Pediatrics

Associations between inhibitory control, eating behaviours and adiposity in 6-year-old children

Abstract

Background

Lower inhibitory control has been associated with obesity. One prediction is that lower inhibitory control underlies eating behaviours that promote increased energy intakes. This study examined the relationships between children’s inhibitory control measured using the Stop Signal Task (SST), body composition and eating behaviours, which included self-served portion size, number of servings, eating rate, and energy intake at lunch and in an eating in the absence of hunger (EAH) task.

Methods

The sample included 255 6-year-old children from an Asian cohort. Stop-signal reaction time (SSRT) was used as an index of inhibitory control. Children participated in a recorded self-served lunchtime meal, followed by the EAH task where they were exposed to energy-dense snacks. Behavioural coding of oral processing was used to estimate eating rates (g/min). BMI, waist circumference and skinfolds were used as indices of adiposity.

Results

Children with lower inhibitory control tended to self-serve larger food portions (p = 0.054), had multiple food servings (p = 0.006) and significantly faster eating rates (p = 0.041). Inhibitory control did not predict energy intake at lunch (p = 0.17) or during the EAH task (p = 0.45), and was unrelated to measures of adiposity (p > 0.32). Twenty percent of the children in the sample had problems focusing on the SST and were described as ‘restless’. Post-hoc analysis revealed that these children had lower inhibitory control (p < 0.001) and consumed more energy during the EAH task (p = 0.01), but did not differ in any other key outcomes from the rest of the sample (p > 0.1).

Conclusions

Children with lower inhibitory control showed a trend to select larger food portions, had multiple food servings and faster eating rates, but were equally as responsive to snacks served in the absence of hunger as children with better inhibitory control. Inhibitory control may impact a number of eating behaviours, not limited to energy-dense snacks.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

Data availability

The datasets generated and/or analysed during the current study are not publicly available yet due to ongoing data collection, but are available from the corresponding author on reasonable request.

References

  1. 1.

    Birch LL, Davison KK. Family environmental factors influencing the developing behavioral controls of food intake and childhood overweight. Pediatr Clin. 2001;48:893–907.

    CAS  Google Scholar 

  2. 2.

    Stunkard AJ, Berkowitz RI, Schoeller D, Maislin G, Stallings VA. Predictors of body size in the first 2 y of life: a high-risk study of human obesity. Int J Obes Relat Metab Disord. 2004;28:503–13.

    Article  CAS  Google Scholar 

  3. 3.

    Llewellyn C, Wardle J. Behavioral susceptibility to obesity: gene-environment interplay in the development of weight. Physiol Behav. 2015;152(Pt B):494–501.

    Article  CAS  Google Scholar 

  4. 4.

    Anderson SE, Whitaker RC. Association of self-regulation with obesity in boys vs girls in a US National Sample. JAMA Pediatr. 2018;172:842–50.

    Article  Google Scholar 

  5. 5.

    Thamotharan S, Lange K, Zale EL, Huffhines L, Fields S. The role of impulsivity in pediatric obesity and weight status: a meta-analytic review. Clin Psychol Rev. 2013;33:253–62.

    Article  Google Scholar 

  6. 6.

    Guerrieri R, Nederkoorn C, Jansen A. How impulsiveness and variety influence food intake in a sample of healthy women. Appetite. 2007;48:119–22.

    Article  Google Scholar 

  7. 7.

    Nederkoorn C, Braet C, Van Eijs Y, Tanghe A, Jansen A. Why obese children cannot resist food: the role of impulsivity. Eat Behav. 2006;7:315–22.

    Article  Google Scholar 

  8. 8.

    Kamijo K, Khan NA, Pontifex MB, Scudder MR, Drollette ES, Raine LB, et al. The relation of adiposity to cognitive control and scholastic achievement in preadolescent children. Obesity . 2012;20:2406–11.

    Article  Google Scholar 

  9. 9.

    Pauli-Pott U, Albayrak Ö, Hebebrand J, Pott W. Association between inhibitory control capacity and body weight in overweight and obese children and adolescents: dependence on age and inhibitory control component. Child Neuropsychol. 2010;16:592–603.

    Article  Google Scholar 

  10. 10.

    Reinert KRS, Po’e EK, Barkin SL. The relationship between executive function and obesity in children and adolescents: a systematic literature review. J Obes. 2013;2013:820956.

