The effect of meal-time exposure to food advertisements (FA) on food intake, subjective appetite and caloric compensation was investigated in overweight/obese (OW/OB) and normal weight (NW) boys (study 1) and girls (study 2). In random order, each participant watched either FA or non-food advertisements (NFA) 30 min after consumption of either a non-caloric sweetened control (CON) or a glucose (GLU) drink. Food advertisements increased food intake only in OW/OB girls. The GLU drink reduced food intake in both girls and boys despite no changes in subjective appetite. Food advertisements did not modify the response to the GLU drink in girls and contrary to the hypothesis they magnified the reduction in energy intake following the GLU drink in boys. In conclusion, FA in a TV program during consumption of a pizza meal by NW and OW/OB boys and girls increased food intake only in OW/OB girls and increased caloric compensation for the GLU drink at meal time in boys but not in girls.

The effect of meal-time exposure to food advertisements (FA) on food intake, subjective appetite and caloric compensation was investigated in overweight/obese (OW/OB) and normal weight (NW) boys (study 1) and girls (study 2). In random order, each participant watched either FA or non-food advertisements (NFA) 30 min after consumption of either a non-caloric sweetened control (CON) or a glucose (GLU) drink. Food advertisements increased food intake only in OW/OB girls. The GLU drink reduced food intake in both girls and boys despite no changes in subjective appetite. Food advertisements did not modify the response to the GLU drink in girls and contrary to the hypothesis they magnified the reduction in energy intake following the GLU drink in boys. In conclusion, FA in a TV program during consumption of a pizza meal by NW and OW/OB boys and girls increased food intake only in OW/OB girls and increased caloric compensation for the GLU drink at meal time in boys but not in girls.

Être capable d’ajuster les quantités consommées selon la densité énergétique des aliments contribue au maintien de l’équilibre de la balance énergétique. Dans un contexte de prévalence du surpoids chez l’enfant, il est crucial d’identifier les facteurs précoces susceptibles d’affecter les capacités d’ajustement énergétique. Durant toute la diversification alimentaire, les quantités ingérées, et donc les capacités d’ajustement énergétique, dépendent en partie de la qualité de l’interaction parent-enfant. Une étude épidémiologique suggère que les capacités d’ajustement énergétique se détérioreraient vers l’âge de un an. C’est aussi à cette période que survient le passage d’une alimentation spécifique bébé à une alimentation de type adulte.Aussi, dans ce travail, nous avons mis en place un suivi longitudinal afin de décrire, à l’aide d’une mesure expérimentale de compensation calorique, les changements développementaux des capacités d’ajustement énergétique entre 11 et 15 mois. Nous avons aussi exploré si certains facteurs relatifs aux caractéristiques individuelles des nourrissons, aux aliments qu’ils avaient consommés ou à l’interaction mère-nourrisson au cours du repas étaient liés aux capacités d’ajustement énergétique.Nous avons mis en évidence qu’à 11 et 15 mois les nourrissons sous-compensent leur prise énergétique à la suite de la consommation d’un premier aliment plus ou moins calorique, avec cependant de grandes différences interindividuelles. L’ajustement énergétique n’est pas meilleur si l’on considère l’ensemble des prises alimentaires au cours des 24h suivant la consommation de ce premier aliment. À 11 mois, les nourrissons ont de meilleures capacités d’ajustement énergétique lorsque, au cours du repas, la mère adapte le rythme des cuillerées à la taille des cuillerées ce qui pourrait refléter un nourrissage réceptif. À 15 mois, les nourrissons ajustent leur prise alimentaire sur des critères volumétriques plutôt que caloriques. Quel que soit l’âge, aucun lien n’a été mis en évidence entre l’expérience alimentaire des nourrissons (lactée et diversifiée) et leurs capacités d’ajustement énergétique. Concernant les changements développementaux, nous avons montré que les capacités d’ajustement énergétique se détériorent de 11 à 15 mois. Les nourrissons pour lesquels cette détérioration est plus importante sont perçus par leur mère comme étant plus ‘attirés’ par la nourriture. De plus, la détérioration des capacités d’ajustement énergétique est associée à une augmentation du z-IMC entre 11 et 15 mois et à un z-IMC plus élevé à 24 mois. Par ailleurs, plus les nourrissons sont exposés à des recettes de légumes de densité énergétique variable entre 8 et 11 mois, moins leur z-IMC est élevé à 8 mois et 11 mois. Ce travail souligne que les capacités d’ajustement énergétique sont associées à différents facteurs précoces relatifs au fonctionnement de la dyade mère-nourrisson