Rates of childhood overweight/obesity have risen for decades; however, data show the prevalence increased at a faster rate during the COVID-19 pandemic. Pandemic-associated increases in youth’s body mass index (BMI; kg/m²) have been attributed to decreases in reported physical activity; few studies have examined changes in food intake. We therefore examined changes in total energy, nutrient consumption, BMI, BMIz, and adiposity longitudinally over 3 years, comparing healthy youth aged 8–17 years assessed twice prior to the pandemic, to youth seen once before and once during the pandemic. The total energy intake and percent macronutrient consumption were assessed using a standardized, laboratory-based, buffet-style meal. Height and weight were measured and adiposity was collected via dual energy X-ray absorptiometry. Generalized linear model univariate analyses investigated differences between groups. One-hundred-fifteen youth (15.6 + 2.8 years 47.8% female; 54.8% White) from the Washington D.C., Maryland, and Virginia greater metropolitan area participated. In this secondary analysis, neither changes in total energy intake (p = 0.52) nor changes in nutrient consumption were significantly different between the two groups (ps = 0.23–0.83). Likewise, changes in BMI, BMIz, and adiposity (ps = 0.95–0.25) did not differ by group. Further research should investigate food intake and body composition, comparing youth with and without overweight/obesity to better identify those at greatest risk of excess weight gain during the pandemic.

Background/Objectives: Attention bias (AB) toward food is associated with obesity, but it is unclear if programs designed to reduce AB can impact adolescents’ eating behavior. We investigated whether a two-week, smartphone-delivered attention retraining (AR) program (vs a control program) altered food AB in adolescent girls with overweight. Methods: Participants completed three food-cue visual-probe trainings/day. The AR and control programs directed attention away from food stimuli during 100% and 50% of trainings, respectively. Before and after completion of the programs, girls completed a food-cue visual-probe task while undergoing magnetoencephalography (MEG), and then a laboratory test meal. Results: Sixty-eight adolescents were randomized; 58 completed post-program visits. There was minimal effect of condition on AB scores (β [95%CI] = −1.9 [−20.8, 16.9]; d = −0.06). There was a small effect of condition on energy intake (EMM_control = 1017 kcal, EMM_AR = 1088 kcal, d = 0.29). Within the AR group, there was slightly blunted initial engagement in brain areas associated with reward response and subsequent increased goal-directed attention and action control. Conclusions: We found preliminary support for efficacy of an intensive smartphone-delivered AR program to alter neural correlates of attention processing in adolescent girls with overweight or obesity. Studies with larger sample sizes are needed to elucidate if AR trainings disrupt the link between food AB and eating behavior.

Among youth, greater heart rate (HR) and lesser HR variability (HRV) are precursors to loss-of-control (LOC) eating episodes in the natural environment. However, there are limited data examining whether pre-meal HR and HRV are associated with greater LOC-eating in the laboratory setting. We therefore examined temporal relationships between pre-meal HR, frequency- and time-based metrics of pre-meal HRV, perceived LOC-eating, and energy intake during a meal designed to simulate a LOC-eating episode. Among 209 participants (54.5% female, 12.58 ± 2.72 years, 0.52 ± 1.02 BMIz), 19 reported LOC-eating in the prior month. Perceived LOC-eating during the laboratory meal was not significantly linked to pre-meal HR (p = 0.37), but was positively related to pre-meal HRV (ps = 0.02–0.04). This finding was driven by youth with recent LOC-eating, as these associations were not significant when analyses were run only among participants without recent reported LOC-eating (p = 0.15–0.99). Pre-meal HR and HRV were not significantly related to total energy intake (ps = 0.27–0.81). Additional research is required to determine whether early-stage pediatric LOC-eating is preceded by a healthy pre-meal stress response. Longitudinal studies could help clarify whether this pattern becomes less functional over time among youth who develop recurrent LOC-eating episodes.