Negative Affect, Disinhibited Eating Found In Youth Genetically Predisposed to T2D

Marian Tanofsky-Kraff, PhD

Previous research has shown that children whose parents have type 2 diabetes (T2D) are at high-risk for developing T2D, but it is unknown if youth with a parent with T2D (P-T2D) reported greater psychological and behavioral symptoms compared to those without a P-T2D.

Led by Marian Tanofsky-Kraff, PhD, Professor, Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, a team of investigators set out to compare youth with and without a P-T2D on symptoms of negative affect and disinhibited-eating.

They observed that self-reported negative affect and disinhibited eating behaviors were higher among youth who were genetically predisposed to T2D, compared to those without a P-T2D.

Methods

They assembled a convenience sample from 7 protocols involving youths (ages 8 - 18 years) between June 1996 - November 2020. They defined 3 studies involving interventions and 4 were non-treatment protocols.

In the study measures, data on child’s race and ethnicity and biological parents’ T2D status was reported during their child’s health history with a nurse practitioner or an endocrinologist. They measured body mass index (BMI) from height and fasting weight.

They determined insulin resistance using blood samples obtained in the morning after an overnight fast to measure serum insulin and glucose.

For negative affect, the State-Trait Anxiety Inventory for Children is a 20-item self-report measure of trait anxiety, rated on a 3-point Likert scale ranging from 1 (hardly ever) to 3 (often).

Further, the Childrens’ Depression Inventory is a 27-item measure that assesses depressive behaviors and cognitions, rated on a 0 (absence of symptom) to 3 (high severity of symptom) scale.

They used the Eating in the Absence of Hunger (EAH) for Children, a 14-item measure used to assess eating when not hungry or past satiation in response to external cues, fatigue and boredom, and negative affect. Items are rated on a 5-point Likert scale ranging from 0 (never) to 4 (always).

Additionally, the Emotional Eating Scale for Children and Adolescents is a 25-item self-report measure to describe a desire to eat based on feelings of anxiety, anger, and frustration, depressive symptoms, and feeling unsettled. The scores ranged from 0 (no desire to eat) to 4 (having a very strong desire to eat).

They noted that loss-of-control eating was assessed by interview, while energy intake was determined using laboratory test meals simulating eating in the absence of hunger and LOC-eating.

Findings

In the analysis, a total of 932 participants, with a mean age of 13.3 ± 2.6 years, a BMIz score of  1.06 ± 1.06, consisted of 67.8% female patients and 53.6% people of color. From that sample, 21.8% of patients (n = 203) were overweight and 34.5% had obesity.

They noted that patients with one of two P-T2D were older, more likely to be female, Black, and had higher standardized BMI (BMIz), in comparison to participants without a P-T2D (P ≤ .001).

In models adjusting for age, sex, and race/ethnicity, children with a P-T2D reported higher symptoms of anxiety (F(1, 733) = 5.78, P = .016) and depression (F(1, 621) = 7.26, P = .007), in comparison to children without a P-T2D, remaining significant if adiposity and height were included.

Additionally, in models adjusting for age, sex, and race/ethnicity, children with a P-T2D reported greater EAH (F(1, 811) = 17.48, P < .001) and emotional-eating (F(1, 869) = 8.62, P = .003), remaining consistent when adiposity and height were included.

Further, when adjustment for intervention-seeking status, the relationship between P-T2D and EAH remained significant (F(1, 807) = 9.88, P = .002). However, no significant differences were found for LOC-eating in either children with or without a P-T2D (β = 0.14, P = .541, OR = 1.15).

Takeaways

“If replicated, providers who work with youth genetically predisposed to T2D might consider recommending interventions that address negative affect and disinhibited eating,” investigators wrote.

The study, “A Comparison of Negative Affect and Disinhibited Eating Between Children with and without Parents with Type 2 Diabetes,” was published in Pediatric Diabetes.