Department of Pediatrics, UC San Diego, La Jolla, CA, USA.
Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA.
Int J Obes (Lond). 2019 Nov;43(11):2302-2308. doi: 10.1038/s41366-019-0463-4. Epub 2019 Oct 7.
Emerging evidence suggests that individual appetitive traits may usefully explain patterns of weight loss in behavioral weight loss treatments for children. The objective of this study was to identify trajectories of child appetitive traits and the impact on child weight changes over time.
Secondary data analyses of a randomized noninferiority trial conducted between 2011 and 2015 evaluated children's appetitive traits and weight loss. Children with overweight and obesity (mean age = 10.4; mean BMI z = 2.0; 67% girls; 32% Hispanic) and their parent (mean age = 42.9; mean BMI = 31.9; 87% women; 31% Hispanic) participated in weight loss programs and completed assessments at baseline, 3, 6,12, and 24 months. Repeated assessments of child appetitive traits, including satiety responsiveness, food responsiveness and emotional eating, were used to identify parsimonious grouping of change trajectories. Linear mixed-effects models were used to identify the impact of group trajectory on child BMIz change over time.
One hundred fifty children and their parent enrolled in the study. The three-group trajectory model was the most parsimonious and included a high satiety responsive group (HighSR; 47.4%), a high food responsive group (HighFR; 34.6%), and a high emotional eating group (HighEE; 18.0%). Children in all trajectories lost weight at approximately the same rate during treatment, however, only the HighSR group maintained their weight loss during follow-ups, while the HighFR and HighEE groups regained weight (adjusted p-value < 0.05).
Distinct trajectories of child appetitive traits were associated with differential weight loss maintenance. Identified high-risk subgroups may suggest opportunities for targeted intervention and maintenance programs.
新出现的证据表明，个体的食欲特征可以有效地解释儿童行为减肥治疗中减肥模式。本研究的目的是确定儿童食欲特征的轨迹及其对随时间变化的儿童体重变化的影响。
对 2011 年至 2015 年期间进行的一项随机非劣效性试验的二次数据分析评估了儿童的食欲特征和减肥效果。超重和肥胖的儿童（平均年龄 10.4 岁；平均 BMI z 值 2.0；67%为女孩；32%为西班牙裔）及其父母（平均年龄 42.9 岁；平均 BMI 为 31.9；87%为女性；31%为西班牙裔）参加了减肥计划，并在基线、3、6、12 和 24 个月时完成了评估。对儿童食欲特征的重复评估，包括饱腹感反应、食物反应和情绪性进食，用于确定变化轨迹的简约分组。线性混合效应模型用于确定组轨迹对儿童 BMIz 随时间变化的影响。
共有 150 名儿童及其父母参加了该研究。三群组轨迹模型是最简约的，包括高饱腹感反应组（HighSR；47.4%）、高食物反应组（HighFR；34.6%）和高情绪性进食组（HighEE；18.0%）。所有轨迹的儿童在治疗期间减肥速度大致相同，但只有 HighSR 组在随访期间保持了减肥效果，而 HighFR 和 HighEE 组体重又有所增加（调整后的 p 值 < 0.05）。
儿童食欲特征的不同轨迹与减肥维持的差异有关。确定的高风险亚组可能为有针对性的干预和维持计划提供机会。