    Article  Google Scholar 

  11. 11.

    Lavagnino L, Arnone D, Cao B, Soares JC, Selvaraj S. Inhibitory control in obesity and binge eating disorder: a systematic review and meta-analysis of neurocognitive and neuroimaging studies. Neurosci Biobehav Rev. 2016;68:714–26.

    Article  Google Scholar 

  12. 12.

    Yang Y, Shields GS, Guo C, Liu Y. Executive function performance in obesity and overweight individuals: a meta-analysis and review. Neurosci Biobehav Rev. 2018;84:225–44.

    Article  Google Scholar 

  13. 13.

    Levitan R, Rivera J, Silveira P, Steiner M, Gaudreau H, Hamilton J, et al. Gender differences in the association between stop-signal reaction times, body mass indices and/or spontaneous food intake in pre-school children: an early model of compromised inhibitory control and obesity. Int J Obes. 2015;39:614–9.

    Article  CAS  Google Scholar 

  14. 14.

    Guerrieri R, Nederkoorn C, Stankiewicz K, Alberts H, Geschwind N, Martijn C, et al. The influence of trait and induced state impulsivity on food intake in normal-weight healthy women. Appetite. 2007;49:66–73.

    Article  Google Scholar 

  15. 15.

    Nederkoorn C. Effects of sales promotions, weight status, and impulsivity on purchases in a supermarket. Obesity. 2014;22:E2–5.

    Article  Google Scholar 

  16. 16.

    Nederkoorn C, Guerrieri R, Havermans R, Roefs A, Jansen A. The interactive effect of hunger and impulsivity on food intake and purchase in a virtual supermarket. Int J Obes. 2009;33:905–12.

    Article  CAS  Google Scholar 

  17. 17.

    Nederkoorn C, Dassen FCM, Franken L, Resch C, Houben K. Impulsivity and overeating in children in the absence and presence of hunger. Appetite. 2015;93(Supplement C):57–61.

    Article  Google Scholar 

  18. 18.

    Fisher JO. Effects of age on children’s intake of large and self-selected food portions. Obesity. 2007;15:403–12.

    Article  Google Scholar 

  19. 19.

    Roe LS, Kling SM, Rolls BJ. What is eaten when all of the foods at a meal are served in large portions? Appetite. 2016;99:1–9.

    Article  Google Scholar 

  20. 20.

    Kelly MT, Wallace JMW, Robson PJ, Rennie KL, Welch RW, Hannon-Fletcher MP, et al. Increased portion size leads to a sustained increase in energy intake over 4 d in normal-weight and overweight men and women. Br J Nutr. 2009;102:470–7.

    Article  CAS  Google Scholar 

  21. 21.

    French SA, Mitchell NR, Wolfson J, Harnack LJ, Jeffery RW, Gerlach AF, et al. Portion size effects on weight gain in a free living setting. Obesity . 2014;22:1400–5.

    Article  Google Scholar 

  22. 22.

    Syrad H, Llewellyn CH, Johnson L, Boniface D, Jebb SA, Van Jaarsveld CH, et al. Meal size is a critical driver of weight gain in early childhood. Sci Rep. 2016;6:28368.

    Article  CAS  Google Scholar 

  23. 23.

    Birch LL, Johnson SL, Andresen G, Peters JC, Schulte MC. The variability of young children’s energy intake. N Engl J Med. 1991;324:232–5.

    Article  CAS  Google Scholar 

  24. 24.

    Savage JS, Haisfield L, Fisher JO, Marini M, Birch LL. Do children eat less at meals when allowed to serve themselves? Am J Clin Nutr. 2012;96:36–43.

    Article  CAS  Google Scholar 

  25. 25.

    McCrickerd K, Leong C, Forde CG. Preschool children’s sensitivity to teacher-served portion size is linked to age related differences in leftovers. Appetite. 2017;114(Supplement C):320–8.

    Article  Google Scholar 

  26. 26.

    Fogel A, Goh AT, Fries LR, Sadananthan SA, Velan SS, Michael N, et al. Faster eating rates are associated with higher energy intakes during an ad libitum meal, higher BMI and greater adiposity among 4.5-year-old children: results from the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) cohort. Br J Nutr. 2017;117:1042–51.

