimulation are Pavlovian reflexes that become conditioned to the test situation. A typical neuroendocrine response to alimentary frustration is also described. The results are discussed in perspective with animal works, in terms of the effects of neuroendocrine events on feeding behavior.
Adult↗
Deprivation, palatability and the micro-structure of meals in human subjects.
Changes in the micro-structure of meals were studied in ten human subjects under different palatability and deprivation conditions. The oscillographic recording of chewing and swallowing movements during standardized meals allowed many meal parameters to be precisely measured. Both increases in deprivation time (from 4 to 15 h) and in food preference produce larger, longer meals. These factor's effects were additive. Eating rate was accelerated in high relative to low preference conditions. The micro-structure of meals proved to be more sensitive to food preferences than to deprivation levels: chewing activity per standard food piece tended to decrease as preference increased, as observed in a previous study. However, in the first quarter of meals, chewing time was affected similarly by deprivation and by preference. A clear deceleration of eating rate was apparent between the beginning and the end of meals. The results are discussed in perspective with other human studies and with reference to preference and deprivation as continua.
Adult↗
Adiposity rebound in children: a simple indicator for predicting obesity.
To follow and predict the evolution of adiposity during growth, individual adiposity curves, assessed by the weight/height2 index, were drawn for 151 children from the age of 1 month to 16 yr. Adiposity increases during the 1st yr and then decreases. A renewed rise, termed here the adiposity rebound, occurs at about 6 yr. Individual weight/height2 curves may differ regarding their percentile range level and age at adiposity rebound. The present study shows a relationship between the age at adiposity rebound and final adiposity. An early rebound (before 5.5 yr) is followed by a significantly higher adiposity level than a later rebound (after 7 yr). This phenomenon is observed whatever the subject's adiposity at 1 yr. The present observations might be connected with the cellularity of adipose tissue.
Adipose Tissue↗
Reflex insulin response associated to food intake in human subjects.
The occurrence of a reflex insulin discharge at the beginning of a meal, and its possible influence on intake were studied in 7 normal weight humans. Each subject was tested twice under three standard meal conditions. The evolutions of insulinemia and glycemia were recorded over an 84 min observation period, starting 2 min before food presentation. Blood was drawn continuously from an antecubital vein, and collected in 1-min samples for the first 30 min, and then in 3-min samples. The average glycemia curve was stable until some 18-20 min after meal onset. By contrast, a significant rise in plasma insulin appeared as early as the 4th min after meal onset and it is hypothesized to be preabsorptive, of cephalic and/or gastric origin. However, inter-test variations were large even in the same person. Schematically, three types of early insulin responses were observed: high and/or sustained rise, moderate and/or short increase, moderate decrease in plasma insulin. The shape of the early insulin response was not related to any meal characteristic. The potential biological and behavioral significance of the early insulin release is discussed.
Adult↗