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Pediatrics

The effects of acute social ostracism on subsequent snacking behavior and future body mass index in children

International Journal of Obesity (2024)Cite this article

Subjects

Abstract

Background/Objectives

Ostracism may lead to increased food intake, yet it is unclear whether greater reactivity to ostracism contributes to higher body mass index (BMI). We investigated whether children who exhibited greater stress to social exclusion subsequently consume more energy and whether this predicts BMI 6- and 18-months later.

Subjects/Methods

Children (8.5 years-old) (N = 262, males = 50.4%; Chinese = 58.4%) completed a laboratory-based manipulation of social exclusion (the Cyberball task) prior to an ad-libitum snack. Heart rate variability (HRV) was measured during the inclusion and exclusion conditions and proportionate changes were calculated as a physiological measure of exclusion-related stress. Social anxiety and social-emotional assets were also measured as moderators.

Results

Greater stress (as measured physiologically or by self-report) did not directly, or indirectly via energy intake, predict later BMI (at 9- and 10-years). However, among children reporting higher social anxiety, greater stress as measured by proportionate changes in HRV was associated with increased energy intake (B = 532.88, SE = 226.49, t(255) = 2.35, [CI95 = 86.85,978.92]). A significant moderated mediation was also observed (index: (b = 0.01, bootSE = 0.01, [CI95 = 0.001, 0.036]), such that among children reporting higher social anxiety, greater stress from social exclusion predicted increased energy intake from a subsequent snack, which in turn predicted higher BMI 1.5 years later.

Conclusion

This prospective study suggests that a pattern of greater snack intake in response to heightened vulnerability to the effects of ostracism may contribute to increases in child BMI scores.

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Fig. 1: Moderation results for proportionate change in heart rate variability and social and emotional assets and social anxiety on energy intake.
Fig. 2: Moderated mediation model of social anxiety as a moderator of the mediation of energy intake between proportionate HRV change and BMI z-scores.

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Data availability

All materials and data are not in the public domain but can be requested by contacting the corresponding authors. The design and analysis plans were not preregistered.

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Acknowledgements

We would like to thank Ang Li Ting for their assistance with data management and Darren Jeffian Wijaya for their assistance with data curation. We would also like to thank and acknowledge the wider GUSTO study group and research assistants, please see supplementary materials and [37] for all members names.

Funding

The study is supported by the National Research Foundation (NRF) under the Open Fund-Large Collaborative Grant (OF-LCG; MOH-000504) administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC) and the Agency for Science, Technology and Research (A*STAR). Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not reflect the views of the A*STAR. In Research, Innovation and Enterprise 2025 (RIE2025), GUSTO is supported by funding from the NRF’s Human Health and Potential (HHP) Domain, under the Human Potential Programme. BKC’s contribution to this manuscript was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD009004-01656312).

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Authors and Affiliations

  1. Institute of High Performance Computing (IHPC), Agency for Science, Technology and Research (A*STAR), 1 Fusionopolis Way, #16-16 Connexis, Singapore, 138632, Republic of Singapore

    Aimee E. Pink & Charmaine H. Y. Tan

  2. Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Brenner Centre for Molecular Medicine, Singapore, 117609, Republic of Singapore

    Aimee E. Pink, Reena Teo, Bob Chua, Fabian Kong, Ranjani Nadarajan, Jia Ying Pei, Charmaine H. Y. Tan, Jia Ying Toh, Yap-Seng Chong, Michael J. Meaney & Birit F. P. Broekman

  3. School of Psychology, Faculty of Medicine, Health and Life Sciences, Swansea University, Swansea, SA2 8PP, UK

    Aimee E. Pink

  4. Department of Psychiatry and Douglas Mental Health University Institute, McGill University, Montreal, Canada

    Ranjani Nadarajan & Michael J. Meaney

  5. Department of Obsteterics & Gynaecology, Yoo Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore

    Yap-Seng Chong

  6. Duke-NUS Medical School, Singapore, Singapore

    Kok Hian Tan & Fabian Yap

  7. Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore

    Kok Hian Tan

  8. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore

    Fabian Yap

  9. Department of Paediatric Endocrinology, KK’s Women’s and Children’s Hospital, Singapore, Singapore

    Fabian Yap

  10. Brain-Body Strategic Research Program, Agency for Science Technology and Research (A*STAR), Singapore, 117609, Republic of Singapore

    Michael J. Meaney

  11. Department of Psychiatry and Medical Psychology, OLVG, Amsterdam Public Health, Amsterdam, The Netherlands

    Birit F. P. Broekman

  12. Department of Psychiatry, Amsterdam UMC, Vrije Universiteit van, Amsterdam, The Netherlands

    Birit F. P. Broekman

  13. Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 20847, USA

    Bobby K. Cheon

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  1. Aimee E. Pink
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Contributions

Conceptualization: AEP, RT, BFPB, BKC. Methodology: JYT, YSC, MM, KHT, FY, BFPB, BKC. Investigation: BC, FK, RN, JYP. Resources: JYT, YSC, MM, KHT, FY, BFPB, BKC. Data Curation: AEP, RT, BC, FK, RN, JYP, CHYT. Formal Analysis: AEP, RT. Writing – Original Draft: AEP, RT. Writing – Review and Editing: AEP, RT, BC, FK, RN, JYP, CHYT, JYT, MM, BFPB, BKC. Project administration: BC, FK, RN, JYT.

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Correspondence to Aimee E. Pink or Bobby K. Cheon.

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Pink, A.E., Teo, R., Chua, B. et al. The effects of acute social ostracism on subsequent snacking behavior and future body mass index in children. Int J Obes (2024). https://doi.org/10.1038/s41366-024-01489-4

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