et au statut pondéral des nourrissons. Ces résultats ouvrent un nouveau champ de recherche visant à comprendre la causalité de ces liens. In fine, cela permettrait de mieux accompagner les parents pour qu’ils adoptent des pratiques permettant le développement optimal des capacités d’ajustement énergétique de leur enfant au cours de la période clé des 1000 premiers jours. / Being able to adjust food intake according to the energy density of food is one way to self-regulate energy intake and maintain a healthy energy balance. In the context of the prevalence of overweight in children, it appears crucial to identify early factors that may affect caloric adjustment abilities. During the complementary feeding process, the amount consumed, and in turn, the caloric adjustment abilities depend in part on the quality of the caregiver-infant interaction. An epidemiological study suggests that caloric adjustment abilities might deteriorate around one year old; a time when the transition from baby-foods towards adult like foods occurs in the infant diet.In this work, we performed a laboratory-based assessment of the infants’ caloric adjustment ability by adapting the preload paradigm. By using a longitudinal approach, we first described the developmental changes in infants’ caloric adjustment ability between 11 and 15 mo. Then, we explored whether some factors related to the infants’ characteristics, the type of foods consumed or the mother-infant interaction during the meal were linked to the caloric adjustment ability.We showed that, at 11 and 15 mo, the infants under-compensated their energy intake after consuming a food preload more or less caloric. However, we observed large inter-individual variation in this ability. The level of caloric adjustment was not better when considering the total food intake during the 24 h following the food preload consumption. At 11 mo, infants had better caloric adjustment ability when the mother adapted the spoonful pace to the spoonful weight content; this dynamic during the meal could reflect a responsive feeding. At 15 mo, the infants exhibited a volumetric adjustment rather than a caloric adjustment. Regardless of the studied age, no significant links were found between the infants’ feeding experience (milk and complementary foods) and their caloric adjustment ability. Regarding the developmental changes, we observed that the infants’ caloric adjustment ability deteriorated from 11 to 15 mo. The more this deterioration, the more the infants were perceived as ‘attracted by food’ by their mothers. Moreover, the more this deterioration, the more the z-BMI increased between 11 and 15 mo, and the higher the z-BMI was at 24 mo. In addition, the more the infants were exposed to a wide range of energy density for the vegetable-based recipes between 8 and 11 mo, the lower their z-BMI was at 8 and at 11 mo. This work highlights that caloric adjustment ability is associated with various early factors related to the mother-infant dyadic functioning and the infants’ weight status. These results open up a new research field to understand the causality underpinning these links. In fine, this would allow to assist parents to support an optimal development of their infant’s caloric adjustment abilities during the key period of the first 1000 days.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro / Nas últimas décadas, tem sido observado o aumento da oferta de bebidas com elevado conteúdo calórico e com grandes quantidades de açúcar de rápida absorção. Essas bebidas adoçadas, cujo consumo tem aumentado no Brasil assim como em outras partes do mundo, são consideradas fatores de risco para obesidade e diabetes. O consumo de bebidas adoçadas pode levar ao balanço energético positivo e consequentemente ao ganho de peso. Essa associação pode ser explicada pelo mecanismo regulatório de compensação de calorias líquidas. Compensação calórica ocorre quando há redução no consumo de calorias provenientes de alimentos sólidos para compensar as calorias líquidas adicionadas à refeição ou dieta. No entanto, não há consenso em relação a evidências da compensação calórica, dificultando a elaboração de recomendações sobre essas bebidas em saúde pública. Razões para a falta de consenso incluem a diversidade de desenhos de estudos, experimentos realizados em ambientes controlados e não reais em relação ao consumo de alimentos e bebidas, e estudos com amostras pequenas ou de conveniência. Esta dissertação estudou a associação entre bebidas adoçadas e consumo calórico, verificando se calorias de bebidas adoçadas são compensadas em refeições realizadas em um ambiente pragmático. Os dados de consumo calórico de 34.003 indivíduos, com idade igual ou superior a dez anos, foram obtidos pelo Inquérito Nacional de Alimentação 2008-2009, em todo território nacional. Os participantes completaram dois registros alimentares, em