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减少进食速度(RePace)行为干预对易肥胖或肥胖儿童的作用:乌龟是否赢得比赛?

Reduced Eating Pace (RePace) Behavioral Intervention for Children Prone to or with Obesity: Does the Turtle Win the Race?

机构信息

Department of Counseling, School and Educational Psychology, Graduate School of Education, University at Buffalo, State University of New York, Buffalo, New York, USA.

M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, USA.

出版信息

Obesity (Silver Spring). 2019 Jan;27(1):121-129. doi: 10.1002/oby.22329. Epub 2018 Dec 4.

Abstract

OBJECTIVE

Rapid eating is a risk factor for childhood obesity but has not been a focus of intervention with young children. The short-term effects of a novel family-based treatment, "Reduced Eating Pace" (RePace), were tested on child eating speed and secondary outcomes.

METHODS

Twenty-eight rapid eating children were randomized to RePace (n  = 14) or Delayed Usual Care Control (DUC) (n  = 14). RePace taught families a slower eating pace using psychoeducational and behavioral techniques, including silent vibrating devices that prompted 30-second "turtle bites." Outcomes included child "slowness in eating" assessed by parent-report questionnaire and observed eating in the laboratory (i.e., mouthfuls/minute and kilocalories/minute). Child BMI and other eating variables were secondary outcomes.

RESULTS

Children in RePace compared with DUC showed increased "slowness in eating" (P  <  0.001), increased food enjoyment (P  = 0.04), and less BMI gain (P  = 0.02) after 8 weeks. There was no treatment effect for observed eating speed, although typicality of the laboratory test meal was an effect modifier in exploratory analyses. Specifically, RePace versus DUC showed attenuated increases in mouthfuls per minute over time among youth for whom the laboratory food amount was more typical of amounts served at home.

CONCLUSIONS

Slower eating may be a novel target for family-based obesity prevention targeting high-risk children.

摘要

目的

快速进食是儿童肥胖的一个风险因素,但它并未成为针对幼儿的干预重点。本研究旨在检验一种新的基于家庭的治疗方法“减慢进食速度”(RePace)对儿童进食速度和次要结果的短期影响。

方法

将 28 名快速进食的儿童随机分为 RePace 组(n = 14)或延迟常规护理对照组(DUC)(n = 14)。RePace 组采用心理教育和行为技术教家庭采用较慢的进食速度,包括提示 30 秒“乌龟咬”的无声振动装置。主要结局包括通过父母报告问卷和实验室观察到的儿童“进食缓慢”(即每分钟口数和每分钟千卡)来评估。儿童 BMI 和其他进食变量为次要结局。

结果

与 DUC 相比,RePace 组儿童的“进食缓慢”程度增加(P < 0.001),食物享受程度增加(P = 0.04),8 周后 BMI 增加减少(P = 0.02)。观察到的进食速度没有治疗效果,但在探索性分析中,实验室测试餐的典型性是一个效应修饰因素。具体来说,与 DUC 相比,对于实验室食物量更接近家庭中所提供量的儿童,RePace 与 DUC 相比,每分钟口数的增加速度在随访期间有所减缓。

结论

减慢进食速度可能是针对高危儿童的基于家庭的肥胖预防的新目标。

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