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Comportamentos alimentares relacionados com o apetite: determinantes e efeitos no estado ponderal da criança
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Abstract(s)
Apesar de existir alguma investigação nas áreas dos comportamentos alimentares e apetite, perceber quais são os comportamentos das crianças que estão associados às diferenças ponderais tem sido um desafio ao longo do tempo.
Com este trabalho pretendeu-se realizar uma revisão bibliográfica de estudos que abordem as formas de avaliação e regulação do apetite, e como este processo se desenvolve e determina os comportamentos alimentares em idades precoces, assim como alguns dos seus efeitos no estado ponderal.
Foi feita uma revisão da literatura utilizando a base de dados PubMed®, complementada por uma pesquisa em snowball. Incluíram-se artigos relacionados com os mecanismos de regulação de apetite, os métodos de avaliação do apetite e dos comportamentos alimentares e seus determinantes e efeitos dos comportamentos alimentares no estado ponderal.
O processo da regulação do apetite é essencialmente explicado através da interação entre mecanismos homeostáticos e hedónicos. Os mecanismos homeostáticos são mediados pela necessidade biológica de manter as reservas energéticas do corpo, aumentando a motivação para a ingestão de alimentos, enquanto que os mecanismos hedónicos são mediados pela recompensa alimentar e parecem superar os mecanismos homeostáticos em períodos de “abundância”, aumentando o desejo de consumir alimentos de elevada palatibilidade e desencadeando a libertação mesolímbica de dopamina e serotonina
Existem métodos biológicos (marcadores biológicos como enzimas intestinais e hormonas como a leptina, grelina e insulina) e métodos comportamentais de avaliação do apetite, sendo o instrumento mais frequentemente utilizado o Children’s Eating Behaviour Questionnaire (CEBQ), por apresentar boas propriedades psicométricas, avaliando o comportamento alimentar das crianças de forma abrangente.
A formação dos primeiros comportamentos alimentares inicia-se in útero e são vários os fatores que os determinam e que podem contribuir para uma diminuição da capacidade de autorregulação da ingestão alimentar da criança, como a predisposição genética, as primeiras experiências gustativas e o ambiente e influências familiares, que se assumem como determinantes-chave neste processo. Tem sido um desafio entender quais os comportamentos alimentares que mais contribuem para o excesso de peso infantil. Entre eles destacam-se a ingestão externa (comer por estímulos externos como a simples presença do alimento ou o seu cheiro), a restrição alimentar (que pode potenciar o aumento desinibido da ingestão dos alimentos restringidos) e a ingestão emocional (que resulta da ingestão face a variações emocionais, especialmente, sentimentos negativos).
Dada esta estreita relação entre comportamentos alimentares relacionados com o apetite e excesso de peso, estudos futuros sobre os determinantes dos comportamentos alimentares das crianças poderão favorecer o desenvolvimento de ferramentas úteis para a prevenção, apoio e tratamento da obesidade infantil.
Although there is some research in the scope of feeding behaviors and appetite, understanding which are the eating behaviors of children that are associated with weight differences has been a challenge over time. This work aims to carry out a literature review of studies that address the forms of evaluation and regulation of appetite, and how this process develops and determines the eating habits at early ages, as well as some of its effects on weight status. A literature review was performed using the database PubMed®, complemented by a survey of snowball effect. They included articles related to appetite control mechanisms, assessment methods of appetite and feeding behaviors and their determinants and effects of feeding behavior on weight status. Appetite regulation process is essentially explained by the interaction between homeostatic and hedonic mechanisms: The homeostatic mechanisms are mediated by the biological need to maintain energy reserves of the body, increasing motivation to food intake, while the hedonic mechanisms are mediated by food reward and seem to overcome the homeostatic mechanisms during periods of “fullness", increasing the craving for high palatable foods and triggering the mesolimbic release of dopamine and serotonin. There are biological methods (biological markers such as intestinal enzymes and hormones, such as leptin, ghrelin and insulin) and behavioral evaluation methods of appetite, being the most often used the Children's Eating Behaviour Questionnaire (CEBQ) due its good psychometric properties, assessing the eating behavio of children comprehensively. The formation of the first eating behaviors begins in utero and there are several determining factors which may contribute to a decrease of the self-regulation ability for food intake of children, such as the genetic predisposition, the first taste experiences and the environment and family influences, which are key determinants in this process. It has been a challenge to understand which eating behaviors contribute most to childhood overweight. Among them are the external eating (eating by external stimuli such as the mere presence of the food or its smell), food restriction (which may potentiate the uninhibited increased intake of the restricted foods) and emotional eating (resulting from the intake due to emotional variations, especially negative feelings). Given this close relation between appetite-related eating behaviors and overweight, future studies on the determinants of eating behavior of children may favor the development of useful tools for prevention, support and treatment of childhood obesity.
Although there is some research in the scope of feeding behaviors and appetite, understanding which are the eating behaviors of children that are associated with weight differences has been a challenge over time. This work aims to carry out a literature review of studies that address the forms of evaluation and regulation of appetite, and how this process develops and determines the eating habits at early ages, as well as some of its effects on weight status. A literature review was performed using the database PubMed®, complemented by a survey of snowball effect. They included articles related to appetite control mechanisms, assessment methods of appetite and feeding behaviors and their determinants and effects of feeding behavior on weight status. Appetite regulation process is essentially explained by the interaction between homeostatic and hedonic mechanisms: The homeostatic mechanisms are mediated by the biological need to maintain energy reserves of the body, increasing motivation to food intake, while the hedonic mechanisms are mediated by food reward and seem to overcome the homeostatic mechanisms during periods of “fullness", increasing the craving for high palatable foods and triggering the mesolimbic release of dopamine and serotonin. There are biological methods (biological markers such as intestinal enzymes and hormones, such as leptin, ghrelin and insulin) and behavioral evaluation methods of appetite, being the most often used the Children's Eating Behaviour Questionnaire (CEBQ) due its good psychometric properties, assessing the eating behavio of children comprehensively. The formation of the first eating behaviors begins in utero and there are several determining factors which may contribute to a decrease of the self-regulation ability for food intake of children, such as the genetic predisposition, the first taste experiences and the environment and family influences, which are key determinants in this process. It has been a challenge to understand which eating behaviors contribute most to childhood overweight. Among them are the external eating (eating by external stimuli such as the mere presence of the food or its smell), food restriction (which may potentiate the uninhibited increased intake of the restricted foods) and emotional eating (resulting from the intake due to emotional variations, especially negative feelings). Given this close relation between appetite-related eating behaviors and overweight, future studies on the determinants of eating behavior of children may favor the development of useful tools for prevention, support and treatment of childhood obesity.
Description
Trabalho Complementar apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de licenciada em Ciências da Nutrição
Keywords
Comportamento alimentar Apetite Obesidade Infantil Feeding Behavior Appetite Childhood Obesity