dias não consecutivos da mesma semana. Foram selecionadas as refeições dos períodos café da manhã, almoço e jantar de cada indivíduo em cada um dos dias. Para cada refeição, foi calculado o valor calórico de alimentos e de bebidas adoçadas consumidos. Para testar a compensação calórica, um modelo de regressão linear multinível com efeitos mistos foi ajustado para analisar cada período. A variável reposta utilizada foi consumo calórico proveniente de alimentos e a variável explicativa foi consumo calórico de bebida adoçada na refeição. Os efeitos intra-indivíduo da bebida adoçada no consumo calórico foram estimados e interpretados. Esses efeitos são considerados não-enviesados pois são controlados pelas características constantes dos indivíduos, tendo assim o indivíduo atuando como seu próprio controle na análise. Covariadas incluídas no modelo foram variáveis da refeição: local, dia da semana, horário, consumo calórico na refeição anterior e intervalo de tempo desde a última refeição; e do indivíduo: sexo, faixa etária, categoria de Índice de Massa Corpórea e quartos de renda per capita. Efeitos aleatórios dos indivíduos e dos domicílios foram incluídos no modelo para melhor estimar a estrutura de erros de dados correlacionados. A compensação calórica foi de 42% para o café da manhã, não houve compensação no almoço e para o jantar, compensação variou de 0 a 22%, tendo interação com quartos de renda per capita. A conclusão desta dissertação é que as bebidas adoçadas não são completamente compensadas em refeições realizadas em ambiente pragmático. Assim, a redução do consumo de bebidas adoçadas em refeições pode ajudar a diminuir o consumo calórico excessivo e levar a um melhor controle do peso em indivíduos. / Over the past decades, an increase has been observed in the availability of beverages that are high in energy and rapidly absorbed sugar. These sugar-sweetened beverages, whose consumption has increased in Brazil as well as in other parts of the world, are considered risk factors for obesity and diabetes. The consumption of sugar-sweetened beverages can lead to positive energy balance and consequently to weight gain. This association can be explained by the compensatory regulation of liquid calories. Caloric compensation occurs when there is a reduction in the caloric consumption derived from solid food to compensate for the liquid calories added to the meal or diet. However, the evidence for a public health policy recommendation remains inconclusive. Among reasons for the lack of consensus are the diversity of study designs, experiments conducted in controlled environments that do not reflect the natural consumption of food and beverages, and the use of small or convenient samples. This dissertation studied the association between sugar-sweetened beverages and energy intake, analyzing if calories of sugar-sweetened beverages are compensated during meals in a pragmatic environment. The dietary data was obtained from the National Dietary Survey 2008-2009, which collected information on food consumption from 34,003 individuals, aged 10 years and older, from within the entire national territory. The participants completed two food records over non-consecutive days of the same week. The meals breakfast, lunch and dinner were identified for each individual on each of the days. For each meal, energy intake from food and sugar-sweetened beverages was measured. To test for caloric compensation, a multi-level mixed-effects linear regression model was adjusted for each meal type. The outcome variable was food energy intake and the explicative variable was energy from sugar-sweetened beverages during the meal. The intra-individual effects of the sugar-sweetened beverages on food energy intake were estimated and interpreted. These effects are considered unbiased because they are controlled by all stable characteristics of the subject, and thus the individual acts as his/her own control in the analysis. Covariates included in the model were the meal variables, such as location, day of the week, time of day, energy intake in the previous meal and time interval since the previous meal. And variables of the subject included sex, age group, BMI category and quartiles of per capita income. Random effects of subjects and of households were included in the model to better estimate the structure of errors within the correlated data. The caloric compensation was 42% for breakfast; there was no compensation for lunch; and for dinner, compensation ranged between 0 and 22%, with significant interaction with quartiles of per capita income. The conclusion of this dissertation is that sugar-sweetened beverages are not completely compensated in meals that take place in a pragmatic environment. Therefore, a reduction in the consumption of sugar-sweetened beverages in meals may help reduce excessive caloric consumption, leading to better weight control.