Impact of physical activity on energy balance, food intake and choice in normal weight and obese children in the setting of acute social stress: a randomized controlled trial

Background: Psychological stress negatively influences food intake and food choices, thereby contributing to the development of childhood obesity. Physical activity can also moderate eating behavior and influence calorie intake. However, it is unknown if acute physical activity influences food intake and overall energy balance after acute stress exposure in children. We therefore investigated the impact of acute physical activity on overall energy balance (food intake minus energy expenditure), food intake, and choice in the setting of acute social stress in normal weight (NW) and overweight/obese (OW/OB) children as well as the impact of psychological risk factors. Method : After receiving written consent from their parents, 26 NW (BMI < 90th percentile) and 24 7-to 11-year-old OW (n = 5)/OB (n = 19, BMI ≥ 90th percentile) children were randomly allocated using computer-generated numbers (1:1, after stratification for weight status) to acute moderate physical or to sedentary activity for 30 min. Afterwards, all children were exposed to an acute social stressor. Children and their parents completed self-report questionnaires. At the end of the stressor, children were allowed to eat freely from a range of 12 different foods (6 sweet/6 salty; each of low/high caloric density). Energy balance, food intake/choice and obesity-related psychological risk factors were assessed. Results: Lower overall energy balance (p = 0.019) and a decreased choice of low density salty foods (p < 0.001) in NW children compared with OW/OB children was found after acute moderate physical activity but not sedentary activity. Independent of their allocation, OW/OB children ate more high density salty foods (104 kcal (34 to 173), p = 0.004) following stress. They scored higher on impulsive behavior (p = 0.005), restrained eating (p < 0.001) and parental corporal punishment (p = 0.03), but these psychological factors were not related to stress-induced food intake/choice. Positive parenting tended to be related to lower intake of sweet high density food (−132 kcal, −277 to 2, p = 0.054). Conclusions: In the setting of stress, acute moderate physical activity can address energy balance in children, a benefit which is especially pronounced in the OW/OB. Positive parenting may act as a protective factor preventing stress-induced eating of comfort food

La régulation émotionnelle au cœur des relations d’attachement

Au cœur des relations d’attachement, la dimension de sécurité émotionnelle est centrale. Il s’agit de pouvoir explorer, dans le lien à l’autre, sans peur et sans risque de représailles, les émotions qui nous habitent et de grandir de cette expression profondément régulatrice. Dans la relation parent-enfant comme dans la relation thérapeutique, cette dynamique sécurisante, ancrée dans les subtilités des échanges interactifs, autorise l’autonomie grandissante, source d’apaisement et de plaisir partagé. L’objectif du présent texte est de revisiter la relation d’attachement à la lumière de ce qu’elle représente en termes de régulation des émotions dans la relation à l’autre. Le calme du parent ainsi que les bases d’orientation qu’il peut donner à l’enfant comme autant de feedbacks informatifs et organisateurs sont au centre de ce processus. Quelques vignettes cliniques viennent illustrer ce point de vue en mettant en évidence comment la théorie de l’attachement peut venir enrichir les prises en charge thérapeutiques