Children's satiety responsiveness moderates the association between food reinforcement and eating in the absence of hunger.

The reinforcing value of food, a measure of motivation to obtain food, is associated with obesity in children. However, the extent to which food reinforcement predicts children's intake under different contexts (i.e., meals fasted, eating in the absence of hunger-EAH) is unknown. We hypothesized that food reinforcement would be positively associated with intake at meals and EAH and examined whether satiety responsiveness (SR) moderates this association. As part of an ongoing 5-visit study, 96 children (7-9 years <95th BMI%) completed a Relative Reinforcing Value task (visit-V1) to assess willingness to work for candy and toys. Thirty minutes before the task, children consumed an ad libitum multi-item meal (grilled cheese, chicken tenders, etc.). On V3 and V4, children consumed the same meal followed 20 min later by presentation of nine snacks for measurement of EAH. SR was assessed from parent report (Children's Eating Behavior Questionnaire). Mixed effect regressions showed a positive association between food reinforcement and energy intake at the meals (p < 0.01). SR was negatively associated with food reinforcement (p = 0.03) and moderated the association between food reinforcement and EAH (p = 0.03). In children with low SR (-1SD below mean), food reinforcement and EAH were positively associated (p = 0.03). No associations were seen in children with SR near or above the mean. This demonstrates that willingness to work for food is associated with greater energy intake during a meal across children and EAH among children with low sensitivity to satiety cues. Interventions promoting SR may help mitigate effects of food reinforcement on non-hunger-related intake.