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro / Nas últimas décadas, tem sido observado o aumento da oferta de bebidas com elevado conteúdo calórico e com grandes quantidades de açúcar de rápida absorção. Essas bebidas adoçadas, cujo consumo tem aumentado no Brasil assim como em outras partes do mundo, são consideradas fatores de risco para obesidade e diabetes. O consumo de bebidas adoçadas pode levar ao balanço energético positivo e consequentemente ao ganho de peso. Essa associação pode ser explicada pelo mecanismo regulatório de compensação de calorias líquidas. Compensação calórica ocorre quando há redução no consumo de calorias provenientes de alimentos sólidos para compensar as calorias líquidas adicionadas à refeição ou dieta. No entanto, não há consenso em relação a evidências da compensação calórica, dificultando a elaboração de recomendações sobre essas bebidas em saúde pública. Razões para a falta de consenso incluem a diversidade de desenhos de estudos, experimentos realizados em ambientes controlados e não reais em relação ao consumo de alimentos e bebidas, e estudos com amostras pequenas ou de conveniência. Esta dissertação estudou a associação entre bebidas adoçadas e consumo calórico, verificando se calorias de bebidas adoçadas são compensadas em refeições realizadas em um ambiente pragmático. Os dados de consumo calórico de 34.003 indivíduos, com idade igual ou superior a dez anos, foram obtidos pelo Inquérito Nacional de Alimentação 2008-2009, em todo território nacional. Os participantes completaram dois registros alimentares, em dias não consecutivos da mesma semana. Foram selecionadas as refeições dos períodos café da manhã, almoço e jantar de cada indivíduo em cada um dos dias. Para cada refeição, foi calculado o valor calórico de alimentos e de bebidas adoçadas consumidos. Para testar a compensação calórica, um modelo de regressão linear multinível com efeitos mistos foi ajustado para analisar cada período. A variável reposta utilizada foi consumo calórico proveniente de alimentos e a variável explicativa foi consumo calórico de bebida adoçada na refeição. Os efeitos intra-indivíduo da bebida adoçada no consumo calórico foram estimados e interpretados. Esses efeitos são considerados não-enviesados pois são controlados pelas características constantes dos indivíduos, tendo assim o indivíduo atuando como seu próprio controle na análise. Covariadas incluídas no modelo foram variáveis da refeição: local, dia da semana, horário, consumo calórico na refeição anterior e intervalo de tempo desde a última refeição; e do indivíduo: sexo, faixa etária, categoria de Índice de Massa Corpórea e quartos de renda per capita. Efeitos aleatórios dos indivíduos e dos domicílios foram incluídos no modelo para melhor estimar a estrutura de erros de dados correlacionados. A compensação calórica foi de 42% para o café da manhã, não houve compensação no almoço e para o jantar, compensação variou de 0 a 22%, tendo interação com quartos de renda per capita. A conclusão desta dissertação é que as bebidas adoçadas não são completamente compensadas em refeições realizadas em ambiente pragmático. Assim, a redução do consumo de bebidas adoçadas em refeições pode ajudar a diminuir o consumo calórico excessivo e levar a um melhor controle do peso em indivíduos. / Over the past decades, an increase has been observed in the availability of beverages that are high in energy and rapidly absorbed sugar. These sugar-sweetened beverages, whose consumption has increased in Brazil as well as in other parts of the world, are considered risk factors for obesity and diabetes. The consumption of sugar-sweetened beverages can lead to positive energy balance and consequently to weight gain. This association can be explained by the compensatory regulation of liquid calories. Caloric compensation occurs when there is a reduction in the caloric consumption derived from solid food to compensate for the liquid calories added to the meal or diet. However, the evidence for a public health policy recommendation remains inconclusive. Among reasons for the lack of consensus are the diversity of study designs, experiments conducted in controlled environments that do not reflect the natural consumption of food and beverages, and the use of small or convenient samples. This dissertation studied the association between sugar-sweetened beverages and energy intake, analyzing if calories of sugar-sweetened beverages are compensated during meals in a pragmatic environment. The dietary data was obtained from the National Dietary Survey 2008-2009, which collected information on food consumption from 34,003 individuals, aged 10 years and older, from within the entire national territory. The participants completed two food records over non-consecutive days of the same week. The meals breakfast, lunch and dinner were identified for each