Carnell S, Benson L, Gibson E L, Mais L A, Warkentin S
Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Appetite. 2017 Sep 1;116:82-89. doi: 10.1016/j.appet.2017.04.018. Epub 2017 Apr 19.
Maintaining a healthy weight may involve compensating for previously consumed calories at subsequent meals. To test whether heavier children demonstrated poorer caloric compensation across a range of conditions, and to explore whether compensation failure was the result of inadequate adjustment of overall intake or specific over-consumption of highly palatable, high energy-density 'junk' foods, we administered two compensation tests to a sample of 4-5 y olds. For Test A, preloads varied only in carbohydrate content and were organoleptically indistinguishable (200 ml orange-flavored beverage [0 kcal vs. 200 kcal]). For Test B, the preloads varied substantially in both macronutrient composition and learned gustatory cues to caloric content (200 ml water [0 kcal] vs. 200 ml strawberry milkshake [200 kcal]). Each preload was followed 30 min later by a multi-item ad-libitum meal containing junk foods (chocolate cookies, cheese-flavored crackers) and core foods (fruits and vegetables, bread rolls, protein foods). Testing took place at the children's own school under normal lunch-time conditions. Children were weighed and measured. Caloric compensation occurred in both tests, in terms of total, junk and core food intake (RMANOVA, all p < 0.01). Higher BMI z scores were associated with greater average caloric compensation (r = -0.26; p < 0.05), such that overweight/obese children showed least compensation (41%), children over the 50 centile the next least (59%), and children under the 50 centile (80%) the most. For Test A only, obese/overweight children compensated less well than normal-weight children in terms of junk food intake (RMANOVA preload-by-weight group interaction p < 0.05), with no significant effect for core foods. Our results suggest that caloric compensation is consistently poorer in heavier children, and that overweight/obese children's preferences for junk foods may overwhelm intake regulation mechanisms within meals containing those foods.
维持健康体重可能需要在后续餐食中弥补之前摄入的热量。为了测试体重较重的儿童在一系列情况下是否表现出较差的热量补偿能力，并探究补偿失败是否是由于总体摄入量调整不足或过度食用了高美味、高能量密度的“垃圾”食品，我们对一组4至5岁的儿童进行了两项补偿测试。在测试A中，预负荷仅在碳水化合物含量上有所不同，且在感官上无法区分（200毫升橙汁味饮料[0千卡与200千卡]）。在测试B中，预负荷在宏量营养素组成和对热量含量的习得味觉线索方面都有很大差异（200毫升水[0千卡]与200毫升草莓奶昔[200千卡]）。每种预负荷30分钟后，接着是一顿包含垃圾食品（巧克力饼干、奶酪味饼干）和核心食品（水果和蔬菜、面包卷、蛋白质类食品）的随意多选餐。测试在孩子们自己的学校正常午餐时间进行。对孩子们进行了称重和测量。在两项测试中，就总热量、垃圾食品和核心食品摄入量而言，都出现了热量补偿（重复测量方差分析，所有p<0.01）。较高的BMI z评分与更大的平均热量补偿相关（r = -0.26；p<0.05），超重/肥胖儿童的补偿最少（41%），处于第50百分位以上的儿童其次少（59%），处于第50百分位以下的儿童（80%）补偿最多。仅在测试A中，肥胖/超重儿童在垃圾食品摄入量方面的补偿不如正常体重儿童（重复测量方差分析中预负荷与体重组的交互作用p<0.05），对核心食品没有显著影响。我们的结果表明，体重较重儿童的热量补偿能力始终较差，超重/肥胖儿童对垃圾食品的偏好可能会压倒含有这些食品的餐食中的摄入调节机制。
