Role of energy balance behaviors in modifying biobehavioral risk factors for childhood obesity - Obesity is a multifactorial disease which results from complex interactions among multiple genes, behaviors, and environmental factors. A heightened genetic risk does not always translate to the development of obesity among children, which points to the presence of risk-modifying factors that likely relate to energy balance behaviors as key behavioral drivers. This study will build on our prior research to comprehensively examine the interplay between genotype and phenotype and, for the first time, systematically assess if energy balance behaviors in the context of the family environment, alone or in combination, can modify behavioral and genetic predispositions to childhood obesity. Specifically, this research aims to prospectively evaluate the extent to which associations of a heightened drive to eat (HDE) on 1-year changes in weight and adiposity outcomes are independent or additive to those of a genetic risk for obesity among children, ages 5 to 7, from families with low resource backgrounds. HED will be conceptualized as a broader behavioral phenotype which combines hyperphagic appetitive traits (i.e., the relative reinforcing value of food, a rapid eating rate, and eating in the absence of hunger). Children’s genotype will be assessed using a genetic risk score (GRS), which serves as an aggregate measure from multiple obesity risk single nucleotide polymorphisms (SNPs). In addition, the study aims to prospectively examine risk-modifying energy balance behaviors in areas of diet, physical activity, and sleep that may mitigate the detrimental impact of a HDE or high genetic risk on weight and adiposity outcomes and test whether these factors differ for HDE versus a high genetic risk of obesity on those outcomes. Lastly, the research aims to examine the impact of family-level influences in areas of family functioning and parent feeding on risk-modifying energy balance behaviors in children. Primary outcomes will include 1-year changes in children’s body mass index (BMI) z-score, percent body fat, and waist circumference. Identifying behavioral and family factors that may mitigate the impact of obesity risk on weight and adiposity outcomes is critical for moving the prevention of childhood obesity into a new direction. If successful, the knowledge gleaned from this research will offer new and powerful targets for addressing health disparities in obesity and formulating tailored family-based interventions in the fight against childhood obesity.
