在基层医疗环境中通过控制饮食量来治疗肥胖症。
Portion control for the treatment of obesity in the primary care setting.
作者信息
Kesman Rebecca L, Ebbert Jon O, Harris Katherine I, Schroeder Darrell R
机构信息
Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA.
出版信息
BMC Res Notes. 2011 Sep 9;4:346. doi: 10.1186/1756-0500-4-346.
BACKGROUND
The increasing prevalence of obesity is a significant health threat and a major public health challenge. A critical need exists to develop and evaluate practical methods for the treatment of obesity in the clinical setting. One of the factors contributing to the obesity epidemic is food portion sizes. Limited data are available on the efficacy of visual or tactile devices designed to enhance patient understanding and control of portion sizes. A portion control plate is a commercially-available product that can provide visual cues of portion size and potentially contribute to weight loss by enhancing portion size control among obese patients. This tool holds promise as a useful adjunct to dietary counseling. Our objective was to evaluate a portion control intervention including dietary counseling and a portion control plate to facilitate weight loss among obese patients in a primary care practice.
FINDINGS
We randomized 65 obese patients [body mass index (BMI) ≥ 30 and < 40] to an intervention including counseling by a dietitian incorporating a portion control plate or to usual care. Following initial consultation, patients in the intervention arm were contacted at 1, 3, and 5 months by the dietician for brief follow-up counseling. Usual care subjects received instructional handouts on diet and exercise. Forty-two (65%) subjects returned to have weight assessed at 6 months. Subjects in the portion control intervention had a greater percentage change (± SD) in weight from baseline at 3 months (-2.4% ± 3.7% vs. -0.5% ± 2.2%; p = 0.041) and a non significant trend in weight change from baseline at 6 months (-2.1% ± 3.8% vs. -0.7% ± 3.7%; p = 0.232) compared with usual care. Nearly one-half of patients assigned to the portion control intervention who completed the study reported the overall intervention was helpful and the majority would recommend it to others.
CONCLUSIONS
Our findings suggest that a portion control intervention incorporating dietary counseling and a portion control plate may be effective for enhancing weight loss among obese subjects. A portion control intervention deserves further evaluation as a weight control strategy in the primary care setting.
TRIAL REGISTRATION
Current controlled trials NCT01451554.
背景
肥胖患病率的不断上升是一个重大的健康威胁，也是一项重大的公共卫生挑战。迫切需要开发和评估在临床环境中治疗肥胖的实用方法。导致肥胖流行的因素之一是食物份量。关于旨在增强患者对份量理解和控制的视觉或触觉设备的功效，现有数据有限。份量控制盘是一种商业产品，它可以提供份量大小的视觉提示，并可能通过增强肥胖患者对份量大小的控制来促进体重减轻。作为饮食咨询的有用辅助工具，该工具具有应用前景。我们的目标是评估一种份量控制干预措施，包括饮食咨询和份量控制盘，以促进初级保健机构中肥胖患者的体重减轻。
研究结果
我们将65名肥胖患者[体重指数（BMI）≥30且<40]随机分为两组，一组接受由营养师进行的包含份量控制盘的咨询干预，另一组接受常规护理。在初次咨询后，干预组的患者在第1、3和5个月由营养师进行简短的随访咨询。常规护理组的受试者收到有关饮食和运动的指导手册。42名（65%）受试者在6个月时返回进行体重评估。与常规护理相比，份量控制干预组的受试者在3个月时体重较基线的变化百分比（±标准差）更大（-2.4%±3.7%对-0.5%±2.2%；p = 0.041），在6个月时体重较基线的变化趋势不显著（-2.1%±3.8%对-0.7%±3.7%；p = 0.232）。在完成研究的分配到份量控制干预组的患者中，近一半报告总体干预有帮助，且大多数人会向他人推荐。
结论
我们的研究结果表明，包含饮食咨询和份量控制盘的份量控制干预措施可能对促进肥胖受试者的体重减轻有效。作为初级保健环境中的体重控制策略，份量控制干预值得进一步评估。
试验注册
现行对照试验NCT01451554。
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