individual on each of the days. For each meal, energy intake from food and sugar-sweetened beverages was measured. To test for caloric compensation, a multi-level mixed-effects linear regression model was adjusted for each meal type. The outcome variable was food energy intake and the explicative variable was energy from sugar-sweetened beverages during the meal. The intra-individual effects of the sugar-sweetened beverages on food energy intake were estimated and interpreted. These effects are considered unbiased because they are controlled by all stable characteristics of the subject, and thus the individual acts as his/her own control in the analysis. Covariates included in the model were the meal variables, such as location, day of the week, time of day, energy intake in the previous meal and time interval since the previous meal. And variables of the subject included sex, age group, BMI category and quartiles of per capita income. Random effects of subjects and of households were included in the model to better estimate the structure of errors within the correlated data. The caloric compensation was 42% for breakfast; there was no compensation for lunch; and for dinner, compensation ranged between 0 and 22%, with significant interaction with quartiles of per capita income. The conclusion of this dissertation is that sugar-sweetened beverages are not completely compensated in meals that take place in a pragmatic environment. Therefore, a reduction in the consumption of sugar-sweetened beverages in meals may help reduce excessive caloric consumption, leading to better weight control.

Il a été largement démontré que la saveur sucrée était la saveur la plus appréciée chez les nouveau-nés et que cette attirance demeurait élevée tout au long de l’enfance et de l’adolescence. Il semble primordial de mieux caractériser le comportement alimentaire des enfants pour cette saveur en s’intéressant au rôle joué par les expériences alimentaires et aux apprentissages qui en découlent dans la mise en place de l’attirance pour les aliments et boissons sucrés. Pour répondre à cette problématique nous avons allié une approche comportementale et une approche en imagerie cérébrale (IRMf) chez les enfants de 7-12 ans afin de caractériser leur comportement alimentaire envers la saveur sucrée. Les résultats montrent peu de liens entre expositions à la saveur sucrée et attirance pour la saveur sucrée. Cependant, l’attirance pour la saveur sucrée est fortement associée à la quantité de glucides simples consommés en situation de libre choix. De plus, les sucres caloriques jouent un rôle renforçateur dans l’apprentissage de l’appréciation d’une flaveur nouvelle et l’exposition répétée à des boissons sucrées et édulcorées permet aux enfants d’apprendre à compenser l’énergie consommée aux repas suivants l’ingestion des boissons. La compensation n’est cependant que partielle. Enfin, les analyses en IRMf suggèrent que plus les enfants sont exposés aux boissons sucrées moins il y a d’activation en réponse aux sucres au niveau de régions du circuit de la récompense. Par une approche originale, ces travaux ont permis de mieux caractériser l’attirance des enfants pour la saveur sucrée et soulignent le rôle des apprentissages dans la mise en place des préférences alimentaires. / It has been widely demonstrated that infants have a higher preference for sweetness than for any other tastes and that sweetness attraction remain high throughout childhood and adolescence. Therefore, better characterizing children’s eating behavior toward sweetness by evaluating the role of food experiences and learning in the development of children’s attraction toward sweet foods and drinks seems essential. To better address this issue behavioral and brain imaging (fMRI) protocols were combined in 7 to 12 year-old children in order to characterize in different ways their eating behavior toward sweetness. Results showed few links between early and current sweetness exposure and attraction toward sweet taste. However, attraction toward sweet taste is strongly associated with simple carbohydrate intake in a free choice buffet. Moreover, nutritive carbohydrates play a reinforcing role in food learning in terms of children’s food liking. Children’s capacities to compensate the calories consumed in a preload drink are learned after repeated exposures to caloric and non-caloric drinks. However, caloric compensation remains uncomplete. Furthermore, fMRI data suggest that sweet drink exposure could lead to decreased activations in regions involved in food reward. Using an original methodological approach, the present work resulted in a better characterization of children’s attraction toward sweetness. Moreover, these results give an interesting insight regarding the role of experiences with sweet foods and drinks during childhood in the development of children’s food preferences.