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This prospective random controlled cross-over intervention studies is designed to ascertain if children feel different levels of hunger and fullness before and after eating test meals consisting of high-satiety vs. usual foods and if the child's perceived hunger/fullness is related to their salivary ghrelin levels and a variety of learning outcomes. Data are collected at the Diet and Nutrition (DAN) laboratory on repeated study days (8am - 4 pm).
The investigator's previous research has shown that preschoolers recognized changes in the feelings of hunger/fullness before and after a single test meal. If preschooler's feelings of hunger are associated with their ghrelin (hunger hormone) levels is not known. This study is designed to assess children's changes in feelings of hunger throughout the day (8 pm to 4 pm) and to measure both subjective feelings of hunger and salivary ghrelin levels before and after a standardized test meal (lunch).
An important secondary outcome related to children's feelings of hunger is their ability to learn. Currently, there is lack of data on the direct link between perceived hunger/fullness and learning processes. This study addresses these gaps using preschooler's perceived feelings of hunger and fullness (using a published 4-point scale (Kranz S.et al. "High-Protein and High-Dietary-Fiber Breakfasts Result in Equal Feelings of Fullness and Better Diet Quality in Low-Income Preschoolers Compared with Their Usual Breakfast" J Nutr doi: 10.3945/jn.116.234153, 2017) and a battery of learning tests (HTKS, KRISP, Stroop-style tasks, Woodcock Johnson vocabulary test, DCCS, and curisoty measures.)
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| diet | Experimental | high fiber high protein foods served in childcare centers are offered for meals and snacks |
|
| usual diet | Other | foods representing the usual diet in childcare centers are offered for meals and snacks |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| diet | Other | foods with high satiation (high protein and high fiber foods) are offered to modify children's hunger and fullness ratings postprandial |
|
| Measure | Description | Time Frame |
|---|---|---|
| hunger/fullness 120 minutes postprandial using "children's hunger scale" | hunger/fullness scale. change in children's perceived hunger and fullness on an age-appropriate scale: children respond to the question of "are you hungry or full" (coded hungry (1 or 2) or full (3 or 4)) followed by "are you very hungry( or full) or just a little hungry (or full)" coded as 1=very hungry, 2=a little hungry, 3- a little full, 4=very full, thus leading to a 4-point likert scale (from 1 to 4 with 1 being "very hungry" and 4 being "very full"). The development of the scale and its use are published by Kranz S. et al, Journal of Nutrition, 2017. | change on hunger/fullness scale from pre-lunch to 2-hours post lunch |
| salivary ghrelin levels | change in salivary ghrelin levels will be measured | change in salivary ghrelin from pre-lunch to 2-hours post lunch |
| Measure | Description | Time Frame |
|---|---|---|
| learning (working memory) | Head Toes Knee and Shoulders test | change from pre-lunch to 2-hours post lunch |
| physical activity level | children will wear accelerators while at the laboratory ( 8 pm to 4 pm) to calculate average activity level across the 4 study days |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Sibylle Kranz, PhD | University of Virginia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Virginia | Charlottesville | Virginia | 22904 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28077732 | Background | Kranz S, Brauchla M, Campbell WW, Mattes RD, Schwichtenberg AJ. High-Protein and High-Dietary Fiber Breakfasts Result in Equal Feelings of Fullness and Better Diet Quality in Low-Income Preschoolers Compared with Their Usual Breakfast. J Nutr. 2017 Mar;147(3):445-452. doi: 10.3945/jn.116.234153. Epub 2017 Jan 11. | |
| Background | Kranz S, Marshall YW, Wight A, Bordi PL, Kris-Etherton PM. Liking and consumption of high-fiber snacks in preschool-age children. Food Quality and Preference 22: 486-489, 2011. |
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| ID | Term |
|---|---|
| D005247 | Feeding Behavior |
| D009765 | Obesity |
| D005518 | Food Preferences |
| ID | Term |
|---|---|
| D001522 | Behavior, Animal |
| D001519 | Behavior |
| D050177 | Overweight |
| D044343 | Overnutrition |
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| ID | Term |
|---|---|
| D004032 | Diet |
| ID | Term |
|---|---|
| D009747 | Nutritional Physiological Phenomena |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
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| usual diet | Other | foods representing the usually provided foods at childcare are offered |
|
| through study completion, on average of 8 weeks |
| liking of food | children will rate the foods provided using an age-appropriate visual (smiley faces) response coded as "like"(smiling face), "neutral" (face with straight line as mouth(, and "don't like" (face with tongue sticking out). | through study completion, on average of 8 weeks |
| anthropometric data | measured height and weight to calculate CDC BMI-for-age percentiles of body weight status | at baseline |
| systolic and diastolic blood pressure | measured systolic and diastolic blood pressure | through study completion, on average of 8 weeks |
| D009748 |
| Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |