Department of Nutrition, University of Tennessee Knoxville, Knoxville, Tennessee, USA.
Obes Rev. 2021 Sep;22(9):e13266. doi: 10.1111/obr.13266. Epub 2021 May 5.
A multicomponent approach for the treatment of pediatric overweight/obesity, which includes behavioral strategies to alter diet and physical activity/sedentary behavior, has graded recommendations for its use. Dietary interventions to be used within this approach do not. In adults, research indicates that strongly graded dietary interventions providing greater structure (or more control over the types/amount of food consumed) produce better weight outcomes. For this critical review, dietary interventions recommended by the Expert Committee for the treatment of pediatric overweight/obesity were categorized according to their potential degree of dietary structure, and their impact on weight outcomes was described. Four levels of dietary structure were reviewed, operationalized as alterations to the following: food groups, such as fruits and vegetables (low structure); daily eating occasions, such as meals (moderate structure); large nutrients, such as energy (high structure); and energy plus additional dietary alterations (very high structure). In total, 24 interventions (four low, three moderate, five high, and 12 very high structure structure) were identified and reviewed. Reductions in standardized body mass index increased with increasing structure, and interventions ≥6 months had better outcomes than interventions <6 months. Future research should empirically test dietary intervention structure to determine its impact on weight status during pediatric overweight/obesity treatment.
一种多组分方法用于治疗儿科超重/肥胖，包括改变饮食和身体活动/久坐行为的行为策略，该方法有使用的分级推荐。在这种方法中使用的饮食干预措施没有。在成年人中，研究表明，提供更强结构（或对所消耗食物的类型/数量有更多控制）的强烈分级饮食干预措施会产生更好的体重结果。在这项关键审查中，根据潜在的饮食结构程度对治疗儿科超重/肥胖的专家委员会推荐的饮食干预措施进行了分类，并描述了它们对体重结果的影响。审查了四个级别的饮食结构，具体操作为以下方面的改变：食物组，如水果和蔬菜（低结构）；每日进食机会，如餐食（中度结构）；大营养素，如能量（高结构）；以及能量加其他饮食改变（极高结构）。共确定并审查了 24 种干预措施（4 种低结构、3 种中度结构、5 种高结构和 12 种极高结构）。标准化体重指数的减少随着结构的增加而增加，并且持续时间≥6 个月的干预措施比<6 个月的干预措施效果更好。未来的研究应该通过实证检验饮食干预措施的结构，以确定其对儿科超重/肥胖治疗期间体重状况的影响。