    Article  CAS  Google Scholar 

  27. 27.

    Fogel A, Fries LR, McCrickerd K, Goh AT, Quah PL, Chan MJ, et al. Oral processing behaviours that promote children’s energy intake are associated with parent-reported appetitive traits: Results from the GUSTO cohort. Appetite. 2018;126:8–15.

    Article  Google Scholar 

  28. 28.

    Fogel A, Goh AT, Fries LR, Sadananthan SA, Sendhil Velan S, Michael N, et al. A description of an ‘obesogenic’ eating style that promotes higher energy intake and is associated with greater adiposity in 4.5 year-old children: Results from the GUSTO cohort. Physiol Behav. 2017;176:107–16.

    Article  CAS  Google Scholar 

  29. 29.

    Fisher JO, Rolls BJ, Birch LL. Children’s bite size and intake of an entrée are greater with large portions than with age-appropriate or self-selected portions. Am J Clin Nutr. 2003;77:1164–70.

    Article  CAS  Google Scholar 

  30. 30.

    Soh SE, Tint MT, Gluckman PD, Godfrey KM, Rifkin-Graboi A, Chan YH, et al. Cohort profile: growing up in singapore towards healthy outcomes (GUSTO) birth cohort study. Int J Epidemiol. 2014;43:1401–9.

    Article  Google Scholar 

  31. 31.

    Fisher JO, Birch LL. Eating in the absence of hunger and overweight in girls from 5 to 7 y of age. Am J Clin Nutr. 2002;76:226–31.

    Article  CAS  Google Scholar 

  32. 32.

    Phua DY-L, Rifkin-Graboi A, Saw S-M, Meaney MJ, Qiu A. Executive functions of six-year-old boys with normal birth weight and gestational age. PLoS ONE. 2012;7:e36502.

    Article  CAS  Google Scholar 

  33. 33.

    Luciana M, Nelson CA. Assessment of neuropsychological function through use of the Cambridge Neuropsychological Testing Automated Battery: performance in 4 to 12-year-old children. Dev Neuropsychol. 2002;22:595–624.

    Article  Google Scholar 

  34. 34.

    de Onis M, Onyango AW, Van den Broeck J, Chumlea CW, Martorell R. Measurement and standardization protocols for anthropometry used in the construction of a new international growth reference. Food Nutr Bull. 2004;25(1_suppl1):S27–S36.

    Article  Google Scholar 

  35. 35.

    Hamilton CM, Strader LC, Pratt JG, Maiese D, Hendershot T, Kwok RK, Hammond JA, Huggins W, Jackman D, Pan H, Nettles DS. The PhenX Toolkit: get the most from your measures. Am J Epidemiol. 2011;174:253–60.

    Article  Google Scholar 

  36. 36.

    WHO. Child growth standards. 2003. Accessed on: 1 September 2016. http://www.who.int/childgrowth/standards/Technical_report.pdf.

  37. 37.

    Wang Y, Chen HJ. Use of percentiles and z-scores in anthropometry. In: Handbook of anthropometry. Springer, New York, NY.; 2012. p. 29–48.

    Google Scholar 

  38. 38.

    Centres for Disease Control and Prevention (CDC). Defining childhood obesity. 2015. https://www.cdc.gov/obesity/childhood/defining.html.

  39. 39.

    Berkowitz RI, Moore RH, Faith MS, Stallings VA, Kral TV, Stunkard AJ. Identification of an obese eating style in 4‐year‐old children born at high and low risk for obesity. Obesity. 2010;18:505–12.

    Article  Google Scholar 

  40. 40.

    Nightingale CM, Rudnicka AR, Owen CG, Cook DG, Whincup PH. Patterns of body size and adiposity among UK children of South Asian, black African-Caribbean and white European origin: Child Heart And health Study in England (CHASE Study). Int J Epidemiol. 2011;40:33–44.

    Article  Google Scholar 

  41. 41.

    Farrow CV. Do parental feeding practices moderate the relationships between impulsivity and eating in children? Eat Behav. 2012;13:150–3.

    Article  Google Scholar 

  42. 42.

    Bennett C, Blissett J. Parental monitoring may protect impulsive children from overeating. Pediatr Obes. 2017;12:414–21.

    Article  CAS  Google Scholar 

  43. 43.

