对超重或肥胖的儿童和青少年不良进食习惯的生态瞬时评估。
Ecological momentary assessment of maladaptive eating in children and adolescents with overweight or obesity.
机构信息
Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Weight Control and Diabetes Research Center/The Miriam Hospital, Providence, Rhode Island.
Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota.
出版信息
Int J Eat Disord. 2018 Jun;51(6):549-557. doi: 10.1002/eat.22864. Epub 2018 Apr 6.
OBJECTIVES
Contextual factors related to maladaptive eating behavior in youth with overweight/obesity are poorly understood. This pilot study sought to elucidate immediate internal and external cues related to perceptions of overeating and loss of control (LOC) over eating in a heterogeneous sample of children and adolescents with overweight/obesity assessed in their natural environments.
METHOD
Community-based youth [N = 40; 55% female (n = 22)], aged 8-14 y (M age = 11.2 ± 1.9 y), with overweight/obesity (M z-BMI = 2.07 ± 0.49) reported on all eating episodes and their physiological, environmental, affective, and interpersonal antecedents and correlates via ecological momentary assessment over a 2-week period. Generalized estimating equations were used to assess the relationship between contextual variables and degree of overeating and LOC.
RESULTS
Eating occasions involving greater food hedonics (i.e., perceived palatability of food being consumed) were associated with greater LOC severity (within-subjects effect: B = 0.01, p = .015), although youth with lower overall levels of food hedonics reported higher LOC severity ratings on average (between-subjects effect: B = -0.04, p = .005). Youth reporting higher overall cravings reported higher average ratings of LOC severity (between-subjects effect: B = 0.20, p = .001). Finally, youth reporting greater overall influence of others on eating behavior evidenced greater average levels of overeating severity (between-subjects effect: B = 0.17, p < .001).
DISCUSSION
Eating-related factors appear to be most strongly associated with LOC severity, while environmental factors were most associated with overeating severity. Interventions targeting maladaptive eating in youth with overweight/obesity may benefit from helping youth incorporate palatable foods and satisfy cravings in a planned and controlled manner, and enhancing awareness of social-contextual effects on eating.
目的
与超重/肥胖青少年适应不良进食行为相关的情境因素尚未得到充分理解。本研究旨在阐明在自然环境中评估的超重/肥胖儿童和青少年异质样本中，与感知暴食和失控（LOC）进食相关的即时内部和外部线索。
方法
社区为基础的青少年[N=40；55%为女性（n=22）]，年龄 8-14 岁（M 年龄=11.2±1.9 岁），超重/肥胖（M z-BMI=2.07±0.49），通过生态瞬时评估在 2 周内报告所有进食事件及其生理、环境、情感和人际前因和相关性。广义估计方程用于评估情境变量与进食过量和 LOC 严重程度的关系。
结果
涉及更大食物快感（即，正在消耗的食物的可感知美味）的进食场合与更高的 LOC 严重程度相关（个体内效应：B=0.01，p=0.015），尽管整体食物快感水平较低的青少年平均报告更高的 LOC 严重程度评分（个体间效应：B=-0.04，p=0.005）。报告整体食欲较高的青少年报告较高的 LOC 严重程度平均评分（个体间效应：B=0.20，p=0.001）。最后，报告他人对进食行为更大整体影响的青少年表现出更高的平均进食过量严重程度（个体间效应：B=0.17，p<0.001）。
讨论
与进食相关的因素似乎与 LOC 严重程度最相关，而环境因素与进食过量严重程度最相关。针对超重/肥胖青少年适应不良进食行为的干预措施可能受益于帮助青少年以计划和控制的方式摄入美味食物和满足食欲，并增强对社会环境对进食影响的认识。
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