Murdoch Children's Research Institute, Parkville, VIC, Australia.
Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.
Int J Obes (Lond). 2019 Oct;43(10):1891-1902. doi: 10.1038/s41366-019-0407-z. Epub 2019 Jul 18.
Snacks contribute to overconsumption of energy-dense foods and thence obesity. Previous studies in this area are limited by self-reported data and small samples. In a large population-based cohort of parent-child dyads, we investigated how modification of pre-packaged snack food, i.e. (a) item quantity and variety, and (b) dishware (boxed container) size affected intake.
Design: Randomized trial nested within the cross-sectional Child Health CheckPoint of the Longitudinal Study of Australian Children, clustered by day of visit.
1299 11-12 year olds, 1274 parents.
2 × 2 manipulation of snack box container size and item quantity/variety: (1) small box, few items, (2) large box, few items, (3) small box, more items, (4) large box, more items.
Participants received a snack box during a 15 min break within their 3.5 h visit; any snacks remaining were weighed.
Consumed quantity (grams) and energy intake (kilojoules).
Unadjusted linear regression.
Children who were offered a greater quantity and variety of snack items consumed considerably more energy and a slightly higher food mass (main effect for energy intake: 349 kJ, 95% CI 282-416, standardized mean difference (effect size) 0.66; main effect for mass: 10 g, 95% CI 3-17, effect size 0.17). In contrast, manipulating box size had little effect on child consumption, and neither box size nor quantity/variety of items consistently affected adults' consumption.
In children, reducing the number and variety of snack food items available may be a more fruitful intervention than focusing on container or dishware size. Effects observed among adults were small, although we could not exclude social desirability bias in adults aware of observation.
零食会导致人们过度摄入高热量食物，从而导致肥胖。以往这方面的研究存在数据依赖自我报告和样本量小的局限性。在一个大型基于人群的亲子双生子队列中，我们调查了预包装零食的改良，即（a）项目数量和种类，和（b）餐具（盒式容器）大小如何影响摄入量。
设计：在澳大利亚儿童纵向研究的横断面 Child Health CheckPoint 中嵌套的随机试验，按访问日进行聚类。
1299 名 11-12 岁儿童，1274 名家长。
零食盒容器大小和项目数量/种类的 2×2 处理：（1）小盒子，少量项目，（2）大盒子，少量项目，（3）小盒子，更多项目，（4）大盒子，更多项目。
参与者在 3.5 小时访问期间的 15 分钟休息时间内收到一个零食盒；任何剩余的零食都被称重。
消耗的数量（克）和能量摄入（千焦耳）。
未调整的线性回归。
提供更多数量和种类零食的儿童摄入的能量和食物质量明显更高（能量摄入的主要效应：349kJ，95%CI 282-416，标准化均数差（效应大小）0.66；质量的主要效应：10g，95%CI 3-17，效应大小 0.17）。相比之下，改变盒子大小对儿童的消费影响不大，盒子大小和项目数量/种类都不会一致影响成人的消费。
在儿童中，减少可获得的零食数量和种类可能比关注容器或餐具大小更有效的干预措施。在意识到观察的成年人中，观察到的成年人的影响较小，但我们不能排除社会期望偏差。