    Robinson E, Almiron-Roig E, Rutters F, de Graaf C, Forde CG, Tudur Smith C, et al. A systematic review and meta-analysis examining the effect of eating rate on energy intake and hunger. Am J Clin Nutr. 2014;100:123–51.

    Article  CAS  Google Scholar 

  44. 44.

    Hill C, Llewellyn CH, Saxton J, Webber L, Semmler C, Carnell S, et al. Adiposity and’eating in the absence of hunger in children. Int J Obes. 2008;32:1499.

    Article  CAS  Google Scholar 

  45. 45.

    Moens E, Braet C. Predictors of disinhibited eating in children with and without overweight. Behav Res Ther. 2007;45:1357–68.

    Article  Google Scholar 

  46. 46.

    Braet C, Claus L, Verbeken S, Van Vlierberghe L. Impulsivity in overweight children. Eur Child Adolesc Psychiatry. 2007;16:473–83.

    Article  Google Scholar 

  47. 47.

    McWilliams L, Sayal K, Glazebrook C. Inattention and hyperactivity in children at risk of obesity: a community cross-sectional study. BMJ Open. 2013;3:e002871.

    Article  Google Scholar 

  48. 48.

    Holtkamp K, Konrad K, Müller B, Heussen N, Herpertz S, Herpertz-Dahlmann B, et al. Overweight and obesity in children with attention-deficit/hyperactivity disorder. Int J Obes. 2004;28:685–9.

    Article  CAS  Google Scholar 

  49. 49.

    Kim KM, Lim MH, Kwon H-J, Yoo S-J, Kim E-j, Kim JW, et al. Associations between attention-deficit/hyperactivity disorder symptoms and dietary habits in elementary school children. Appetite. 2018;127:274–9.

    Article  Google Scholar 

  50. 50.

    Jones A, Di Lemma LCG, Robinson E, Christiansen P, Nolan S, Tudur-Smith C, et al. Inhibitory control training for appetitive behaviour change: a meta-analytic investigation of mechanisms of action and moderators of effectiveness. Appetite. 2016;97:16–28.

    Article  Google Scholar 

  51. 51.

    Jiang Q, He D, Guan W, He X. Happy goat says: the effect of a food selection inhibitory control training game of children’s response inhibition on eating behavior. Appetite. 2016;107:86–92.

    Article  Google Scholar 

  52. 52.

    Salazar Vázquez BY, Salazar Vazquez MA, López Gutiérrez G, Acosta Rosales K, Cabrales P, Vadillo‐Ortega F, Intaglietta M, Pérez Tamayo R, Schmid‐Schönbein GW. Control of overweight and obesity in childhood through education in meal time habits. the ‘good manners for a healthy future’ programme. Pediatric Obesity. 2016:6;484–490.

  53. 53.

    Hamilton-Shield J, Goodred J, Powell L, Thorn J, Banks J, Hollinghurst S, et al. Changing eating behaviours to treat childhood obesity in the community using Mandolean: the Community Mandolean randomised controlled trial (ComMando)—a pilot study. Health Technol Assess. 2014;18

    Article  Google Scholar 

  54. 54.

    Ford AL, Bergh C, Södersten P, Sabin MA, Hollinghurst S, Hunt LP, et al. Treatment of childhood obesity by retraining eating behaviour: randomised controlled trial. BMJ. 2010;340:250.

    Google Scholar 

  55. 55.

    Forde C, Leong C, Chia-Ming E, McCrickerd K. Fast or slow-foods? Describing natural variations in oral processing characteristics across a wide range of Asian foods. Food Funct. 2017;8:595–606.

    Article  CAS  Google Scholar 

  56. 56.

