Fulkerson Jayne A, Friend Sarah, Flattum Colleen, Horning Melissa, Draxten Michelle, Neumark-Sztainer Dianne, Gurvich Olga, Story Mary, Garwick Ann, Kubik Martha Y
School of Nursing, University of Minnesota, 5-160 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN, 55455, USA.
Department of Family Medicine & Community Health, University of Minnesota, Minneapolis, Minnesota, USA.
Int J Behav Nutr Phys Act. 2015 Dec 15;12:154. doi: 10.1186/s12966-015-0320-3.
Family meal frequency has been shown to be strongly associated with better dietary intake; however, associations with weight status have been mixed. Family meals-focused randomized controlled trials with weight outcomes have not been previously conducted. Therefore, this study purpose was to describe weight-related outcomes of the HOME Plus study, the first family meals-focused randomized controlled trial to prevent excess weight gain among youth.
Families (n = 160 8-12-year-old children and their parents/guardians) were randomized to intervention (n = 81) or control (n = 79) groups. Data were collected at baseline (2011-2012), post-intervention (12-months post-baseline) and follow-up (21-months post-baseline). The intervention included ten monthly group sessions (nutrition education; hands-on meal and snack planning, preparation, and skill development; screen time reductions) and five motivational, goal-setting phone calls. The main outcome was child body mass index (BMI) z-score.
General linear models, adjusted for baseline values and demographics, showed no significant treatment group differences in BMI z-scores at post-intervention or follow-up; however, a promising reduction in excess weight gain was observed. Post-hoc stratification by pubertal onset indicated prepubescent children in the intervention group had significantly lower BMI z-scores than their control group counterparts.
The study used a strong theoretical framework, rigorous design, quality measurement and a program with high fidelity to test a family meals-focused obesity prevention intervention. It showed a modest decrease in excess weight gain. The significant intervention effect among prepubescent children suggests the intervention may be more efficacious among relatively young children, although more research with appropriately powered samples are needed to replicate this finding.
This study is registered at www.clinicaltrials.gov NCT01538615. Registered 01/17/2012.
家庭用餐频率已被证明与更好的饮食摄入密切相关；然而，其与体重状况的关联却并不一致。此前尚未开展过以家庭用餐为重点且有体重相关结果的随机对照试验。因此，本研究旨在描述“家庭强化计划（HOME Plus）研究”与体重相关的结果，该研究是首个以家庭用餐为重点的随机对照试验，旨在预防青少年体重过度增加。
将家庭（n = 160名8至12岁儿童及其父母/监护人）随机分为干预组（n = 81）和对照组（n = 79）。在基线期（2011 - 2012年）、干预后（基线期后12个月）和随访期（基线期后21个月）收集数据。干预措施包括十次月度小组会议（营养教育；实际操作的膳食和零食计划、准备及技能培养；减少屏幕使用时间）以及五次激励性目标设定电话沟通。主要结局指标是儿童体重指数（BMI）z评分。
经基线值和人口统计学因素校正的一般线性模型显示，干预后或随访时，治疗组在BMI z评分上无显著差异；然而，观察到超重增加有了令人期待的减少。按青春期发育起始进行的事后分层表明，干预组的青春期前儿童的BMI z评分显著低于对照组的同龄人。
该研究采用了强大的理论框架、严谨的设计、高质量的测量以及高度保真的项目来测试一项以家庭用餐为重点的肥胖预防干预措施。研究表明超重增加有适度下降。青春期前儿童中的显著干预效果表明，该干预措施可能对年龄相对较小的儿童更有效，不过需要更多有足够样本量的研究来重复这一发现。
本研究已在www.clinicaltrials.gov上注册，注册号为NCT01538615。于2012年1月17日注册。
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