title: 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.
abstract: 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.
  
  
  METHODS
  After receiving written consent from their parents, 26 NW (BMI < 90(th) percentile) and 24 7-to 11-year-old OW (n = 5)/OB (n = 19, BMI ≥ 90(th) 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.
  
  
  BACKGROUND
  clinicaltrials.gov NCT01693926 The study was a pilot study of a project funded by the Swiss National Science Foundation (CRSII3_147673).
authors: Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent (SUPEA), Unité de recherche, Centre Hospitalier Universitaire Vaudois, 25 A, Rue du Bugnon, Lausanne, CH-1011, Switzerland. antje.horsch@chuv.ch.
authors: Antje
authors: A
authors: Horsch
authors: Faculté des Sciences Sociales et Politiques, Institute des Sciences du Sport, Université de Lausanne, Lausanne, Switzerland. marion.wobmann@unil.ch.
authors: Marion
authors: M
authors: Wobmann
authors: Institute of Social and Preventative Medicine, University of Zürich, Zürich, Switzerland. susi.kriemler@ifspm.uzh.ch.
authors: Susi
authors: S
authors: Kriemler
authors: Department of Clinical Psychology, University of Fribourg, Fribourg, Switzerland. simone.munsch@unifr.ch.
authors: Simone
authors: S
authors: Munsch
authors: Division d'Endocrinologie, Diabétologie et Obésité Pédiatrique, Département Médico-chirurgical de Pédiatrie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. sylvie.borloz-deladoey@chuv.ch.
authors: Sylvie
authors: S
authors: Borloz
authors: Division d'Endocrinologie, Diabétologie et Obésité Pédiatrique, Département Médico-chirurgical de Pédiatrie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. alexandra.balz@chuv.ch.
authors: Alexandra
authors: A
authors: Balz
authors: Institut Universitaire de Médecine Sociale et Préventive, Université de Lausanne, Lausanne, Switzerland. pedro-manuel.marques-vidal@chuv.ch.
authors: Pedro
authors: P
authors: Marques-Vidal
authors: Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent (SUPEA), Unité de recherche, Centre Hospitalier Universitaire Vaudois, 25 A, Rue du Bugnon, Lausanne, CH-1011, Switzerland. ayala.borghini@chuv.ch.
authors: Ayala
authors: A
authors: Borghini
authors: Division d'Endocrinologie, Diabétologie et Obésité Pédiatrique, Département Médico-chirurgical de Pédiatrie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. jardena.puder@chuv.ch.|Service d' Endocrinologie, Diabétologie et Métabolisme, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. jardena.puder@chuv.ch.
authors: Jardena J
authors: JJ
authors: Puder
mesh_terms: D001835:Body Weight; D002648:Child; D002149:Energy Intake; D004734:Energy Metabolism; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D008297:Male; D009043:Motor Activity; D050177:Overweight / Q000523:psychology; D016487:Parenting; D063766:Pediatric Obesity / Q000523:psychology*; D010865:Pilot Projects; D012307:Risk Factors; D013315:Stress, Psychological / Q000503:physiopathology*; D011795:Surveys and Questionnaires