    McCrickerd K, Lim CMH, Leong C, Chia EM, Forde CG. Texture-based differences in eating rate reduce the impact of increased energy density and large portions on meal size in adults. J Nutr. 2017;147:1208–17.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The GUSTO study group includes Allan Sheppard, Amutha Chinnadurai, Anne Eng Neo Goh, Anne Rifkin-Graboi, Anqi Qiu, Arijit Biswas, Bee Wah Lee, Birit F.P. Broekman, Boon Long Quah, Borys Shuter, Chai Kiat Chng, Cheryl Ngo, Choon Looi Bong, Christiani Jeyakumar Henry, Claudia Chi, Cornelia Yin Ing Chee, Yam Thiam Daniel Goh, Doris Fok, E Shyong Tai, Elaine Tham, Elaine Quah Phaik Ling, Evelyn Chung Ning Law, Evelyn Xiu Ling Loo, Fabian Yap, Falk Mueller-Riemenschneider, George Seow Heong Yeo, Helen Chen, Heng Hao Tan, Hugo P S van Bever, Iliana Magiati, Inez Bik Yun Wong, Ivy Yee-Man Lau, Izzuddin Bin Mohd Aris, Jeevesh Kapur, Jenny L. Richmond, Jerry Kok Yen Chan, Joanna D. Holbrook, Joanne Yoong, Joao N. Ferreira., Jonathan Tze Liang Choo, Jonathan Y. Bernard, Joshua J. Gooley, Keith M. Godfrey, Kenneth Kwek, Kok Hian Tan, Krishnamoorthy Niduvaje, Kuan Jin Lee, Leher Singh, Lieng Hsi Ling, Lin Lin Su, Ling-Wei Chen, Lourdes Mary Daniel, Lynette P Shek, Marielle V. Fortier, Mark Hanson, Mary Foong-Fong Chong, Mary Rauff, Mei Chien Chua, Melvin Khee-Shing Leow, Michael Meaney, Mya Thway Tint, Neerja Karnani, Ngee Lek, Oon Hoe Teoh, P. C. Wong, Paulin Tay Straughan, Peter D. Gluckman, Pratibha Agarwal, Queenie Ling Jun Li, Rob M. van Dam, Salome A. Rebello, Seang-Mei Saw, See Ling Loy, S. Sendhil Velan, Seng Bin Ang, Shang Chee Chong, Sharon Ng, Shiao-Yng Chan, Shirong Cai, Shu-E Soh, Sok Bee Lim, Stella Tsotsi, Chin-Ying Stephen Hsu, Sue Anne Toh, Swee Chye Quek, Victor Samuel Rajadurai, Walter Stunkel, Wayne Cutfield, Wee Meng Han, Wei Wei Pang, Yap-Seng Chong, Yin Bun Cheung, Yiong Huak Chan and Yung Seng Lee.

Author contributions

This study was conceived and designed by AF, KMC and CGF. ATG, KMC and AF processed the data. Analyses were performed and interpreted by AF. AF, KMC and CGF prepared the draft manuscript with input from LRF and MFFC. YSC, KHT, FY, LPS, MJM, BFPB, YSL and KMG were responsible for conception and recruitment for the GUSTO cohort. KMC and CGF designed the eating behaviour measures. BFPB, CS and PPS contributed to the design of neurocognitive measures. CGF had full access to the data and final responsibility for the decision to submit for publication. All authors reviewed and approved the final draft.

Funding

This work was supported by the Translational Clinical Research (TCR) Flagship Program on Developmental Pathways to Metabolic Disease funded by the National Research Foundation (NRF) and administered by the National Medical Research Council (NMRC), Singapore-NMRC/TCR/004-NUS/2008. Additional funding was provided by the Singapore Institute for Clinical Sciences, A*STAR and Nestec SA. KMG is supported by the UK Medical Research Council (MC_UU_12011/4), the National Institute for Health Research (as an NIHR Senior Investigator (NF-SI-0515–10042) and through the NIHR Southampton Biomedical Research Centre and by the European Union’s Erasmus + Capacity-Building ENeASEA Project and Seventh Framework Programme (FP7/2007–2013), project Early Nutrition under grant agreement n°289346.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Ciarán G. Forde.

Ethics declarations

Conflict of interest

KMG, CGF, YSL and YSC have received reimbursement for speaking at conferences sponsored by companies selling nutritional products. They are part of an academic consortium that has received research funding from Abbott Nutrition, Nestec and Danone. LRF is an employee of Nestec SA, working at the Nestlé Research Center. CGF currently serves on the Scientific Advisory Council for Kerry Taste and Nutrition. The remaining authors declare that they have no conflict of interest.

Additional information

Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Fogel, A., McCrickerd, K., Goh, A.T. et al. Associations between inhibitory control, eating behaviours and adiposity in 6-year-old children. Int J Obes 43, 1344–1353 (2019). https://doi.org/10.1038/s41366-019-0343-y

Download citation

Further reading

Search