Food Addiction Risk Accelerates Fat Accumulation in Youth: Potential Protective Roles of Left Insula and Mindful Eating.

Abstract

Food addiction (FA) is implicated in obesity, yet the potential moderating role of mindful eating and the underlying neural mechanisms in youth remain unclear. This study integrated a multicenter cross-sectional survey, a longitudinal study with 6- and 12-month follow-ups, and an independent magnetic resonance imaging (MRI) sample. FA, eating motives, mindful eating, BMI z-score, fat content, and visceral fat level were assessed. Analyses utilized structural equation modeling, latent growth modeling, and voxel-based morphometry. Among 2071 screened, 1601 youth (55.5% boys; mean age = 12.69 ± 3.04 years) completed the baseline survey, with 880 and 564 completing the 6- and 12-month follow-ups, respectively. FA mediated the relationship between eating motives and weight status, and mindful eating moderated this pathway (p < 0.05). Longitudinally, baseline FA predicted accelerated accumulation of fat content and visceral fat level, but not BMI z-score (p > 0.05). The independent 75-MRI sample revealed that left insula gray-matter volume was negatively associated with FA but positively associated with mindful eating. FA may link eating motives to fat accumulation in youth, particularly abdominal fat; mindful eating may be protective, with left insula structure and left insula-striatum connectivity as possible neural correlates.